Balance, Falls, Fear of Falling, and Foot Function in Elderly People in Community-Dwelling Older Adults

Raziye Şavkın; Gökhan Bayrak; Nihal Büker

doi:10.31067/acusaglik.847281

Research Article

Toplumda Yaşayan Yaşlılarda Ayak Fonksiyonunun Denge, Düşme ve Düşme Endişesi ile İlişkisi

Year 2021, Volume: 12 Issue: 2, 279 - 283, 01.04.2021

Raziye Şavkın Gökhan Bayrak Nihal Büker

https://doi.org/10.31067/acusaglik.847281

Cited By: 1

Abstract

Amaç: Bu çalışmanın amacı toplumda yaşayan yaşlılarda ayak fonksiyonunun denge, düşme ve düşme endişesi ile ilişkisini belirlemektir.
Gereç ve Yöntem: Denizli merkezde yaşayan 47 yaşlı (13 kadın, 34 erkek) çalışmaya dahil edildi. Ayak fonksiyonları Ayak Fonksiyon İndeksiyle (FFI), düşme endişesi Uluslararası Düşme Etkinliği Ölçeğiyle (FES-I), dinamik denge ve düşme riski Süreli Kalk-Yürü Testiyle (SKYT) değerlendirildi. Ayrıca yaşlıların son bir yıldaki düşme sayıları da sorgulandı.
Bulgular: Çalışmaya katılan yaşlıların yaş ortalaması 75.34±7.81 yıldı. FFI skoruna göre yaşlılarda hafif derecede ayak ağrısı (21.19±19.87) ve aktivite kısıtlılığı (15.34±12.20), orta derecede yetersizlik (32.72±26.00) bulundu. Yaşlıların %76.7’sinin düşme endişesi yaşadığı, %57.4’ünün düşme riski taşıdığı saptandı. FES-I ile FFI’nin ağrı (r=0.538 p=0.000), yetersizlik (r=0.417 p=0.004) ve aktivite kısıtlılığı (r=0.532 p=0.000) alt grupları arasında pozitif yönde orta düzeyde anlamlı ilişki saptandı. SKYT ile FFI’nin ağrı (r=0.367 p=0.011) ve yetersizlik (r=0.352 p=0.015) alt grupları arasında pozitif yönde hafif düzeyde anlamlı ilişki gözlenirken aktivite kısıtlılığı (r=0.602 p=0.000) alt grubu ile yüksek düzeyde anlamlı ilişki bulundu.
Sonuç: Çalışmamız sonucunda ayak ağrısının ve ayak problemlerinden kaynaklanan günlük yaşam aktivitelerindeki yetersizlik ve aktivite kısıtlılığının denge kaybını, düşme riski ve endişesini arttırabileceği saptandı. Ayak problemleri nedeniyle fiziksel aktivite kısıtlaması veya fiziksel aktiviteden kaçınma kısa vadede yaşlıyı düşmelere karşı korusa da, uzun vadede yaşlının fiziksel ve zihinsel sağlığına zarar vermekte, sosyal katılımını kısıtlanmakta, yaşam kalitesini azaltmakta ve gelecekteki düşme riskini arttırmaktadır. Bu sebeple yaşlıların ayak sağlığıyla ilgili farkındalıklarının artırılmasının, ayak problemlerinin belirlenip gerekli önlemlerin alınmasının tüm bu risklerin ortadan kaldırılması açısından önemli olduğunu düşünmekteyiz.

