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Foot symptoms are associated with poorer physical function

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  #1  
Old 13th January 2011, 07:41 AM
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Default Foot symptoms are associated with poorer physical function

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Foot symptoms are independently associated with poor self-reported and performance-based physical function: The johnston county osteoarthritis project.
Golightly YM, Hannan MT, Amy X, Helmick CG, Renner JB, Jordan JM.
Arthritis Care Res (Hoboken). 2011 Jan 10. [Epub ahead of print]
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OBJECTIVE.: To examine associations of foot symptoms with self-reported and performance-based measures of physical function in a large, bi-racial, community-based sample of individuals ≥45 years old.

METHODS.: Data from 2,589 Johnston County participants (evaluated 1999-2004) were used in cross-sectional analyses. Presence of foot symptoms was defined as pain, aching, or stiffness of at least one foot on most days. Physical function was assessed by the Stanford Health Assessment Questionnaire (HAQ; 0, > 0 but < 1, ≥1), timed 5 repeated chair stands (completion time <12 seconds (s), ≥12 s, unable), and 8-foot walk time (<3.35 s, ≥3.35 s). Separate multivariable logistic regression models examined associations between foot symptoms and physical function measures, controlling for age, race, gender, body mass index (BMI), radiographic knee osteoarthritis (OA), radiographic hip OA, knee symptoms, hip symptoms, and depressive symptoms. Interaction terms between each of the 3 physical function measures and each demographic and clinical characteristic were examined.

RESULTS.: The prevalence of foot symptoms was 37%. Participants with foot symptoms were more likely than those without symptoms to have higher HAQ scores (adjusted odds ratio [aOR]=1.79, 95% confidence interval [CI] 1.50-2.12). Among obese participants, those with foot symptoms had longer chair stand (aOR=1.38, 95% CI 1.04-1.87) and 8-foot walk times (aOR=1.61, 95% CI 1.21-2.15) than those without symptoms.

CONCLUSIONS.: Foot symptoms were independently and significantly associated with 2 of 3 measures of poorer physical function. Interventions for foot symptoms may be important for helping patients prevent or deal with an existing decline in physical function.
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Old 18th October 2011, 07:01 PM
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Default Re: Foot symptoms are associated with poorer physical function

Prevalence of foot conditions in a geriatric population and their impact on mobility, gait and tendency to falls.
Martínez-Gallardo Prieto L, Hermida Galindo LF, D'hyver de Las Deses C.
Rev Esp Geriatr Gerontol. 2011 Oct 13. [Epub ahead of print]
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INTRODUCTION:
Foot disease is common among the elderly. Little is known about its prevalence and impact over mobility, gait and tendency to fall.

MATERIAL AND METHODS:
A geriatric history was taken from 171 women living in a long-term care facility. Photographs were taken of the feet and evaluated by an orthopaedic surgeon and a dermatologist. A multivariate analysis was made to assess de effect of the independent variables over mobility, gait and tendency to fall.

RESULTS:
The foot diseases most commonly found were hammer toes (122), callus (79) and peripheral vascular disease (74). Hallux rigidus (OR 24.897, 95% CI, 1.231-503.542) and peripheral vascular disease (OR 2.481, 95% CI, 1.095-5.623) seemed to be associated with changes in gait; both where associated with dependency on instrumental activities of daily living (OR 44.166, 95% CI, 2.402-812.233, and OR 2.659, 95% CI, 1.069-6.615). Hallux rigidus was related to falls (OR 19.27, 95% CI, 1.102-337.26). Tinea pedis was associated with dependency in activities of daily living (OR 11.52, 95% CI, 1.325-100.125).

