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In older adults, some podiatry interventions reduce falls compared with usual care

Wylie G, Torrens C, Campbell P, et al. Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis. Age Ageing. 2019;48:327-36.

Review question

In older adults who live in the community or in care homes, do podiatry interventions prevent falls?

Background

Foot problems like pain, bunions, and low ankle range of motion can lead to higher risk of falls. So too can shoes with heels or without straps or closures. Podiatrists can do an assessment of a person’s foot concerns and recommend treatments like exercises, orthotics or proper shoes, and bunion removal.

How the review was done

The researchers did a systematic review based on studies available up to July 2018.

They found 7 randomized controlled trials and 2 non-randomized studies with 6,502 people.

The key features of the studies were:

  • people were mostly women (65%) ranging from 69 to 87 years of age on average, who had fallen or were at risk of falling;
  • 7 studies were of people who lived in the community, and 2 were of people living in care homes;
  • interventions were grouped as having one component (podiatrist care and use of insoles or off-the-shelf shoes only), multiple components (podiatrist care and information, shoes or orthotics as needed, and exercises), or offered by a multidisciplinary team and included a podiatry risk assessment and referral;
  • interventions were compared with usual care; and
  • people used the interventions for 3 months to 2 years.

What the researchers found

Single component interventions did not affect falls.

Multiple component and multidisciplinary interventions reduced falls compared with usual care.

Conclusion

In older adults, including podiatry assessment as part of a multiple component approach reduces falls compared with usual care. If you have a history of falling or are at risk of falling, seeing a podiatrist, in addition to other measures such as doing foot exercises and wearing proper shoes, may reduce your risk.

Podiatrist interventions vs usual care in older adults

Intervention category*

Number of trials (and people)

Effect of podiatrist interventions vs usual care on the rate of falls

Single component interventions

1 trial (121 people)

No difference in effect

Multiple component interventions

3 trials (1,339 people)

23 fewer people fell out of 100 (from as few as 1 to as many as 39)

Multidisciplinary interventions

3 trials (1,243 people)

27 fewer people fell out of 100 (from as few as 2 to as many as 46)

*Intervention categories had a single component (podiatrist care and use of insoles or shoes only), multiple components (podiatrist care and information, shoes or orthotics as needed, and exercises), or were offered by a multidisciplinary team that included a podiatry assessment and referral.




Glossary

Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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