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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.
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.
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).
Foot disorders are common in the elderly. Only hallux rigidus and peripheral vascular disease had an impact on function and gait.
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.
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.
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).
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.
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.