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Foot and Ankle Characteristics Associated With Impaired Balance and Functional Ability in Older People

¹ Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia.
² School of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia.
³ Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia.

Address all correspondence to Hylton B. Menz, PhD, Musculoskeletal Research Centre, School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria 3086, Australia. E-mail: h.menz{at}latrobe.edu.au

Background. Ageing is associated with changes to the structure and function of the foot and ankle, and there is preliminary evidence that foot problems impair balance and increase the risk of falls. To explore this in more detail, we conducted a study to determine the relative contribution of several foot and ankle characteristics to performance on a range of balance and functional tests.

Methods. One hundred seventy-six people (56 men and 120 women, mean age 80.1 years, standard deviation 6.4 years) residing in a retirement village underwent tests of foot and ankle characteristics (including foot posture, range of motion, strength, and deformity), sensorimotor function (including vision, sensation, strength, and reaction time), and balance and functional ability (including tests of standing balance, leaning balance, stepping, sit-to-stand, and walking speed).

Results. Many foot and ankle characteristics and sensorimotor measures were associated with performance on the balance and functional tests in univariate analyses. Multiple regression analysis consistently revealed that ankle flexibility, plantar tactile sensitivity, and toe plantarflexor strength were significant and independent predictors of balance and functional test performance, explaining up to 59% of the variance in these test scores.

Conclusions. Foot and ankle characteristics, particularly ankle flexibility, plantar tactile sensation, and strength of toe plantarflexor muscles, are significant independent predictors of balance and functional ability in older people. Programs to improve the strength and flexibility of the foot and interventions to augment plantar sensation may be beneficial in improving mobility and reducing the risk of falls.

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				H. B. Menz, M. E. Morris, and S. R. Lord Foot and Ankle Risk Factors for Falls in Older People: A Prospective Study J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2006; 61(8): 866 - 870. [Abstract] [Full Text] [PDF]

				H. B. Menz, A. Tiedemann, M. M. S. Kwan, K. Plumb, and S. R. Lord Foot pain in community-dwelling older people: an evaluation of the Manchester Foot Pain and Disability Index Rheumatology, July 1, 2006; 45(7): 863 - 867. [Abstract] [Full Text] [PDF]