Keywords

Ayak ağrısı, ayak fonksiyonu, düşme, düşme endişesi, yaşlılık

References

1. TÜİK, Türkiye İstatistik Kurumu, İstatistiklerle Yaşlılar, 2018.
2. Ferreira OGL, Maciel SC, Costa SMG, Silva AO, Moreira MASP. Active Aging and its Relationship to Functional İndependence. Texto Contexto - Enferm 2012; 21(3):513-518.
3. Menz HB, Lord SR. The Contribution of Foot Problems to Mobility İmpairment and Falls in Community-Dwelling Older People. J Am Geriatr Soc 2001; 49(12):1651-56.
4. Davidovich O. An Overview of The Painful Geriatric Foot. Geriatr Aging 2003; 6(8):26-29.
5. Muchna A, Najafi B, Wendel CS, Schwenk M, Armstrong DG, Mohler J. Foot Problems in Older Adults (Associations with Incident Falls, Frailty Syndrome, and Sensor-Derived Gait, Balance, and Physical Activity Measures). J Am Podiatr Med Assoc 2018; 108(2):126-139. doi: 10.7547/15-186.
6. Thomas MJ, Roddy E, Zhang W, Menz HB, Hannan MT, Peat GM. The Population Prevalence of Foot and Ankle Pain in Middle and Old Age: A Systematic Review. Pain 2011; 152(12):2870-2880. doi: 10.1016/j.pain.2011.09.019. Epub 2011 Oct 21.
7. Menz HB, Morris ME, Lord SR. Foot and Ankle Characteristics Associated with İmpaired Balance and Functional Ability in Older People. J Gerontol A Biol Sei Med Sei 2005; 60(12):1546-1552. doi: 10.1093/gerona/60.12.1546.
8. Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. Foot Pain, Plantar Pressures, and Falls in Older People: A Prospective Study. J Am Geriatr Soc 2010; 58(10):1936-1940.doi: 10.1111/j.1532-5415.2010.03061.x.
9. Stubbs B, Binnekade T, Eggermont L, Sepehry AA, Patchay S, Schofield P. Pain and The Risk For Falls in Community-Dwelling Older Adults: Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2014; 95(1):175-187. doi: 10.1016/j.apmr.2013.08.241.
10. Masud, T. and Morris, R.O. Epidemiology of Falls. Age and Aging 2001; 30:3-7.
11. Deshpande N, Metter EJ, Bandinelli S, Lauretani F, Windham BG, Ferrucci L. Psychological, Physical, and Sensory Correlates of Fear of Falling and Consequent Activity Restriction in the Elderly: The Inchıantı Study. Am J Phys Med Rehabil 2008; 87(5):354-362. doi: 10.1097/PHM.0b013e31815e6e9b.
12. Howland J, Lachman ME, Peterson EW, Cote J, Kasten L, Jette A. Covariates of Fear of Falling and Associated Activity Curtailment. Gerontologist 1998; 38(5):549-555.
13. Awale A. Hagedorn TJ. Dufour AB. Menz HB. Casey VA. Hannan MT. Foot Function, Foot Pain, and Falls in Older Adults: The Framingham Foot Study. Gerontology 2017; 63(4):318-324. doi: 10.1159/000475710.
14. Lach HW and Parsons JL. Impact of Fear of Falling in Long Term Care: An İntegrative Review. J Am Med Dir Assoc 2013; 14(8):573-577. doi: 10.1016/j.jamda.2013.02.019.
15. Yalıman A, Şen Eİ, Eskiyurt N, Budıman-mak E. Ayak Fonksiyon İndeksi’nin Plantar Fasiitli Hastalarda Türkçe’ye Çeviri ve Adaptasyonu. Türk Fiz Tıp Rehab Derg 2014; 60:212-22. doi: 10.5152/tftrd.2014.26086.
16. Ulus Y, Durmus D, Akyol Y, Terzi Y, Bilgici A, Kuru O. Reliability and Validity of the Turkish Version of the Falls Efficacy Scale International (FES-I) in Community-Dwelling Older Persons. Archives of Gerontology and Geriatrics 2012; 54(3):429-433. doi:10.1016/j.archger.2011.06.010.
17. Bischoff HA, Stähelin HB, Monsch AU, Iversen MD, Weyh A, Von Dechend M, et al. Identifying a Cut-off Point for Normal Mobility: A Comparison of The Timed 'Up and Go' Test in Community-Dwelling and İnstitutionalised Elderly Women. Age Ageing 2003; 32(3):315-320. doi: 10.1093/ageing/32.3.315.
18. Novak P, Burger H, Marincek C, Meh D. Influence of Foot Pain on Walking Ability of Diabetic Patients. J Rehabil Med 2004; 36(6):249-252. Doi: 10.1080/16501970410029816.
19. Williams AE, O’Neill TW, Mercer S, Toro B, Nester CJ. Foot Pathology in Patients with Paget’s Disease of Bone. Journal of the American Podiatric Medical Association 2006; 96(3):226-231. doi: 10.7547/0960226.
20. Kamanli A, Suluhan Ö, Özgöçmen S, Kaya A, Çiftçi İ, Ardiçoglu Ö. Measurement of Foot Bone Mineral Density in Rheumatoid Arthritis: Its Application and Clinical Relevance/Romatoid Artritli Hastalarda Ayak Kemik Mineral Yoğunluğunun Ölçülmesi: Yöntemin Uygulanması ve Klinik Önemi. Turkish Journal of Rheumatology 2010; 25(2):56-62. doi: 10.5152/tjr.2010.02.
21. Kavlak Y, ve Demirtaş RN. Effect of Foot Problems on Foot Function in Elderly Men. Turkish Journal of Geriatrics 2010; 13(3):191-196.
22. Menz HB, Dufour AB, Casey VA, Riskowski JL, McLean RR, Katz P, et al. Foot Pain and Mobility Limitations in Older Adults: The Framingham Foot Study. J Gerontol A Biol Sci Med Sci 2013;68(10):1281-1285. doi:10.1093/gerona/glt048.
23. Hill CL, Gill TK, Menz HB, Taylor AW. Prevalence and Correlates of Foot Pain in a Population-Based Study: The North West Adelaide Health Study. J Foot Ankle Res 2008; 1(1):1-7. doi: 10.1186/1757-1146-1-2.
24. Roddy E, Muller S, Thomas E. Onset and Persistence of Disabling Foot Pain in Community-Dwelling Older Adults over a 3-Year Period: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 2011; 66:474-480. doi: 10.1093/gerona/glq203.
25. Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. ISB Clinical Biomechanics Award 2009: Toe Weakness and Deformity İncrease the Risk of Falls in Older People. Clin Biomech (Bristol, Avon) 2009; 24(10):787-791. doi: 10.1016/j.clinbiomech.
26. Menz HB, Morris ME, Lord SR. Foot and Ankle Risk Factors for Falls in Older People: A Prospective Study. J Gerontol a Biol Sci Med Sci 2006; 61(8):866-870. doi: 10.1093/gerona/61.8.866.
27. Chaiwanichsiri D, Janchai S, Tantisiriwat N. Foot Disorders and Falls in Older Persons. Gerontology 2009; 55(3):296-302. doi: 10.1159/000181149.
28. Menz HB, Auhl M, Spink MJ. Foot Problems as a Risk Factor for Falls in Community-Dwelling Older People: A Systematic Review and Meta-Analysis. Maturitas 2018; 118:7-14. doi: 10.1016/j.maturitas.2018.10.001.
29. Legters K. Fear of Falling. Phys Ther 2002; 82(3):264-272.
30. Delbaere K, Crombez G, Vanderstraeten G, Willems T, Cambier D. Fear-related Avoidance of Activities, Falls and Physical Frailty. A Prospective Community-Based Cohort Study. Age Ageing 2004; 33(4):368-373. doi: 10.1093/ageing/afh106.
31. Deshpande N, Metter EJ, Laurentani F, Bandinelli S, Guralnik J, Ferrucci L. Activity Restriction İnduced by Fear of Falling and Objective and Subjective Measures of Physical Function: A Prospective Cohort Study. J Am Geriatr Soc 2008; 56(4):615-620. doi: 10.1111/j.1532-5415.2007.01639.x.
32. Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI. Prevalence and Correlates of Fear of Falling, and Associated Avoidance of Activity in the General Population of Community-Living Older People. Age Ageing 2007;36(3):304-9.

