Foot Function, Foot Pain, and Falls in Older Adults: The Framingham Foot Study

Background: Although foot pain has been linked to fall risk, contributions of pain severity, foot posture, or foot function are unclear. These factors were examined in a cohort of older adults. Objective: The purpose of this study was to examine the associations of foot pain, severity of foot pain, and measures of foot posture and dynamic foot function with reported falls in a large, well-described cohort of older adults from the Framingham Foot Study. Methods: Foot pain, posture, and function were collected from Framingham Foot Study participants who were queried about falls over the past year (0, 1, and ≥2 falls). Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of falls with foot pain, pain severity, foot posture, and foot function adjusting for covariates. Results: The mean age of the 1,375 participants was 69 years; 57% were female, and 21% reported foot pain (40% mild pain, 47% moderate pain, and 13% severe pain). One-third reported falls in the past year (1 fall: n = 263, ≥2 falls: n = 152). Foot pain was associated with a 62% increased odds of recurrent falls. Those with moderate and severe foot pain showed increased odds of ≥2 falls (OR 1.78, CI 1.06-2.99, and OR 3.25, CI 1.65-7.48, respectively) compared to those with no foot pain. Foot function was not associated with falls. Compared to normal foot posture, those with planus foot posture had 78% higher odds of ≥2 falls. Conclusion: Higher odds of recurrent falls were observed in individuals with foot pain, especially severe foot pain, as well as in individuals with planus foot posture, indicating that both foot pain and foot posture may play a role in increasing the risk of falls among older adults.

Download Full-text

Foot Pain and Pronated Foot Type Are Associated with Self-Reported Mobility Limitations in Older Adults: The Framingham Foot Study

Gerontology ◽

10.1159/000442089 ◽

2015 ◽

Vol 62 (3) ◽

pp. 289-295 ◽

Cited By ~ 7

Author(s):

Hylton B. Menz ◽

Alyssa B. Dufour ◽

Patricia Katz ◽

Marian T. Hannan

Keyword(s):

Older Adults ◽

Weight Bearing ◽

Community Dwelling ◽

The Body ◽

Pressure Measurements ◽

Foot Pain ◽

Mobility Limitations ◽

Foot Posture ◽

Foot Function ◽

And Function

Background: The foot plays an important role in supporting the body when undertaking weight-bearing activities. Aging is associated with an increased prevalence of foot pain and a lowering of the arch of the foot, both of which may impair mobility. Objective: To examine the associations of foot pain, foot posture and dynamic foot function with self-reported mobility limitations in community-dwelling older adults. Methods: Foot examinations were conducted on 1,860 members of the Framingham Study in 2002-2005. Foot posture was categorized as normal, planus or cavus using static pressure measurements, and foot function was categorized as normal, pronated or supinated using dynamic pressure measurements. Participants were asked whether they had foot pain and any difficulty performing a list of eight weight-bearing tasks. Multivariate logistic regression and linear regression models were used to examine the associations of foot pain, posture, function and ability to perform these activities. Results: After adjusting for age, sex, height and weight, foot pain was significantly associated with difficulty performing all eight weight-bearing activities. Compared to those with normal foot posture and function, participants with planus foot posture were more likely to report difficulty remaining balanced [odds ratio (OR) = 1.40, 95% confidence interval (CI) 1.06-1.85; p = 0.018] and individuals with pronated foot function were more likely to report difficulty walking across a small room (OR = 2.07, 95% CI 1.02-4.22; p = 0.045). Foot pain and planus foot posture were associated with an overall mobility limitation score combining performances on each measure. Conclusion: Foot pain, planus foot posture and pronated foot function are associated with self-reported difficulty undertaking common weight-bearing tasks. Interventions to reduce foot pain and improve foot posture and function may therefore have a role in improving mobility in older adults.

Download Full-text

Spatiotemporal Parameters And Gait Variability In People With Psoriatic Arthritis (Psa) : A Cross-Sectional Study.

