Prevalence and risk factors associated with the formation of dermal lesions on the foot during hiking

• Published in: Journal of tissue viability Vol. 29; no. 3; pp. 218 - 223
• Main Authors: Chicharro-Luna, Esther, Martínez-Nova, Alfonso, Ortega-Ávila, Ana Belén, Requena-Martínez, Aranza, Gijón-Noguerón, Gabriel
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-08-2020
• Subjects: Adult; Blister; Cross-Sectional Studies; Dermatology; Female; Foot - pathology; Foot - physiopathology; Hiking; Humans; Logistic Models; Male; Nursing; Prevalence; Risk Factors; Spain; trekking; Walking; Walking - injuries; Walking - physiology; Spain; Walking; Blister; trekking; Dermatology; Hiking
• ISSN: 0965-206X
• DOI: 10.1016/j.jtv.2020.04.002

The aim of this study is to assess the prevalence of blisters on the foot during hiking and the factors associated with this condition.
A cross-sectional observational comparative study was conducted of 315 patients treated at two hostels, located on the Way of Saint James, in northern Spain.
The study participants were interviewed and clinically examined to obtain sociodemographic and clinical variables. The variables recorded concerned the type of terrain covered (asphalt or dirt trails), the weight carried (backpack), the footwear used (weight, type, impermeability), the type of socks worn and the hydration of the skin obtained. The inclusion criteria were at least 18 years and to walk at least 20 km in the last five days.
74% (n = 233) of the hikers presented a bullous lesion on the foot after completing several stages of hiking. The most frequent locations were the first or second metatarsal head and the fifth toe. Logistic regression showed that risk factors for the appearance of blistering were the number of kilometres walked on asphalt (p = .001 [95% CI (1.019–1.064)]) and having wet socks at the end of the day (p = . 006 [95% CI (1.286–4.479)]). The protective factors identified were walking on a dirt, grass or gravel surface (p < .001 [95% CI (0.982- 0.995)]) and using customised plantar orthoses (p = .001 [95% CI (0.085) - 0.512)]).
The type of terrain is a determining factor in the appearance of blisters. Walking on a dirt trail reduces the risk. Using custom made insoles and controlling humidity are other factors that should be considered as preventive measures.
•The most frequent location of foot blisters was the fifth toe.•The preventive measures were plantar orthoses and the control of humidity.•No association between the foot posture and the probability of blisters were found.