Effect of a foot gymnastic exercise programme on gait performance in older adults

NewsBot · May 31, 2009

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The effect of a foot gymnastic exercise programme on gait performance in older adults: A randomised controlled trial.
Hartmann A, Murer K, De Bie RA, De Bruin ED.
Disabil Rehabil. 2009 May 21:1-10. [Epub ahead of print]

Background. Aged-related loss of ankle dorsiflexion range of motion (ROM) and toe plantarflexor strength play an important role in gait performance. Further, conventional strength, balance and gait training can significantly improve the lower extremity muscle power and functional abilities of older individuals. It remains unclear, however, whether training effects can be enhanced by augmenting ankle ROM and toe plantarflexor strength complementary to training.

Objective. This study investigated the effect of physical exercise combined with foot gymnastics on the gait performance in older adults.

Methods. Fifty-six independent living, older adults aged 66-91 years were randomly assigned to either foot gymnastics group (FG; n = 28) or training group (TG; n = 28). Further, 14 subjects were integrated as a control group (CG; n = 14) (no exercise). The FG and TG completed the same training program consisting of aerobic exercises, progressive resistance strength training and stretching exercises twice per week for 12 weeks, whereas the FG performed additional foot gymnastic exercises at the end of the training session and a 10-min foot gymnastics home-program daily. Assessments included the Falls Efficacy Scale - International (FES-I), Expanded Timed Get-up-and-Go test (ETGUG), gait analysis and muscle power measurements of the knee and ankle joint at pre- and post-training.

Results. No significant change in FES-I score occurred in either group. The FG showed a significant improvement of ankle ROM. There were significant time x group interactions in walking speed, step length, in several muscle power measurements and in ETGUG. The positive effects of gait parameters ranged between 1 and 11% and between 2 and 12%, of muscle power between 14 and 34% and 14 and 46% and of ETGUG were 10 and 8% for the FG and TG, respectively. The FG and TG did not differ significantly in their improvements. The CG showed a trend to deteriorations between 0 and -6% for gait parameters, between -4 and -14% for muscle power and 0% for ETGUG.

Conclusions. The results of this study provide evidence of significant improvements in gait performance, muscle power and ETGUG after a conventional training program in independent living, older adults. However, there is no additional effect on physical performance after foot gymnastic exercises.
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Admin2 · May 31, 2009

Related threads:
Effects of hip and ankle stretching on gait function of older people
Other falls related threads
Foot characteristics and balance
Toe clearance variability as falls risk factor
Gait instability associated with ageing

NewsBot · Oct 8, 2016

Efficacy of a progressive resistance exercise program to increase toe flexor strength in older people
Karen J. Mickle et al

Highlights
•We compared a progressive strengthening program to a simple home-based foot exercise program.
•Adherence to supervised, group exercise classes focussed on the feet was very high.
•12 week progressive resistance training increases toe strength in older people.
•General foot exercises (e.g. picking up marbles) do not increase toe strength.
•Foot exercises improve balance in older people.
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Background
Reduced toe flexor strength is an independent predictor of falls in older people. However it is unknown whether strengthening programs can restore toe flexor strength in older individuals. The aim of this study was to investigate whether a progressive resistance training program, focused specifically on the foot muscles, could improve toe flexor strength in community-dwelling older people.

Methods
After baseline testing, 85 men and women (age range 60–90 years) were randomized to either a supervised, progressive resistance training (n = 43) or a home-based exercise (n = 42) group for 12 weeks. A further 32 participants were recruited for a control group. The primary outcome measures were hallux and lesser toe flexor strength pre- and post-intervention. Secondary outcome measures were exercise compliance, components of the Foot Health Status Questionnaire and single-leg balance time.

Findings
Average class attendance was 89% with 68 participants from the two intervention groups (80%) completing the follow-up assessments. Participants in the supervised, progressive resistance training group significantly increased their toe strength (up to 36%; P < 0.02), whereas there was no change in toe strength in either the home-based or control groups. This increased toe strength was accompanied by a significant improvement in perceived general foot health and single-leg balance time compared to the other groups (P < 0.05).

Interpretation
Progressive resistance exercises are a viable intervention to increase toe flexor strength in older adults. A clinical trial is now required to determine whether this intervention can reduce the number of falls suffered by older adults.
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