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Toe training may keep the elderly upright, VU research finds

Discussion in 'Gerontology' started by NewsBot, Aug 22, 2016.

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  1. NewsBot

    NewsBot The Admin that posts the news.

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    Press release;
    Toe training may keep the elderly upright, VU research finds
     
  2. scotfoot

    scotfoot Well-Known Member

    With regard to the above press release and to the work of Dr Luke Kelly it strikes me that the governing bodies of world golf could do a lot of good for older golfers ,and indeed for the older community in general, by putting some funding into looking at postural stability during dynamic tasks such as the golf swing .

    Dr Mickle has shown that toe strength is greatly reduced in older people but that this can be reversed whilst Dr Kelly has shown how important the intrinsic muscles of the foot are during posturally demanding tasks .

    The hypothesis of a study might be that if older golfers strengthen their feet then their ability to swing a golf club in a consistent fashion will improve .

    The benefit for the older community in general would be that a study such as the one outlined above would, if the results are positive ,indicate that Mickles strengthening protocol might help prevent falls among this older group during the performance dynamic tasks in general .

    Gerry
     
  3. Jo BB

    Jo BB Active Member

    Strengthening "older" bowlers [who may also be diabetic] intrinsic foot musculature to improve their game/balance may be a motivator!
     
  4. scotfoot

    scotfoot Well-Known Member

    Hi Jo
    Never a truer sentence written .

    Its one thing to come up with a way to strengthen the intrinsic foot musculature but another to get long term compliance outside of monitored trial .

    If people can see or feel tangible results for their efforts things become much easier . Golfing improvement might be one area were improvement can be measured , and as you have indicate, bowls or ten pin bowling might be another .

    Other areas might include things such as pain reduction .

    Cheers

    Gerry
     
  5. wdd

    wdd Well-Known Member

    I wonder why they stopped at toes? I wonder how much of the effect was due to things other than increased strength, such as, being the centre of attention, giving a purpose to life, simply focusing on the feet, improvement in proprioception, improvement in reflexes. The real measure of success will be the number still doing the exercises a year after the spotlight has gone off them.

    Of course it will be subject to the law of diminishing returns. Exercising feet reduces the risk of falling by 50%, exercising legs reduced falls by 50% of the remaining 50% and so on but possibly in terms of quality of life 5% improvement comes from exercising the feet, 40% comes from including the legs and 100% comes from exercising the whole body.

    Bill
     
  6. scotfoot

    scotfoot Well-Known Member

    Hi Bill
    I don't think they so much stopped at the toes as were the first to get down that far and give toes serious consideration with regard to their possible role in falls prevention .

    After showing an independent link between toe flexor strength and falls in the elderly the next question for Dr Mickle and her co workers to answer was -can toe flexor strength in the elderly be increased to bring if back to the levels found in younger people ?

    The answer to this question appears to be yes although the full details of the techniques used have yet to be made public .

    So now we have an identified need (stronger toe flexors may well help to prevent falls ) and we have an indication that a least one method of toe strengthening will satisfy the need .

    In my opinion ,to have the necessary components for a podiatry driven ,health care initiative Mickle and her team now need an effective, easily available ,measurement tool to identify those who would benefit from a flexor strengthening programme and to keep track of their progress .

    The development of such a tool would be the clincher .

    Would the exercises be continued after the spotlight has moved away ?

    Well in a care home setting ,were falls are more likely ,one would hope that activities that benefit the elderly residents would be continually encouraged .

    Mickle has shown there is a need and that the need can be met .

    So now the hunt is on for measurement tool .

    Gerry
     
  7. Jo BB

    Jo BB Active Member

    What concerns me is the very poor pass rate of the toe grip strength test with my diabetic patients [at any stratification level]. Combined with fasciculations in Abductor hallucis noted in routine care and which can precede the diagnosis of DMt2 up to 2 years [anecdotally I would see this a couple of times per year]any research and evidence based exercise regime is most welcome.
     
  8. scotfoot

    scotfoot Well-Known Member

    Hi Jo
    I agree that research in this area is badly needed and my understanding is that a study investigating the subject has already been registered ,with the seemingly tireless Dr Mickle at the helm .
    If her exercise regime can produce in diabetic patients results similar to those achieved in older patients then this might have a major impact on associated health care issues .

    Gerry
     
  9. HansMassage

    HansMassage Active Member

    My observational investigation findings is that each part of the body has a balance reflex in the foot. The greater toe balances the head. The lesser toe balances the arms. The central toes respond to the position of the shoulders and chest. Elderly clients that have always worn foot ware that restricts the lesser toe tend to have developed restricted reach of there arms. The normal reflex for holding an arm out to the side is to shift the weight to the opposite foot and spred the lesser toe laterly.
     
  10. scotfoot

    scotfoot Well-Known Member

    With regard to Dr Mickles work on toe flexors it might be said that strengthening these muscles gives the body more effective tools for foot related tasks .

    Balance perturbation studies have shown that balance perturbation training may have the potential to reduce falls in older people . That is , perturbation training may improve the bodies ability to use the tools available to it to resist falls .

    What would happen if you ran together Dr Mickles program for toe flexor strengthening and balance perturbation training ? That is ,improve the tools AND the ability to use them .

    Might there be a synergistic effect ?

    Gerry
     
  11. HansMassage

    HansMassage Active Member

    Using a balance inflatable https://www.amazon.com/dp/B01E922WGY?psc=1 is an excellent way to train the foot to respond to body movement. The practitioner can also use it in office to test what body positions cause pain in the foot. Another model http://www.thera-band.com/store/products.php?ProductID=24 There are more expensive ones but I dont think they are worth the cost.
     
  12. scotfoot

    scotfoot Well-Known Member

    The title of Dr Mickles present research is given as "Evaluating a foot strengthening exercise program to improve foot function in adults with diabetes " and it aims to look into restoring foot function in feet with diabetic neuropathy . My understanding is that Mickles toe flexion /theraband exercise will be used as part of the exercise protocol (which I assume will be conducted under close supervision to prevent any toenail induced injury ) . In my opinion this will effectively target the intrinsic foot muscles far more effectively than ,for example , toe curl type activities . Whilst I realise that there are only so many outcome measures than can be looked at in any one study , I wonder if Dr Mickle might intend collecting some evidence ,even if only as subject comments , on the effects of the exercise program on neuropathic pain experience .
    This study will make very interesting reading .

    Gerry
     
    Last edited: Apr 9, 2017
  13. NewsBot

    NewsBot The Admin that posts the news.

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