title: Absent pedal pulse and impaired balance in older people: a cross-sectional and longitudinal study.
abstract: OBJECTIVE
  The purpose of this study was to determine the relationship between abnormal pedal pulse status and postural balance in older people.
  
  
  METHODS
  Prospective, population-based cohort study of older residents in the city of Jyväskylä, Finland. A total of 419 individuals aged 75 or 80 at baseline, with known lower extremity pulse status and balance tests performed on a force platform, were eligible for analysis.
  
  
  RESULTS
  Cross-sectionally, persons with both dorsal pedal artery pulses absent were found to sway more (p=0.047 anteroposterior velocity, normal standing eyes-open position). The risk of being unable to do the full tandem stance was twofold (OR=2.20, 95% CI 1.29-3.78) for persons without palpable dorsal pedal arteries compared with those with normal pulse status. Balance deterioration was observed at five years (p<0.001 for time) but without group-by-time interaction. At ten years, however, the interaction term became significant for the normal standing eyes-closed position (p=0.025 for anteroposterior velocity and p=0.026 for mediolateral velocity), indicating greater balance deterioration among those with both dorsal pedal artery pulses absent.
  
  
  CONCLUSIONS
  According to our study, the absence of both dorsal pedal artery pulses is associated with impaired balance in older people. The association was observed both cross-sectionally and longitudinally. In addition, as diminished pedal pulses are frequently associated with impaired lower extremity circulation, our results have also produced information on the possible pathophysiological mechanisms of balance deterioration in older people, which warrant further study.
authors.affiliation: Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland. velipekka.suominen@pshp.fi
authors.forename: Velipekka
authors.initials: V
authors.lastname: Suominen
authors.forename: Juha
authors.initials: J
authors.lastname: Salenius
authors.forename: Eino
authors.initials: E
authors.lastname: Heikkinen
authors.forename: Maarit
authors.initials: M
authors.lastname: Heikkinen
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005528:Foot / Q000098:blood supply*; D015577:Geriatric Assessment; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011674:Pulse