The podiatrist’s role in preventing falls in the elderly has recently got some attention at the international level. At the national meeting of the American Podiatric Medical Association, podiatrist Doug Richie Jr. presented information regarding the podiatrist’s role in preventing falls in the elderly. Some of the research that he presented was from a study by a podiatry group in Australia, who have contributed significantly to the understanding of the topic.
The Australian study led by by Dr. Martin J. Spink of La Trobe University looked at the effect of a multi-faceted podiatry intervention for older adults compared to routine podiatry care. Multi-faceted intervention was defined as the use of customized foot orthoses, advice on footwear and a subsidy for footwear, home-based foot and ankle exercises, a pamphlet of information regarding fall prevention, and routine podiatry care for a period of 12 months.
The study found that the group receiving the multi-faceted podiatry intervention suffered from 36% fewer falls than the patients randomized to the routine podiatry care group. Muscle strength, range of motion, and balance were all significantly and statistically improved in the intervention group when compared to the routine care group.
This study, in combination of what we already know about falls in the elderly, could be a very important piece of information in the way that health care is delivered. Fall prevention is a major priority in hospitals, with everyone involved in patient care also involved in the prevention of falls. Falls in the elderly can lead to disabling and even life-threatening injuries such as fractures and head injuries. It has been reported that over half of people over the age of 65 years will experience a fall each year, and that a third of these falls will lead to significant injury. The amounts to a health care cost exceeding $20 billion in the management of these injuries, which is projected to double in the next 15 years due to the aging population in the United States. Clearly, the cost associated with these serious injuries is a potential source of savings when discussing Medicare/Medicaid funding.
The role of the podiatrist in preventing falls is likely to increase with more knowledge and awareness of the subject. This prevention hinges on early detection of potential risk factors, including existing foot and ankle pathology, diabetic neuropathy, impaired vision, and impaired mobility just to name a few. Conservative measures such as muscle strength testing, range of motion testing, gait analysis, and the use of customized orthotics and bracing can have a great impact on the health and well-being of the elderly patient, and prevent a potential fall.
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