Balance, Falls, Fear of Falling, and Foot Function in Elderly People in Community-Dwelling Older Adults

Year 2021, Volume: 12 Issue: 2, 279 - 283, 01.04.2021

Raziye Şavkın Gökhan Bayrak Nihal Büker

https://doi.org/10.31067/acusaglik.847281

Cited By: 1

Abstract

Purpose: The aim of this study was to determine whether foot function is associated with balance, falls, fear of falls in community-dwelling older adults.
Materials and Methods: A total of 47 older adults (13 women, 34 men) residing in Denizli were included.Foot functions, fear of falling and dynamic balance and fall risk were evaluated by the Foot Function Index (FFI), Falls Efficacy Scale International (FES-I), Timed Up and Go test (TUG), respectively. The number of falls in the previous year was questioned.
Results: The mean age was 75.34±7.81 years. According to the FFI score, mild foot pain (21.19±19.87) and activity limitation (15.34±12.20), moderate disability (32.72±26.00) were found. 76.7% of the participants had fear of falling and 57.4% had a risk of falling. There was a moderate positive correlation between FES-I and FFI-pain (r=0.538,p=0.000), FFI-disability (r=0.417,p=0.004),FFI-activity limitation (r=0.532,p=0.000). There was a weak positive correlation between TUG and FFI-pain (r=0.367,p=0.011) and FFI-disability (r=0.352,p=0.015), while a strong positive correlation in FFI-activity limitation (r=0.602,p=0.000).
Conclusion: As a result of our study activity limitation and disability of daily living activities due to foot pain and foot problems may increase loss of balance, fall risk and fear of falling.Although in the short term, restriction or avoidance of physical activity due to foot problems protects the elderly against falls, in the long term it deteriorates the physical and mental health, restricts social participation, reduces the quality of life, increases the risk of future falls. Increasing the foot-health awareness and determining foot problems and taking precautions is important to eliminate all these risks.