CONCLUSIONS:
Foot disorders are common in the elderly. Only hallux rigidus and peripheral vascular disease had an impact on function and gait.
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Old 25th May 2013, 07:19 AM
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Default Re: Foot symptoms are associated with poorer physical function

Foot Pain and Mobility Limitations in Older Adults: The Framingham Foot Study.
Menz HB, Dufour AB, Casey VA, Riskowski JL, McLean RR, Katz P, Hannan MT.
J Gerontol A Biol Sci Med Sci. 2013 May 23.
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BACKGROUND:
Foot pain is very common in the general population and has been shown to have a detrimental impact on health-related quality of life. This is of particular concern in older people as it may affect activities of daily living and exacerbate problems with balance and gait. The objective of this study is to evaluate the independent relationships between foot pain and mobility limitation in a population of community-dwelling older adults.

METHODS:
Population-based cross-sectional study. Participants (n = 1,544) from the Framingham Foot Study (2002-2008) were assessed for physical performance. Foot pain was documented using the question "On most days, do you have pain, aching, or stiffness in either foot?" Mobility limitation was assessed using the Short Physical Performance Battery, dichotomized using 1-9 as an indicator of mobility limitation and 10-12 as no mobility limitation.

RESULTS:
Foot pain was reported by 19% of men and 25% of women. After adjusting for age, obesity, smoking status, and depression, foot pain was significantly associated with mobility limitation in both men (odds ratio = 2.00, 95% confidence interval 1.14 - 3.50; p = .016) and women (odds ratio = 1.59, 95% confidence interval 1.03 - 2.46; p = .037).

CONCLUSION:
In our study of older adults from the Framingham Foot Study, foot pain was associated with an increased odds of having mobility limitation in both men and women. Clinicians should consider assessment of foot pain in general examinations of older adults who are at risk of mobility limitation.
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Old 28th May 2013, 01:24 AM
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Default Re: Foot symptoms are associated with poorer physical function

Could it be that the poor levels of fitness lead to their foot conditions?
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Old 7th June 2013, 06:16 PM
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Default Re: Foot symptoms are associated with poorer physical function

Associations of foot posture and function to lower extremity pain: The Framingham Foot Study.
Riskowski J, Dufour A, Hagedorn T, Hillstrom H, Casey V, Hannan M.
Arthritis Care Res (Hoboken). 2013 Jun 5.
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Objective. Studies have implicated foot posture and foot function as risk factors for lower extremity pain. Empirical population-based evidence for this assertion is lacking; therefore, the purpose of this study was to evaluate cross-sectional associations of foot posture and foot function to lower extremity joint pain in a population-based study of adults. Methods. Participants were members of the Framingham Foot Study. lower extremity joint pain was determined by the response to the NHANES-type question, "On most days do you have pain, aching or stiffness in your [hips, knees, ankles, or feet]?" Modified Arch Index (MAI) classified participants as having planus, rectus (referent) or cavus foot posture. Center of Pressure Excursion Index (CPEI) classified participants as having over-pronated, normal (referent) or over-supinated foot function. Crude and adjusted (age, gender, BMI) logistic regression determined associations of foot posture and function to lower extremity pain. Results. Participants with planus structure had higher odds of knee (1.57, 95% CI: 1.24-1.99) or ankle (1.47, 95% CI: 1.05-2.06) pain, whereas those with a cavus foot structure had increased odds of ankle pain only (7.56, 95% CI: 1.99-28.8) and pain at one lower extremity site (1.37, 95% CI: 1.04-1.80). Associations between foot function and lower extremity joint pain were not statistically significant, except for a reduced risk of hip pain in those with an over-supinated foot function (0.69, 95% CI: 0.51-0.93). Conclusions. These findings offer a link between foot posture and lower extremity pain, highlighting the need for longitudinal or intervention studies.
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Old 14th September 2013, 10:28 PM
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Default Re: Foot symptoms are associated with poorer physical function

Foot Disorders, Foot Posture, and Foot Function: The Framingham Foot Study
Thomas J. Hagedorn, Alyssa B. Dufour, Jody L. Riskowski, Howard J. Hillstrom, Hylton B. Menz, Virginia A. Casey, Marian T. Hannan
PLoS ONE 8(9): e74364. doi:10.1371/journal.pone.0074364
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Introduction
Foot disorders are common among older adults and may lead to outcomes such as falls and functional limitation. However, the associations of foot posture and foot function to specific foot disorders at the population level remain poorly understood. The purpose of this study was to assess the relation between specific foot disorders, foot posture, and foot function.

