The establishment of the ECTS (European Credit Transfer System) is one of the pillars of the European Space of Higher Education. This way of accounting for the time spent in training has two essential parts, classroom teaching (work with the professor) and distance learning (work without the professor, whether in an individual or collective way). Much has been published on the distance learning part, but less on the classroom teaching section. In this work, the authors investigate didactic strategies and associated aids for distance learning work in a concept based on flipped classroom where transmitting information is carried out with aids that the professor prepares, so that the student works in an independent way before the classes, thus being able to dedicate the classroom teaching time to more complex learning and being able to count on the professor’s help. Three teaching aids applied to the study of anatomy have been compared: Notes with images, videos, and augmented reality. Four dimensions have been compared: the time spent, the acquired learnings, the metacognitive perception, and the prospects of the use of augmented reality for study. The results show the effectiveness, in all aspects, of augmented reality when compared with the rest of aids. The questionnaire assessed the acquired knowledge through a course exam, where 5.60 points were obtained for the notes group, 6.54 for the video group, and 7.19 for the augmented reality group. That is 0.94 more points for the video group compared with the notes and 1.59 more points for the augmented reality group compared with the notes group. This research demonstrates that, although technology has not been sufficiently developed for education, it is expected that it can be improved in both the autonomous work of the student and the academic training of health science students and that we can teach how to learn. Moreover, one can see how the grades of the students who studied with augmented reality are more grouped and that there is less dispersion in the marks compared with other materials.

Corona Virus Disease 2019 (COVID-19) has caused great changes in daily activities, especially in children. In Spain, to avoid infections, a home quarantine was declared, which caused a drastic reduction in daily or weekly physical activity in children. to analyse the balance performance after the COVID-19-induced quarantine on children’s balance, through the use of balance tests, considering the type of sport practiced. an observational and longitudinal study was carried out with a sample size of 150 healthy children (69 boys and 81 girls) with a mean age of 10.02 ± 1.15 years. Postural control was evaluated under different equilibrium conditions before and after the quarantine period. Two data collections using the Gyko system were compared, with a difference of 8 months between them. In addition, the influence of foot type and physical activity was analysed. After the quarantine, statistically significant differences were found in terms of balance results, which were worse than before (p < 0.05). Postural control was not influenced by the type of sport practiced (i.e., individual, collective and / or not practicing sport), nor by the surface which the test was performed (p > 0.05). Physically active children (i.e., individual and / or collective sport) presented worse results than physically inactive children. A statistically significant impairment in terms of balance was demonstrated in children who performed high and moderate physical activity (p < 0.05). After the quarantine period, a significant reduction in balance performance was found in children. The findings suggest that regular physical activity benefits postural control. Loss of balance does not differ in postural stability by the type of sport practised. Postural stability is not influenced by the type of footprint after the period of physical inactivity. Postural control is influenced in children with a great level of physical activity.

Background: Partial or incomplete osteotomy (IO) of the phalanx is recently described in the literature. However, the clinical outcome and the rate of complications when applied to lesser toe deformities (LTD) have been never addressed. This study aims to find out if the association of tenotomies to incomplete or partial phalanx osteotomies has a significant impact on the clinical outcomes, the occurrence of complications, and the recovery time after surgery. Methods: A retrospective review of two cohorts of cases operated in our institution for hallux abductus valgus (HAV) and associated LTD from 2008 to 2014 was carried out. The surgical correction of both HAV and the associated LTD was always performed by minimally invasive techniques. The study included a total of 223 patients (723 IO in 556 toes). In 129 cases, the IO for LTD correction was performed without tenotomies, and in 94, the procedure was combined with flexor and/or extensor tenotomies. Patients were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire before surgery and at 6- and 12-month follow-up. Results: The mean preoperative AOFAS score before surgery was similar in both cohorts. At 12-month follow-up, the cohort without tenotomies showed better recovery (95.7 ± 2.8 versus 92.5 ± 6.8; p < 0.01). AOFAS scores decreased as the number of associated LTD increased (r = − 0.814; p < 0.001). Cases operated on by PO + tenotomy showed a high rate of complications such as delayed union of the osteotomy (p < 0.01), hypertrophic callus (p < 0.01), phalangeal fracture at the osteotomy site (p < 0.01), and lack of correction (p < 0.05). The overall occurrence of adverse events was 38.6% in cases operated by PO + tenotomy and 13.9% in cases receiving PO alone (p < 0.0001). Cases operated on without tenotomy showed a shorter time to complete recovery for daily life activities (37.4 ± 2.3 versus 43.0 ± 1.7 days; p < 0.01). Conclusion: The performance of associated tenotomies to incomplete phalanx osteotomies provides worse clinical outcomes, higher complication rates, and longer recovery time as compared to similar forefoot surgeries without tenotomies. Trial registration: The study was based on retrospectively registered data starting on May 24, 2008.

A healthy lifestyle and proper nutrition have a major impact on the well-being of a population. Therefore, the aim of this research is to describe the behavior of these habits in relation to sociodemographic variables to provide data on the development of effective training and awareness-raising actions. Methods: An observational, descriptive and cross-sectional study was carried out. To study the behavior of a series of variables related to eating habits and lifestyle, a questionnaire was designed and validated and subsequently disseminated online, by means of nonprobabilistic snowball sampling, relying on social networks. The sample collected consisted of 18,070 young adults of Spanish nationality. Bivariate comparative analyses were performed using t-test independent samples, and the effect size (ES) was calculated by determining Cohen’s D coefficient. A multivariate analysis were conducted using linear regression and principal component analysis. Results: Adults eat better but have a poorer quality of rest and are more sedentary than young people. No gender differences were found in nutritional habits; however, men engage in more sports and sleep better. People with a higher educational level have better nutritional and sleep habits, but are more sedentary, as are people of a higher socioeconomic level. Conclusions: Higher socioeconomic and educational levels seem to favor a healthier lifestyle. The Spanish population aged 18–45 years needs to make dietary changes but leads an active lifestyle.

Background and aims: Surgical procedures for central metatarsalgia seek to harmonise the metatarsal parabola with osteotomies that can be performed by minimally invasive techniques. However, the possible relationship of the foot type and the mid-term postoperative outcome is poorly described. The objective of this prospective pilot study was therefore to determine whether the foot type (pronate, neutral, or supinate) conditions the postoperative mid-term functional outcome.Methods: A series of 28 patients (6 men, 22 women) were treated for primary central metatarsalgia by means of minimally invasive distal metaphyseal osteotomy (DMMO).Results: Their functional outcomes at 6 and 12 months were assessed by the self-reporting AOFAS scale. Pre-surgery, the patients' scores were 42.82 ± 15.60. Scores improved at 6 months to 86.50 ± 8.6 and to 92.93 ± 8.6 at 12 months (p < 0.001 in both cases). There were no differences either by sex or by foot type in these overall values, although there was only a slight limitation of interphalangeal mobility in the supinated feet (p = 0.03) at 6-month follow-up as compared to other foot types.Conclusion: Hence, DMMO provides an optimal clinical and functional outcome for the surgical treatment of metatarsalgia, regardless of the patient's foot posture. The occurrence of adverse events was minimal and clinically irrelevant.Trial registration: The study was authorised by the Research Ethics Committee of the Universidad Católica de Valencia San Vicente Mártir, with the registry UCV/2018-2019/019.