Keywords

Foot pain, foot function, fall, fear of falling, elderly

References

1. TÜİK, Türkiye İstatistik Kurumu, İstatistiklerle Yaşlılar, 2018.
2. Ferreira OGL, Maciel SC, Costa SMG, Silva AO, Moreira MASP. Active Aging and its Relationship to Functional İndependence. Texto Contexto - Enferm 2012; 21(3):513-518.
3. Menz HB, Lord SR. The Contribution of Foot Problems to Mobility İmpairment and Falls in Community-Dwelling Older People. J Am Geriatr Soc 2001; 49(12):1651-56.
4. Davidovich O. An Overview of The Painful Geriatric Foot. Geriatr Aging 2003; 6(8):26-29.
5. Muchna A, Najafi B, Wendel CS, Schwenk M, Armstrong DG, Mohler J. Foot Problems in Older Adults (Associations with Incident Falls, Frailty Syndrome, and Sensor-Derived Gait, Balance, and Physical Activity Measures). J Am Podiatr Med Assoc 2018; 108(2):126-139. doi: 10.7547/15-186.
6. Thomas MJ, Roddy E, Zhang W, Menz HB, Hannan MT, Peat GM. The Population Prevalence of Foot and Ankle Pain in Middle and Old Age: A Systematic Review. Pain 2011; 152(12):2870-2880. doi: 10.1016/j.pain.2011.09.019. Epub 2011 Oct 21.
7. Menz HB, Morris ME, Lord SR. Foot and Ankle Characteristics Associated with İmpaired Balance and Functional Ability in Older People. J Gerontol A Biol Sei Med Sei 2005; 60(12):1546-1552. doi: 10.1093/gerona/60.12.1546.
8. Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. Foot Pain, Plantar Pressures, and Falls in Older People: A Prospective Study. J Am Geriatr Soc 2010; 58(10):1936-1940.doi: 10.1111/j.1532-5415.2010.03061.x.
9. Stubbs B, Binnekade T, Eggermont L, Sepehry AA, Patchay S, Schofield P. Pain and The Risk For Falls in Community-Dwelling Older Adults: Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2014; 95(1):175-187. doi: 10.1016/j.apmr.2013.08.241.
10. Masud, T. and Morris, R.O. Epidemiology of Falls. Age and Aging 2001; 30:3-7.
11. Deshpande N, Metter EJ, Bandinelli S, Lauretani F, Windham BG, Ferrucci L. Psychological, Physical, and Sensory Correlates of Fear of Falling and Consequent Activity Restriction in the Elderly: The Inchıantı Study. Am J Phys Med Rehabil 2008; 87(5):354-362. doi: 10.1097/PHM.0b013e31815e6e9b.
12. Howland J, Lachman ME, Peterson EW, Cote J, Kasten L, Jette A. Covariates of Fear of Falling and Associated Activity Curtailment. Gerontologist 1998; 38(5):549-555.
13. Awale A. Hagedorn TJ. Dufour AB. Menz HB. Casey VA. Hannan MT. Foot Function, Foot Pain, and Falls in Older Adults: The Framingham Foot Study. Gerontology 2017; 63(4):318-324. doi: 10.1159/000475710.
14. Lach HW and Parsons JL. Impact of Fear of Falling in Long Term Care: An İntegrative Review. J Am Med Dir Assoc 2013; 14(8):573-577. doi: 10.1016/j.jamda.2013.02.019.
15. Yalıman A, Şen Eİ, Eskiyurt N, Budıman-mak E. Ayak Fonksiyon İndeksi’nin Plantar Fasiitli Hastalarda Türkçe’ye Çeviri ve Adaptasyonu. Türk Fiz Tıp Rehab Derg 2014; 60:212-22. doi: 10.5152/tftrd.2014.26086.
16. Ulus Y, Durmus D, Akyol Y, Terzi Y, Bilgici A, Kuru O. Reliability and Validity of the Turkish Version of the Falls Efficacy Scale International (FES-I) in Community-Dwelling Older Persons. Archives of Gerontology and Geriatrics 2012; 54(3):429-433. doi:10.1016/j.archger.2011.06.010.
17. Bischoff HA, Stähelin HB, Monsch AU, Iversen MD, Weyh A, Von Dechend M, et al. Identifying a Cut-off Point for Normal Mobility: A Comparison of The Timed 'Up and Go' Test in Community-Dwelling and İnstitutionalised Elderly Women. Age Ageing 2003; 32(3):315-320. doi: 10.1093/ageing/32.3.315.
18. Novak P, Burger H, Marincek C, Meh D. Influence of Foot Pain on Walking Ability of Diabetic Patients. J Rehabil Med 2004; 36(6):249-252. Doi: 10.1080/16501970410029816.