Methods
Participants were from the population-based Framingham Foot Study. Quintiles of the modified arch index and center of pressure excursion index from plantar pressure scans were used to create foot posture and function subgroups. Adjusted odds ratios of having each specific disorder were calculated for foot posture and function subgroups relative to a referent 3 quintiles.

Results
Pes planus foot posture was associated with increased odds of hammer toes and overlapping toes. Cavus foot posture was not associated with the foot disorders evaluated. Odds of having hallux valgus and overlapping toes were significantly increased in those with pronated foot function, while odds of hallux valgus and hallux rigidus were significantly decreased in those with supinated function.

Conclusions
Foot posture and foot function were associated with the presence of specific foot disorders.
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Old 27th October 2013, 01:10 AM
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Default Re: Foot symptoms are associated with poorer physical function

Foot Pain, But Not Foot Structure Or Foot Function, Are Associated With Self-Reported Physical Limitations: The Framingham Foot Study
Dufour, Alyssa B. PhD, Katz, Patricia P. PhD; Casey, Virginia A. PhD; Hannan, Marian T. DSc, MPH; Menz, Hylton B. PhD
American College of Rheumatology Annual Meeting; Oct 26-30, 2013; San Diego
Quote:
Background/Purpose: The purpose of this cross-sectional study was to examine the relation between self reported physical limitations and foot pain, foot structure and foot function in older men and women of the Framingham Foot Study (FFS).

Methods: 1860 participants in the FFS completed the foot questionnaire, which included foot pressure measurements and questions on physical limitations. The presence of foot pain was defined (y/n) using the question “On most days, do you have pain, aching, or stiffness in either of your feet?” Foot structure and foot function were defined using standing and walking foot pressure scans from a Tekscan Matscan system, respectively. The modified arch index describes foot structure as planus, cavus or referent using sex-specific quintiles from the population distribution. The center of pressure excursion index measures dynamic foot function as pronated, supinated, or referent using sex-specific quintiles from the population distribution.

An overall physical limitations score was derived from items assessing difficulty (none vs. any [little, some, a lot, unable]) for 9 activities such as remaining balanced while standing; standing in one place; getting in/out of a car, a chair, or bed; putting on socks/stockings; and up/down 1 flight of stairs. We created an overall score by summing the number of tasks with limitations (range 0-9) and also a mean difficulty score across all levels of difficulty in the 9 items, range 0-4. Linear regression estimated the association between physical limitation score and foot pain, foot structure and foot function, adjusting for age, height, weight and sex

Results: Of the 1860 participants, 55% were women and mean age was 65 yrs (SD=10.6). 37% had no physical limitation. The average overall physical limitations score was 2 (SD=2.4) and average mean difficulty score was 0.36 (SD=0.50). 27% reported foot pain, 34% were pronators, 27% were supinators, 24% had cavus foot and 29% had planus foot.

Those with foot pain reported more physical limitations than those without (p<.0001). Foot structure and foot function were not associated with the overall physical limitation score in adjusted models (Table). Remarkably similar results were seen for the mean difficulty score as seen with the overall physical limitations score.

Conclusion: Foot pain is strongly associated with self-reported physical limitations, but foot structure and foot function are not. Persons may adapt to their own foot structure and foot function so that it does not limit physical activity. Objective measures of physical limitations are needed to provide other insights into the links with foot pain.
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Old 13th November 2014, 12:21 AM
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Default Re: Foot symptoms are associated with poorer physical function

The association of leg lean mass with foot pain, posture and function in the Framingham Foot Study
Robert R McLean, Alyssa B Dufour, Patricia P Katz, Howard J Hillstrom, Thomas J Hagedorn, Marian T Hannan
Journal of Foot and Ankle Research 2014, 7:46 (12 November 2014)
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BackgroundFoot disorders are common in older adults and associated with impaired lower extremity function. Reduced muscle mass may play a role in the etiology of foot disorders and consequent poor function.

