Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/28601
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis
Author(s): Wylie, Gavin
Torrens, Claire
Campbell, Pauline
Frost, Helen
Gordon, Adam Lee
Menz, Hylton B
Skelton, Dawn A
Sullivan, Frank
Witham, Miles
Morris, Jacqui
Keywords: Falls
Podiatry
Care homes
Community dwelling
older people
systematic review
Issue Date: May-2019
Citation: Wylie G, Torrens C, Campbell P, Frost H, Gordon AL, Menz HB, Skelton DA, Sullivan F, Witham M & Morris J (2019) Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis. Age and Ageing, 48 (3), pp. 327-336. https://doi.org/10.1093/ageing/afy189
Abstract: Background foot problems are independent risk factors for falls in older people. Podiatrists diagnose and treat a wide range of problems affecting the feet, ankles and lower limbs. However, the effectiveness of podiatry interventions to prevent falls in older people is unknown. This systematic review examined podiatry interventions for falls prevention delivered in the community and in care homes. Methods systematic review and meta-analysis. We searched multiple electronic databases with no language restrictions. Randomised or quasi-randomised-controlled trials documenting podiatry interventions in older people (aged 60+) were included. Two reviewers independently applied selection criteria and assessed methodological quality using the Cochrane Risk of Bias tool. TiDieR guidelines guided data extraction and where suitable statistical summary data were available, we combined the selected outcome data in pooled meta-analyses. Results from 35,857 titles and 5,201 screened abstracts, nine studies involving 6,502 participants (range 40–3,727) met the inclusion criteria. Interventions were single component podiatry (two studies), multifaceted podiatry (three studies), or multifactorial involving other components and referral to podiatry component (four studies). Seven studies were conducted in the community and two in care homes. Quality assessment showed overall low risk for selection bias, but unclear or high risk of detection bias in 4/9 studies. Combining falls rate data showed significant effects for multifaceted podiatry interventions compared to usual care (falls rate ratio 0.77 [95% CI 0.61, 0.99]); and multifactorial interventions including podiatry (falls rate ratio: 0.73 [95% CI 0.54, 0.98]). Single component podiatry interventions demonstrated no significant effects on falls rate. Conclusions multifaceted podiatry interventions and multifactorial interventions involving referral to podiatry produce significant reductions in falls rate. The effect of multi-component podiatry interventions and of podiatry within multifactorial interventions in care homes is unknown and requires further trial data.
DOI Link: 10.1093/ageing/afy189
Rights: © The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
Licence URL(s): http://creativecommons.org/licenses/by-nc/4.0/

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