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Foot Problems in Older Adults Associations with Incident Falls, Frailty Syndrome, and Sensor-Derived Gait, Balance, and Physical Activity Measures.
J Am Podiatr Med Assoc. 2018 Mar; 108(2):126-139.JA

Abstract

BACKGROUND

Research on foot problems and frailty is sparse and could advance using wearable sensor-based measures of gait, balance, and physical activity (PA). This study examined the effect of foot problems on the likelihood of falls, frailty syndrome, motor performance, and PA in community-dwelling older adults.

METHODS

Arizona Frailty Cohort Study participants (community-dwelling adults aged ≥65 years without baseline cognitive deficit, severe movement disorders, or recent stroke) underwent Fried frailty and foot assessment. Gait, balance (bipedal eyes open and eyes closed), and spontaneous PA over 48 hours were measured using validated wearable sensor technologies.

RESULTS

Of 117 participants, 41 (35%) were nonfrail, 56 (48%) prefrail, and 20 (17%) frail. Prevalence of foot problems (pain, peripheral neuropathy, or deformity) increased significantly as frailty category worsened (any problem: 63% in nonfrail, 80% in prefrail [odds ratio (OR) = 2.0], and 95% in frail [OR = 8.3]; P = .03 for trend) due to associations between foot problems and both weakness and exhaustion. Foot problems were associated with fear of falling but not with fall history or incident falls over 6 months. Foot pain and peripheral neuropathy were associated with lower gait speed and stride length; increased double support time; increased mediolateral sway of center of mass during walking, age adjusted; decreased eyes open sway of center of mass and ankle during quiet standing, age adjusted; and lower percentage walking, percentage standing, and total steps per day.

CONCLUSIONS

Foot problems were associated with frailty level and decreased motor performance and PA. Wearable technology is a practical way to screen for deterioration in gait, balance, and PA that may be associated with foot problems. Routine assessment and management of foot problems could promote earlier intervention to retain motor performance and manage fear of falling in older adults, which may ultimately improve healthy aging and reduce risk of frailty.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28853612

Citation

Muchna, Amy, et al. "Foot Problems in Older Adults Associations With Incident Falls, Frailty Syndrome, and Sensor-Derived Gait, Balance, and Physical Activity Measures." Journal of the American Podiatric Medical Association, vol. 108, no. 2, 2018, pp. 126-139.
Muchna A, Najafi B, Wendel CS, et al. Foot Problems in Older Adults Associations with Incident Falls, Frailty Syndrome, and Sensor-Derived Gait, Balance, and Physical Activity Measures. J Am Podiatr Med Assoc. 2018;108(2):126-139.
Muchna, A., Najafi, B., Wendel, C. S., Schwenk, M., Armstrong, D. G., & Mohler, J. (2018). Foot Problems in Older Adults Associations with Incident Falls, Frailty Syndrome, and Sensor-Derived Gait, Balance, and Physical Activity Measures. Journal of the American Podiatric Medical Association, 108(2), 126-139. https://doi.org/10.7547/15-186
Muchna A, et al. Foot Problems in Older Adults Associations With Incident Falls, Frailty Syndrome, and Sensor-Derived Gait, Balance, and Physical Activity Measures. J Am Podiatr Med Assoc. 2018;108(2):126-139. PubMed PMID: 28853612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Foot Problems in Older Adults Associations with Incident Falls, Frailty Syndrome, and Sensor-Derived Gait, Balance, and Physical Activity Measures. AU - Muchna,Amy, AU - Najafi,Bijan, AU - Wendel,Christopher S, AU - Schwenk,Michael, AU - Armstrong,David G, AU - Mohler,Jane, Y1 - 2017/08/30/ PY - 2017/8/31/pubmed PY - 2018/10/6/medline PY - 2017/8/31/entrez SP - 126 EP - 139 JF - Journal of the American Podiatric Medical Association JO - J Am Podiatr Med Assoc VL - 108 IS - 2 N2 - BACKGROUND: Research on foot problems and frailty is sparse and could advance using wearable sensor-based measures of gait, balance, and physical activity (PA). This study examined the effect of foot problems on the likelihood of falls, frailty syndrome, motor performance, and PA in community-dwelling older adults. METHODS: Arizona Frailty Cohort Study participants (community-dwelling adults aged ≥65 years without baseline cognitive deficit, severe movement disorders, or recent stroke) underwent Fried frailty and foot assessment. Gait, balance (bipedal eyes open and eyes closed), and spontaneous PA over 48 hours were measured using validated wearable sensor technologies. RESULTS: Of 117 participants, 41 (35%) were nonfrail, 56 (48%) prefrail, and 20 (17%) frail. Prevalence of foot problems (pain, peripheral neuropathy, or deformity) increased significantly as frailty category worsened (any problem: 63% in nonfrail, 80% in prefrail [odds ratio (OR) = 2.0], and 95% in frail [OR = 8.3]; P = .03 for trend) due to associations between foot problems and both weakness and exhaustion. Foot problems were associated with fear of falling but not with fall history or incident falls over 6 months. Foot pain and peripheral neuropathy were associated with lower gait speed and stride length; increased double support time; increased mediolateral sway of center of mass during walking, age adjusted; decreased eyes open sway of center of mass and ankle during quiet standing, age adjusted; and lower percentage walking, percentage standing, and total steps per day. CONCLUSIONS: Foot problems were associated with frailty level and decreased motor performance and PA. Wearable technology is a practical way to screen for deterioration in gait, balance, and PA that may be associated with foot problems. Routine assessment and management of foot problems could promote earlier intervention to retain motor performance and manage fear of falling in older adults, which may ultimately improve healthy aging and reduce risk of frailty. SN - 1930-8264 UR - https://www.unboundmedicine.com/medline/citation/28853612/Foot_Problems_in_Older_Adults_Associations_with_Incident_Falls_Frailty_Syndrome_and_Sensor_Derived_Gait_Balance_and_Physical_Activity_Measures_ L2 - https://meridian.allenpress.com/japma/article-lookup/doi/10.7547/15-186 DB - PRIME DP - Unbound Medicine ER -