Members do not see these Ads. Sign Up.

From the December issue of the Journal of Gerontology:

Foot and Ankle Characteristics Associated With Impaired Balance and Functional Ability in Older People

Hylton B. Menz, Meg E. Morris, and Stephen R. Lord

J Gerontol A Biol Sci Med Sci 2005 60: 1546-1552

Background. Ageing is associated with changes to the structure and function of the foot and ankle, and there is preliminary evidence that foot problems impair balance and increase the risk of falls. To explore this in more detail, we conducted a study to determine the relative contribution of several foot and ankle characteristics to performance on a range of balance and functional tests.

Methods. One hundred seventy-six people (56 men and 120 women, mean age 80.1 years, standard deviation 6.4 years) residing in a retirement village underwent tests of foot and ankle characteristics (including foot posture, range of motion, strength, and deformity), sensorimotor function (including vision, sensation, strength, and reaction time), and balance and functional ability (including tests of standing balance, leaning balance, stepping, sit-to-stand, and walking speed).

Results. Many foot and ankle characteristics and sensorimotor measures were associated with performance on the balance and functional tests in univariate analyses. Multiple regression analysis consistently revealed that ankle flexibility, plantar tactile sensitivity, and toe plantarflexor strength were significant and independent predictors of balance and functional test performance, explaining up to 59% of the variance in these test scores.

Conclusions. Foot and ankle characteristics, particularly ankle flexibility, plantar tactile sensation, and strength of toe plantarflexor muscles, are significant independent predictors of balance and functional ability in older people. Programs to improve the strength and flexibility of the foot and interventions to augment plantar sensation may be beneficial in improving mobility and reducing the risk of falls.​

One of the surprising results of this study was that foot posture (measured using the FPI, arch index and navicular height) was not associated with balance ability in older people.

If anyone would like a copy, please email me.

Cheers,

Hylton

 

The 12-month follow-up of this study has been completed, and confirms that foot problems are a falls risk factor:

Foot and Ankle Risk Factors for Falls in Older People: A Prospective Study

Hylton B. Menz, Meg E. Morris and Stephen R. Lord

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 61:866-870 (2006) - link

Background. Foot problems are common in older people and are associated with impaired balance and functional ability. Few prospective studies, however, have been undertaken to determine whether foot problems are a risk factor for falls.

Methods. One hundred seventy-six people (56 men and 120 women, mean age 80.1, standard deviation 6.4 years) residing in a retirement village underwent tests of foot and ankle characteristics (including foot posture, range of motion, strength, and deformity) and physiological falls risk factors (including vision, sensation, strength, reaction time, and balance) and were followed for 12 months to determine the incidence of falls.

Results. Seventy-one participants (41%) reported falling during the follow-up period. Compared to those who did not fall, fallers exhibited decreased ankle flexibility, more severe hallux valgus deformity, decreased plantar tactile sensitivity, and decreased toe plantarflexor strength; they were also more likely to have disabling foot pain. Discriminant function analysis revealed that decreased toe plantarflexor strength and disabling foot pain were significantly and independently associated with falls after accounting for physiological falls risk factors and age.

Conclusions. Foot and ankle problems increase the risk of falls in older people. Interventions to address these factors may hold some promise as a falls prevention strategy.

 

Hi Hylton

Thank you for the information.

I am curious, as gentle mobilisations (even a long time after injury) of the ankle and other foot joints appear to improve joint and muscle function in a good number of people, possibly including awareness of where the feet are, have studies been done to show any efficacy of this as part of treatment for the aging population. Or indeed as a profilactic approach?

Ian