title: Impact of hallux valgus severity on general and foot-specific health-related quality of life.
abstract: OBJECTIVE
  To explore the prevalence of and factors associated with hallux valgus and to assess the impact of hallux valgus severity on general and foot-specific health-related quality of life (HRQOL) in older people.
  
  
  METHODS
  People age ≥56 years who participated in the 6-year followup of the North Staffordshire Osteoarthritis Project (n = 2,831) completed a survey that included the Medical Outcomes Study Short Form 36 (SF-36) health survey and the Manchester Foot Pain and Disability Index (FPDI). Self-reported hallux valgus severity was assessed using a validated instrument. Comparisons of SF-36 and FPDI scores were made across 5 severity grades of hallux valgus.
  
  
  RESULTS
  Hallux valgus was present in 36.3% of the study population and was associated with female sex, older age, and pain in other bodily regions. There was a progressive reduction in all SF-36 component scores as the severity of hallux valgus increased; this association remained after adjusting for age, sex, education, and body mass index. The strength of these associations diminished after also adjusting for pain in the back, hip, knee, and foot, but hallux valgus severity remained significantly associated with reduced physical function, bodily pain, general health, social function, and mental health subscale scores. Among participants with foot pain, increasing hallux valgus severity was also significantly associated with greater impairment on the pain and function subscales of the FPDI after adjusting for age, sex, and body mass index.
  
  
  CONCLUSIONS
  There is a progressive reduction in both general and foot-specific HRQOL with increasing severity of hallux valgus deformity.
authors.affiliation: Keele University, UK. h.menz@latrobe.edu.au
authors.forename: Hylton B
authors.initials: HB
authors.lastname: Menz
authors.forename: Edward
authors.initials: E
authors.lastname: Roddy
authors.forename: Elaine
authors.initials: E
authors.lastname: Thomas
authors.forename: Peter R
authors.initials: PR
authors.lastname: Croft
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D004739:England / Q000453:epidemiology; D005260:Female; D005528:Foot / Q000294:innervation*; D006215:Hallux Valgus / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D015995:Prevalence; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires