Randomised controlled trial of a tailored podiatry intervention to enhance mobility and prevent falls in older people

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Foot problems affect 1 in 3 people over the age of 65 years and are associated with reduced walking speed, difficulty performing activities of daily living, impaired balance and increased risk of falls. Although a range of health professionals provide treatment for foot disorders, the most common chronic foot problems in older people (such as corns and calluses, nail disorders and toe deformities) are frequently managed by podiatrists using treatments such as scalpel debridement of lesions, foot orthoses, exercise prescription and footwear modifications. The 1995 National Health Survey reported that persons aged 80 years or over were most likely to have reported visiting a podiatrist in the previous two weeks, followed by those aged 65-79 years. Similarly, the Australian Department of Veterans Affairs, which provides podiatry services to veterans and their dependants, documented 606,706 episodes of podiatry care to 103,540 veterans in 1998-1999, at a cost of $23M. Podiatry therefore plays a substantial role in the maintenance of foot health and mobility in older Australians. Despite the detrimental effects of foot problems and the widespread utilisation of podiatry services by older people, very few studies have been undertaken to ascertain the efficacy of podiatry treatments. Therefore, the aim of this study is to evaluate the efficacy of an individualised podiatry intervention designed to reduce pain, enhance functional mobility and prevent falls in older people. Given the high prevalence of foot-related disability and falls in older people and their associated health care costs, the study findings will be of considerable public health importance. If found to be clinically effective, the intervention could be easily implemented into a range of healthcare settings and adopted in both state and federal falls prevention policies.