Structural and functional foot and ankle characteristics associated with falls in older people

Abstract

Background: Falls affect approximately one in three older people, and foot problems are amongst the modifiable potential risk factors. Research question: what are the associations between foot and ankle functional and structural characteristics with falls in community-dwelling older adults? Method: One hundred eighty-seven community-dwelling older adults (106 females) aged 62-90 years (mean 70.5 +/- 5.2) from Isfahan, Iran were recruited. Foot and ankle structure and function (including foot posture, range of motion, muscle strength, deformity, pain and plantar loading patterns during walking) were measured. Fall history was documented in the preceding year. Univariate analyses compared fallers and non-fallers on all variables to determine significant differences and logistic regression analysis identified variables independently associated with falls. Results: Seventy-four participants (39.9 ) had experienced a fall in the previous year. Logistic regression analysis revealed that less first metatarsophalangeal joint extension (odds ratio 0.82, 95 CI 0.73-0.91), less plantarflexor muscle strength (odds ratio 0.29, 95 CI 0.15-0.55), greater pressure-time integral in the medial forefoot (odds ratio 2.65, 95 CI 1.10-6.38), greater center of pressure velocity in the forefoot (odds ratio 1.27, 95 CI 1.07-1.49) and greater foot pain (odds ratio 1.09, 95 CI 1.02-1.16) were significantly and independently associated with falls after accounting for physiological falls risk factors. Significance: We have identified several structural and functional foot and ankle characteristics associated with falling in older people. Future development of interventions to help prevent or treat these potentially modifiable risk factors may help decrease the risk of falling in this population.