Frequency of Foot Pain and Assessment of Foot Function Associated with Wearing Point Shoes in Students and Faculty Members of Fashion Designing Schools

assessment of foot function associated with wearing pointed shoes in students and faculty members of fashion designing schools. Methods: This cross-sectional study was conducted on fashion designing students and faculty members from December 2022 to May 2023 in Lahore, Pakistan. 396 participants between the ages of 18 and 50, of both genders with a minimum of 3 hours to a maximum of 8 hours wearing pointed shoes were included. Those with foot deformities or previous foot trauma were excluded. Foot and Ankle Ability Measure (FAAM) and Visual Analogue Scale (VAS) of pain were used. SPSS 25 was used for data analysis. Results: 51.52% reported moderate pain in their feet on Visual Analogue Scale, 30.81% people reported mild pain. 7.32% had no pain and 10.35% complained of severe foot pain. Chi-square test resulted in (110.859) and p-value of less than 0.05. Conclusions: The study concludes that wearing pointed shoes causes mild to moderate foot pain whereas signi�cant impact was observed in their activities of daily living.

frequently than males.Additionally, a random sample of Danish citizens between the ages of 18 and 80 from 2010 showed a prevalence rate of 30.4% for foot pain.In a group of Asians, young urban working women experienced nontraumatic foot discomfort 50% of the time, and 68.4% thought their work shoes contributed to the pain [4].Foot discomfort can be caused by a variety of variables, including: advancing age, gender, poorly tting footwear, obesity, and chronic degenerative disorders [3].It can impair walking, increase the risk of falling, and cause functional incapacity [5].The causes of foot discomfort are frequently multifaceted.In various people pain, Foot Pain and Assessment of Foot Function

I N T R O D U C T I O N
Pointed footwear inclines to remain trendy in the eld of fashion design and causes discomfort and di culty with daily activities.Objective: To determine and evaluate frequency of foot pain and assessment of foot function associated with wearing pointed shoes in students and faculty members of fashion designing schools.Methods: This cross-sectional study was conducted on fashion designing students and faculty members from December 2022 to May 2023 in Lahore, Pakistan.396 participants between the ages of 18 and 50, of both genders with a minimum of 3 hours to a maximum of 8 hours wearing pointed shoes were included.Those with foot deformities or previous foot trauma were excluded.Foot and Ankle Ability Measure (FAAM) and Visual Analogue Scale (VAS) of pain were used.SPSS 25 was used for data analysis.Results: 51.52% reported moderate pain in their feet on Visual Analogue Scale, 30.81% people reported mild pain.7.32% had no pain and 10.35% complained of severe foot pain.Chi-square test resulted in (110.859) and p-value of less than 0.05.Conclusions: The study concludes that wearing pointed shoes causes mild to moderate foot pain whereas signi cant impact was observed in their activities of daily living.According to biomechanics, a higher heel height greatly reduces the trunk's exion angle and raises the body's center of gravity [7].The common summertime footwear, ip-ops, is known to contribute to diseases such overuse injuries of the Tibialis anterior muscle and toes [11].For the diagnosis; Conventional radiography, which permits examination of any suspected bone abnormalities, is typically the initial imaging modality used.The best imaging technique for assessing possible soft-tissue impingement is magnetic resonance imaging (MRI).Additionally, ultrasonography can assess related ligament injuries, diagnose esh tissue collision injury in the anterior and lateral portion of the foot ankle joint and distinguish between illness and bone impingement [12,13].Physical therapy has been proven to be bene cial in a wide variety of foot pathologies.Therapists examine posture, weight distribution, and center of mass distribution while evaluating the kinetic chain.Manual techniques are employed to strengthen proprioception and enhance balance.Calf muscle stretching can help relieve forefoot pressure.Toe powering PT to strengthen the foot muscles, strengthen arch, enhance toe-off phase of gait, and improve balance when walking.Moreover, they also examine and modify the footwear [14,15].The trend of wearing pointed shoes in fashion designers is enhancing day by day.This has not been addressed previously among this population.Due to ill tted shoes, the balance of a person can be distorted; our research also enlightens this aspect of pointed shoes and signi es the importance of footwear in daily life.This research is conducted for the purpose of assessment of foot function and frequency of foot pain and discomfort associated with wearing pointed shoes in students and faculty members of fashion design schools, which in turn will lead to raised awareness about the correct footwear and its effect on foot pain.

R E S U L T S
Approval for this cross-sectional study was obtained from the institutional review board under letter number REC-042-2023.This observational study was conducted at various Fashion Designing Schools of Lahore from December 2022 to May 2023.Non-probability convenient sampling technique was used.The sample size of 396 was calculated from this formula;  This current cross sectional study mainly focused on prevalence of foot pain and assessment of foot functional among faculty members and students of fashion designing schools.Moreover, it included assessment of foot function associated with wearing pointed shoes, discomfort caused by pointed footwear and relationship between pointed shoes and pain on foot.The results of this research showed mild to moderate impact on activities of daily living associated with wearing pointed shoes.Jabbar et al., conducted a study on female teachers and students of a university in 2020, and found 72.5% of the females wearing high heels for up to 6 hours a day, and 27.5% of them wore it for over 6 hours.Visual Analog Scale was used to measure their foot pain.54.5% had mild to moderate pain followed by 29% with severe and 4% with the worst pain.Only 12.5% of them had no pain in their feet [20].In another study of 174 females wearing high heels, a majority of 63% wore wedgetype footwear for more than 4 hours a day.They found a majority of women (39%) to have moderate pain caused by their footwear, while 34% had moderate pain followed by only 8% of them reporting severe pain.19% of the women, however, felt no pain [17].These previous researches go in line with the current research.Majority (51.52%) of the participants in this research reported moderate pain in their feet whereas 30.81% felt mild pain followed by 10.35% feeling severe pain.Only 7.32% of them felt no pain.Güren et al., found no signi cant relationship between physical activity levels of 40 women wearing high-heeled shoes and pain level (p > 0.05).Women who wore high heels were found to experience foot and low back pain both at rest and while moving, but there was no correlation between the degree of physical activity and the severity of the pain [21].In contrast to this, the current study found a signi cant association (p=0.001) between foot pain and di culties during activities of daily living due to wearing pointed shoes.The results of the current study supported the results of a study by Janisse, which suggested that females from 20 to 60 years with no relevant past medical history 88% wore shoes that were not properly tted.As a consequence, 76 percent of these women had foot ailments and associated pain [22].Thus, according to these results the null hypothesis of this study is rejected which says that there is no relationship between foot pain and disability associated with wearing pointed shoes.The limitation of this research is that it does not give information regarding the possible deformities caused by we a r i n g p o i n te d s h o e s o r ex p l a i n s t h e a l te r e d biomechanics caused by the constrictive toe box shoes.Table 2 shows the severity of foot pain and its effects on activities of daily life.179 (45.20%) of the participants had normal status of ADLs and showed no impact of wearing pointed shoes.Another 159 (40.15%) respondents had mildly affected ADLs, 48 (12.12%) participants reported moderately affected ADLs.A very smaller proportion of 2.53% (10 persons) had their ADLs severely affected.The study concludes that wearing pointed shoes causes mild to moderate foot pain in students and faculty of fashion designing.There is a signi cant association between foot pain and di culties during activities of daily living due to wearing pointed shoes amongst them.

Table 1 :
Descriptive statistics for Chi-Square association between foot pain and di culty in ADLs, Cross-tabulation

Table 2 :
Descriptive statistics for ADL Range with foot pain