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

65岁以上的人中有1/3会出现足部问题，并与步行速度减慢、日常生活活动困难、平衡受损和跌倒风险增加有关。尽管有一系列健康专业人员提供足部疾病的治疗，但老年人最常见的慢性足部问题(如鸡眼和老茧、指甲紊乱和脚趾畸形)通常由足科医生使用手术刀清创病变、足部矫形器、运动处方和鞋类修改等治疗方法来处理。1995年全国健康调查报告说，80岁或80岁以上的人最有可能在前两周去看足科医生，其次是65-79岁的人。同样，向退伍军人及其家属提供足部服务的澳大利亚退伍军人事务部记录了1998-1999年为103,540名退伍军人提供足部护理的606,706次，费用为2,300万美元。因此，足疗在维持老年澳大利亚人的足部健康和灵活性方面发挥着重要作用。尽管足部问题的有害影响和老年人广泛使用足部服务，但很少有人进行研究来确定足部治疗的效果。因此，这项研究的目的是评估个性化足部干预的效果，旨在减轻老年人的疼痛，增强功能活动能力，防止跌倒。鉴于老年人中与脚相关的残疾和跌倒的发生率很高，以及他们相关的医疗保健费用，这项研究结果将对公共卫生具有相当重要的意义。如果被发现在临床上有效，这种干预可以很容易地实施到一系列医疗保健环境中，并在州和联邦预防跌倒政策中采用。

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.