MethodsWe examined the association of leg lean mass with foot pain, posture and function among 1,795 individuals (mean age 67?years) from the population-based Framingham Foot Study (2002?2008). Pain was assessed via questionnaire, and a pressure mat classified foot posture (arch: high, low, referent) during standing and function (pronation, supination, referent) during gait. Leg lean mass was measured by whole body dual energy x-ray absorptiometry.

ResultsIn age- and body mass index-adjusted logistic (pain) and multinomial logistic (posture, function) regression models, a 1-standard deviation increase in leg lean mass was associated with lower odds of foot pain (OR?=?0.76, 95% CI: 0.68, 0.86) and pronation (OR?=?0.76, 95% CI: 0.67, 0.85), and higher odds of supination (OR?=?1.17, 95% CI: 1.04, 1.31). Adjustment for sex attenuated these associations. Higher leg lean mass was associated with lower odds of high arch, even after adjustment for sex (OR?=?0.73, 95% CI: 0.60, 0.89).

ConclusionsThough not related to foot pain or function, reduced leg lean mass was associated with extreme foot posture in older adults. Loss of muscle mass with aging may thus play a role in the etiology of functional impairment due to foot disorders.
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Old 14th November 2014, 03:54 PM
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Default Re: Foot symptoms are associated with poorer physical function

The Effect of Foot Pain on Mobility Disability in Older Adults: The FraminghamFootStudy. AlyssaB.Dufour, PatriciaP.Katz, YvonneM. Golightly, Arunima Awale and Marian T. Hannan.
American College of Rheumatology Conference; Boston 14-19 November 2014
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Background/Purpose: While lower extremity function is thought to affect mobility, little is known of the influence of foot structure or function uponmobilitylimitations.Weevaluatedtheassociations offootstructureand footfunctionwithmobilitylimitationsincommunity-dwellingoldermenand women. Methods: FraminghamFootStudyparticipants(2002–2008)withperf or- mance measures of mobility limitations were included in this cross-sectional analysis. Mobility limitations was assessed using the Short Physical Perfor- mance Battery (SPPB), a composite of 3 timed performance tests (4-meter walk (s), chair stands (s), and balance test) with each test scored on a scale of 0 to 4 (total score range 0–12, higher score  better function). Previously, SPPBscoreshavepredictedphysicallimitations,disabil ityandmortality.We dichotomizedSPPBas1–9toindicatemobilitylimitations and10–12asgood mobility. We also examined quartiles of chair stand and walk time. Foot function while walking (pronated, supinated, normal) and weight-bearing archstructure(low,high,normalarch)weredefinedusinga Tekscanmatscan pressuresystem.Age,sex,bodymassindex(BMI;30, 30kg/m2),current smoker (y/n) and depression (CES-D scale) were also obtained. Sex-specific multivariate logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the association between foot structure and function with mobility limitations, adjusting for factors above. Results:In556menand700women,averageagewas70yrs(10 .8)and BMIwas28(5.2).16%hadmobilitylimitations,30%hadhig harchedand 27%hadlowarchedfootstructure;33%hadpronatedand27%h adsupinated foot function. Foot function was not associated with mobility limitations. In womenonly,lowarchedfootstructurewasassociatedwithi ncreasedoddsof mobility limitations (SPPB; OR2.27, p0.005) after adjustment (Table). No associations were seen between foot structure or function and chair stand time (ORs 0.8–1.1, all p 0.4). In quartiles of walk time, men in the 3rd quartile, compared to the lowest (fastest), were less likely to have a high arch foot structure (OR0.53) and supinated foot function (OR0.51). Women with a low arched foot were less likely to be in the 4th quartile (slowest walkers) compared to the fastest walkers and women with a pronated foot functionweremorelikelytobeinthe3rd quartileofwalkingspeedcompared to the fastest walkers. Conclusion: Specific components of foot structure and function were associated with mobility limitations in our study, albeit with inconsistent patterns between men and women. Given these results, future work might examinespecificregionsoffootpressuresandtime-integralmeasuresinorder to drill down to biomechanical mechanisms.
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Old 14th November 2014, 03:59 PM
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Default Re: Foot symptoms are associated with poorer physical function