10.21203/rs.3.rs-883851/v1 ◽

2021 ◽

Author(s):

Roua Walha ◽

Nathaly Gaudreault ◽

Pierre Dagenais ◽

Patrick Boissy

Keyword(s):

Psoriatic Arthritis ◽

Gait Speed ◽

Gait Variability ◽

Functional Mobility ◽

Clinical Settings ◽

Foot Pain ◽

Wide Range ◽

Spatiotemporal Parameters ◽

Foot Function ◽

And Function

Abstract Background: Foot involvement is a major manifestation of psoriatic arthritis (PsA) and could lead to severe levels of foot pain and disability and impaired functional mobility and quality of life. Gait spatiotemporal parameters (STPs) and gait variability, used as a clinical index of gait stability, have been associated with several adverse health outcomes including risk of falling, functional decline, and mortality in a wide range of populations. Previous studies showed some alterations in STPs in people with PsA. However, gait variability and the relationships between STPs, gait variability and self-reported foot pain and disability have never been studied in this populations. Body-worn inertial measurement units (IMUs) are gaining interest in measuring gait parameters in clinical settings.Objectives: To assess STPs and gait variability in people with PsA using IMUs and, to explore their relationship with self-reported foot pain and function and to investigate the feasibility of using IMUs to discriminate patient groups based on gait speed-critical values.Methods: 21 participants with PsA (Age: 53.9 ± 8.9 yrs; median disease duration: 6 yrs) and 21 age and gender-matched healthy participants (Age 54.23 ± 9.3 yrs) were recruited. All the participants performed three 10-meter walk test trials at their comfortable speed. STPs and gait variability were recorded and calculated using six body-worn IMUs and the Mobility Lab software (APDM®). Foot pain and disability were assessed in participants with PsA using the foot function index (FFI).Results: Cadence, gait speed, stride length, and swing phase, were significantly lower, while double support was significantly higher, in the PsA group (p< 0.006). Strong correlations between STPs and the FFI total score were demonstrated (|r|> 0.57, p< 0.006). Gait variability was significantly increased in the PsA group, but it was not correlated with foot pain and function (p< 0.006). Using the IMUs three subgroups of participants with PsA with clinically meaningful differences in self-reported foot pain and disability were discriminated.Conclusion: STPs were significantly altered in participants with PsA which could be associated with self-reported foot pain and disability. Future studies are required to confirm the increased gait variability highlighted in this study and its potential underlying causes. Using IMUs in clinical settings has been useful to objectively assess foot function in people with PsA. Study registration: ClinicalTrials.gov, NCT05075343, Retrospectively registered on 29 September 2021.

Download Full-text

When COVID-19 affects muscle: effects of quarantine in older adults

European Journal of Translational Myology ◽

10.4081/ejtm.0.9069 ◽

2020 ◽

Author(s):

Tatiana Moro ◽

Antonio Paoli

Keyword(s):

Older Adults ◽

Physical Inactivity ◽

Load Resistance ◽

Preventive Action ◽

The Past ◽

Low Load ◽

Increase Risk ◽

Risk Of Fall ◽

And Function ◽

Negative Health Outcomes

At the beginning of 2020 a respiratory diseased named COVID-19 rapidly spread worldwide. Due to the presence of comorbidities and a greater susceptibility to infections, older adults are the population most affected by this pandemic. An efficient pharmacological treatment for COVID-19 is not ready yet; in the meanwhile, a general quarantine has been initiated as a preventive action against the spread of the disease. If on one side this countermeasure is slowing the spread of the virus, on the other side is also reducing the amount of physical activity. Sedentariness is associated with numerous negative health outcomes and increase risk of fall, fractures and disabilities in older adults. Models of physical inactivity have been widely studied in the past decades, and most studies agreed that is necessary to implement physical exercise (such as walking, low load resistance or in bed exercise) during periods of disuse to protect muscle mass and function from catabolic crisis. Moreover, older adults have a blunted response to physical rehabilitation, and a combination of intense resistance training and nutrition are necessary to overcome the loss of in skeletal muscle due to disuse.

Download Full-text

Sarcopenic Knee Osteoarthritis: A Risk Factor for Recurrent Falls

10.21203/rs.3.rs-435543/v1 ◽

2021 ◽

Author(s):

Hirotaka Iijima ◽

Tomoki Aoyama

Keyword(s):