19. Williams AE, O’Neill TW, Mercer S, Toro B, Nester CJ. Foot Pathology in Patients with Paget’s Disease of Bone. Journal of the American Podiatric Medical Association 2006; 96(3):226-231. doi: 10.7547/0960226.
20. Kamanli A, Suluhan Ö, Özgöçmen S, Kaya A, Çiftçi İ, Ardiçoglu Ö. Measurement of Foot Bone Mineral Density in Rheumatoid Arthritis: Its Application and Clinical Relevance/Romatoid Artritli Hastalarda Ayak Kemik Mineral Yoğunluğunun Ölçülmesi: Yöntemin Uygulanması ve Klinik Önemi. Turkish Journal of Rheumatology 2010; 25(2):56-62. doi: 10.5152/tjr.2010.02.
21. Kavlak Y, ve Demirtaş RN. Effect of Foot Problems on Foot Function in Elderly Men. Turkish Journal of Geriatrics 2010; 13(3):191-196.
22. Menz HB, Dufour AB, Casey VA, Riskowski JL, McLean RR, Katz P, et al. Foot Pain and Mobility Limitations in Older Adults: The Framingham Foot Study. J Gerontol A Biol Sci Med Sci 2013;68(10):1281-1285. doi:10.1093/gerona/glt048.
23. Hill CL, Gill TK, Menz HB, Taylor AW. Prevalence and Correlates of Foot Pain in a Population-Based Study: The North West Adelaide Health Study. J Foot Ankle Res 2008; 1(1):1-7. doi: 10.1186/1757-1146-1-2.
24. Roddy E, Muller S, Thomas E. Onset and Persistence of Disabling Foot Pain in Community-Dwelling Older Adults over a 3-Year Period: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 2011; 66:474-480. doi: 10.1093/gerona/glq203.
25. Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. ISB Clinical Biomechanics Award 2009: Toe Weakness and Deformity İncrease the Risk of Falls in Older People. Clin Biomech (Bristol, Avon) 2009; 24(10):787-791. doi: 10.1016/j.clinbiomech.
26. Menz HB, Morris ME, Lord SR. Foot and Ankle Risk Factors for Falls in Older People: A Prospective Study. J Gerontol a Biol Sci Med Sci 2006; 61(8):866-870. doi: 10.1093/gerona/61.8.866.
27. Chaiwanichsiri D, Janchai S, Tantisiriwat N. Foot Disorders and Falls in Older Persons. Gerontology 2009; 55(3):296-302. doi: 10.1159/000181149.
28. Menz HB, Auhl M, Spink MJ. Foot Problems as a Risk Factor for Falls in Community-Dwelling Older People: A Systematic Review and Meta-Analysis. Maturitas 2018; 118:7-14. doi: 10.1016/j.maturitas.2018.10.001.
29. Legters K. Fear of Falling. Phys Ther 2002; 82(3):264-272.
30. Delbaere K, Crombez G, Vanderstraeten G, Willems T, Cambier D. Fear-related Avoidance of Activities, Falls and Physical Frailty. A Prospective Community-Based Cohort Study. Age Ageing 2004; 33(4):368-373. doi: 10.1093/ageing/afh106.
31. Deshpande N, Metter EJ, Laurentani F, Bandinelli S, Guralnik J, Ferrucci L. Activity Restriction İnduced by Fear of Falling and Objective and Subjective Measures of Physical Function: A Prospective Cohort Study. J Am Geriatr Soc 2008; 56(4):615-620. doi: 10.1111/j.1532-5415.2007.01639.x.
32. Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI. Prevalence and Correlates of Fear of Falling, and Associated Avoidance of Activity in the General Population of Community-Living Older People. Age Ageing 2007;36(3):304-9.

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Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Research Articles
Authors	Raziye Şavkın Gökhan Bayrak Nihal Büker
Publication Date	April 1, 2021
Submission Date	November 13, 2019
Published in Issue	Year 2021Volume: 12 Issue: 2

Cite

EndNote	Şavkın R, Bayrak G, Büker N (April 1, 2021) Balance, Falls, Fear of Falling, and Foot Function in Elderly People in Community-Dwelling Older Adults. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 12 2 279–283.

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