SeverityofFootPainIsLinkedtothePrevalenceofDepress iveSymptoms: TheFraminghamFootStudy.
ArunimaAwale,AlyssaB.Dufour,PatriciaP. Katz,VirginiaA.CaseyandMarianT.Hannan.
American College of Rheumatology Conference; Boston 14-19 November 2014
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Background/Purpose: While a number of risk factors for foot pain are established, the relation between depression and foot pain has not been well studied. The purpose of this study was to examine the associations of foot pain and severity of foot pain with depressive symptoms in a population-based study of older adults.
Methods: Avalidatedfootassessmentandthe20-itemCES-Dquestionnaire were administered to Framingham Foot Study (2002–08) participants. Age (years) and body mass index (BMI, kg/m2) were also collected. Foot pain was queried: “On most days, do you have pain, aching or stiffness in either of your feet?”Severityoffootpainwascategorizedas:none(refe rent),mild,moderateor severepain.CES-Dscores16wereconsideredindicativeofsignificantleve lof depressivesymptoms.Sex-specificlogisticregressionwasusedtocalculateodds ratiosand95%confidenceintervalsfortheassociationoff ootpain(y/norseverity of foot pain) with depressive symptoms (y/n) adjusting for age and BMI. In a subsetofparticipants,furthermodelsadjustedforlegpa in(hip,knee,ankle),back pain, or other joint pain (neck, shoulder, elbow, wrist).
Results:Ofthe3321participants(meanage:6610years), 1464weremen (BMI:28.9 4.7kg/m2)and1857werewomen(BMI:28.0 6.0kg/m2).21% menand27%womenhaddepressivesymptoms(CES-Dscore 16).Menwith moderate foot pain vs. none had 2-fold increased odds (Table) of reporting depressive symptoms; men with severe foot pain had a 4-fold increased odds, independent of age and BMI. Women showed a similar trend in which women with moderate foot pain had 2-fold increased odds of depressive symptoms, and womenwithseverefootpainhad3-foldodds,independentofageandBMI.For bothmenandwomen,mildfootpainshowedincreasedodds(ra tiosof1.3and 1.4 respectively), but was only statistically significant for women (p . 046). Modelsconsideringotherregionsofpainattenuatedtheod dsratios(Table);pain variables were non-significant for men, while in women, back pain (p . 007), other pain (p . 019) but not leg pain (p . 775) added to the model.
Conclusion: Severity of foot pain, adjusting for age and BMI, was signifi- cantly associated with the prevalence of depressive symptoms in our study (i.e., thosereportingworsefootpainweremorelikelytoreportd epressivesymptoms). Adding joint pain at other regions attenuated but did not change the pattern of results.Futurestudiesshouldinvestigatethelongitudi nalaspectsoftheseverityof foot pain and depressive symptoms in older adults.
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Old 10th June 2015, 08:24 PM
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Default Re: Foot symptoms are associated with poorer physical function

NON-STRUCTURAL FACTORS ASSOCIATED WITH CURRENT AND NEW FOOT PAIN: DATA FROM THE TASMANIAN OLDER ADULT COHORT STUDY
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Conclusions: Weight, poorer leg strength, and pain at other sites are consistently associated with prevalent foot pain and predict new foot pain. Poor psychological wellbeing is associated with existing foot pain. This suggest that weight reduction, improving leg strength and taking a global approach to the treatment of pain may reduce the prevalence and incidence of foot pain in older adults.
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