Older Adults ◽

Knee Osteoarthritis ◽

Knee Oa ◽

Recurrent Falls ◽

Increased Risk ◽

Risk Of Falls ◽

Interactive Relationship ◽

Falls In Older Adults ◽

Risk Factors For Falls ◽

And Control

Abstract Background: Sarcopenia and knee osteoarthritis (OA) are major risk factors for falls in older adults. The coexistence of these two conditions may exacerbate the risk of falls through the sarcopenia-OA interaction. This study aimed to test the hypothesis that older adults with coexisting sarcopenia and knee OA, defined as “sarcopenic OA,” displayed an increased risk of falls.Methods: Patients in an orthopedics clinic (n = 298, age: 60–90 years, 78.9% women) were divided into 4 groups according to the presence of sarcopenia and radiographic knee OA: isolated sarcopenia, isolated knee OA, sarcopenic knee OA, and control (i.e., non-sarcopenia with non-OA) groups. We used questionnaires to assess fall experience in the prior 12 months. We performed binary and ordinal logistic regression analyses to evaluate the relationship between the 4 groups and falls experience.Results: Of 298 participants, 27 (9.1%) had sarcopenic knee OA. Patients with sarcopenic knee OA had 4.70 times (95% confidence interval: 1.08, 20.5) higher odds of recurrent falls (≥ 2 falls) than those with control after adjustment for age, sex, and body mass index.Conclusions: Patients with sarcopenic knee OA displayed higher frailty. This study provides novel interactive relationship between sarcopenia and knee OA in the context of recurrent falls experience.Trial registration: Not applicable.

Download Full-text

When COVID-19 affects muscle: effects of quarantine in older adults

European Journal of Translational Myology ◽

10.4081/ejtm.2020.9069 ◽

2020 ◽

Vol 30 (2) ◽

pp. 219-222

Author(s):

Tatiana Moro ◽

Antonio Paoli

Keyword(s):

Older Adults ◽

Physical Inactivity ◽

Load Resistance ◽

Preventive Action ◽

The Past ◽

Low Load ◽

Increase Risk ◽

Risk Of Fall ◽

And Function ◽

Negative Health Outcomes

Download Full-text

Increased recurrent falls experience in older adults with coexisting of sarcopenia and knee osteoarthritis: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-021-02654-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hirotaka Iijima ◽

Tomoki Aoyama

Keyword(s):

Older Adults ◽

Knee Osteoarthritis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Knee Oa ◽

Recurrent Falls ◽

Increased Risk ◽

Risk Of Falls ◽

Risk Factors For Falls

Abstract Background Sarcopenia and knee osteoarthritis (OA) are two major risk factors for falls in older adults. The coexistence of these two conditions may exacerbate the risk of falls. This cross-sectional study aimed to test the hypothesis that older adults with coexisting sarcopenia and knee OA displayed an increased risk of falls experience. Methods Participants recruited from an orthopedic clinic were divided into four groups according to the presence of sarcopenia and radiographic knee OA: isolated sarcopenia, isolated knee OA, sarcopenia + knee OA, and control (i.e., non-sarcopenia with non-OA) groups. We used questionnaires to assess falls experience in the prior 12 months. We performed logistic regression analyses to evaluate the relationship between the four groups and falls experience. Results Of 291 participants (age: 60–90 years, 78.7% women) included in this study, 25 (8.6%) had sarcopenia + knee OA. Participants with sarcopenia + knee OA had 4.17 times (95% confidence interval: 0.84, 20.6) higher odds of recurrent falls (≥2 falls) than controls after adjustment for age, sex, and body mass index. The increased recurrent falls experience was not clearly confirmed in participants with isolated sarcopenia and isolated knee OA. Conclusions People with coexisting of sarcopenia and knee OA displayed increased recurrent falls experience. This study suggests a new concept, “sarcopenic knee OA”, as a subgroup associated with higher risk of falls, which should be validated in future large cohort studies. Trial registration. Not applicable.

Download Full-text

Sex Differences in Frail Older Adults with Foot Pain in a Spanish Population: An Observational Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176141 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6141 ◽

Cited By ~ 1

Author(s):

Emmanuel Navarro-Flores ◽

Carlos Romero-Morales ◽

Ricardo Becerro de Bengoa-Vallejo ◽

David Rodríguez-Sanz ◽

Patricia Palomo-López ◽

...

