A step in the right direction

A world-first trial by La Trobe University has highlighted the role of podiatrists in falls prevention.

Above: Researcher, podiatrist and PhD candidate- Martin Spinks.

By Yasmin Noone

Podiatrists could have a greater role to play in the prevention of falls in the older population should the results of an Australian trial, published in the British Medical Journal (BMJ), be anything to go by. 

Marking a world-first, an Australian team of researchers from La Trobe University recently discovered that they could an older person’s risk of falling by more than 35 per cent using a multifaceted podiatry intervention.
The intervention package trialled, which can be implemented by any podiatrist in any setting, boasts a hollistic approach to falls prevention and includes foot orthoses; footwear advice and provisions; a home-based foot and ankle exercise program; and an educational booklet.
“It’s a whole podiatry package that will help older people to reduce their risk of falling,” said researcher, podiatrist and PhD candidate, Martin Spink.

“The intervention will also reduce the number of falls an older person will have because they will have stronger ankles and feet muscles, more balance and firm, and supportive footwear.”

The trial, funded by National Health and Medical Research Council (NHMRC), ran over a 12 month period and involved more than 300 older community dwellers.

Participants were split into a control and intervention group and both groups were asked to continue existing podiatry treatment. Meanwhile, the intervention group performed a standardised 30-minute home based exercise program three times a week.

“Significant improvements in the intervention group compared with the control group were found for the domains of strength, range of motion and balance.

“The reduction in falls is likely to be related to the significant improvements found in several measures of foot and ankle strength and functional ability.”

Mr Spink said that the trial offers proof that an intervention package should be incorporated into routine podiatry practice or multidisciplinary falls prevention clinics. It also highlights the future role for the podiatrists in falls prevention strategies.

“I think podiatrists have been in aged care for ages, since time began. However, their involvement on the falls side of things is new.

“They are only just getting into falls clinics and people are recognising that podiatrists have a bigger part to play in falls prevention.

“There probably needs to be a bit of education for podiatrists as well. It’s a time thing. We only have so many minutes to see someone. So unless a patient complains …most podiatrists won’t go down the path of [falls prevention].

“This trial shows that podiatrists have a greater role to play in falls prevention which can lead to a reduction in falls from a multi-intervention program.

“People should get their feet and footwear checked in relation to fall prevention. That’s what falls guidelines say at the moment. But, [older people] should not only get their feet checked but they should also find out what to do next.”

The study, Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial, was published in the BMJ this month.

Tags: bmj, falls, falls-prevention, la-trobe-university,

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