Keyword(s):

Older Adults ◽

Sex Differences ◽

Observational Study ◽

Correlation Coefficients ◽

Descriptive Study ◽

Spanish Population ◽

Foot Pain ◽

Cross Sectional ◽

Risk Of Falls ◽

Spearman’S Correlation

Frailty is a condition that can increase the risk of falls. In addition, foot pain can influence older adults and affect their frail condition. The main objective was to measure the frailty degree in older adults in a Spanish population with foot pain from moderate to severe. Method: This is a cross-sectional descriptive study. A sample of people older than 60 years (n = 52), including 26 males and 26 females, were recruited, and frailty disability was measured using the 5-Frailty scale and the Edmonton Frailty scale (EFS). Results: Spearman’s correlation coefficients were categorized as weak (rs ≤ 0.40), moderate (0.41 ≤ rs ≥ 0.69), or strong (0.70 ≤ rs ≥ 1.00). There was a statistically significant correlation for the total score (p < 0.001) and most of the subscales of the 5-Frailty scale compared with the EFS, except for Mood (p > 0.05). In addition, females and males showed similar 5-Frailty and Edmonton Frail scales scores with no difference (p > 0.05). Conclusion: Foot pain above 5 points, i.e., from moderate to severe, does not affect the fragility more in one sex than another.

Download Full-text

Association of Planus Foot Posture and Pronated Foot Function With Foot Pain: The Framingham Foot Study

Arthritis Care & Research ◽

10.1002/acr.22079 ◽

2013 ◽

Vol 65 (12) ◽

pp. 1991-1999 ◽

Cited By ~ 26

Author(s):

Hylton B. Menz ◽

Alyssa B. Dufour ◽

Jody L. Riskowski ◽

Howard J. Hillstrom ◽

Marian T. Hannan

Keyword(s):

Foot Pain ◽

Foot Posture ◽

Foot Function

Download Full-text

90 Demographics and Characteristics of Patients with Recurrent Falls Attending Tertiary Hospital Outpatients Department

Age and Ageing ◽

10.1093/ageing/afz103.52 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Mohd Ikhwan Marion ◽

Paula Beatty ◽

Tariq Zainal ◽

Marie-Anne Riordan ◽

Toddy Daly ◽

...

Keyword(s):

Older Adults ◽

Tricyclic Antidepressants ◽

Antihypertensive Agents ◽

Tertiary Hospital ◽

Clinical Notes ◽

Tertiary Centre ◽

Recurrent Falls ◽

High Prevalence ◽

Risk Of Falls ◽

Hospital Outpatients

Abstract Background Falls are a common cause of morbidity and mortality in older adults, with most being caused by identifiable risk factors. This study aimed to assess demographics and clinical characteristics of patients who had recurrent falls attending the medicine for the older person (MFTOP) outpatient department at a tertiary centre. Methods Retrospective analysis of patients seen at MFTOP OPD between January 2018 and December 2018. Data were obtained from clinical notes. Age, gender, blood pressure, cognitive tests, blood tests, diagnoses and medications that could contribute to falls were recorded. Results 100 patients were reviewed. 60% were female (60). Mean and median ages were 83. Causes of falls included; gait/balance disorders or weakness 36.0%, environment-related/'accident' 19.0%, alcohol 5.0%, dizziness/vertigo 5.0%, visual disorder 4.0%, confusion 4.0%, others 3.0%, drop attack 1.0%, unknown 5.0%. 18.4% (18/98) had orthostatic hypotension (OH), of which 44.4% (8/18) had low standing systolic BP <120 P=0.0205 compared to the non-OH group. Median HbA1c was 39 (30 - 83) for 80 patients 95% CI 39.5-43.4. 11.9% (11/92) had low serum sodium (<135) (95% CI 137.7-139.3). 29.0% (29/100) had impaired cognition of which 13.4% (4/29) were at risk of vitamin D deficiency P=0.5767. Other medical conditions potentially contributing to falls included; arthritis 16.0%, Parkinson’s disease 7% and incontinence 3.0%. Medications that can contribute to falls included; antihypertensive agents 67 (66.3%), tricyclic antidepressants 19 (18.8%), antianxiety agents 15 (14.9%), opiates 12 (11.9%), hypnotics/ tranquilizers 27(26.7%) and diuretics 28 (27.7%). Conclusion There is a high prevalence of co-morbidities and polypharmacy in patients with recurrent falls. Identifying modifiable causes may reduce the risk of falls in the future. Tighter glycaemic control was observed and relaxed glucose control in high-risk older adults are recommended.

Download Full-text

Effect of painful keratoses debridement on foot pain, balance and function in older adults

Gait & Posture ◽

10.1016/j.gaitpost.2004.10.006 ◽

2005 ◽

Vol 22 (4) ◽

pp. 302-307 ◽

Cited By ~ 22

Author(s):

Karen R. Balanowski ◽

Lynne M. Flynn

Keyword(s):

Older Adults ◽

Foot Pain ◽

And Function

Download Full-text