title: Foot and ankle strength, range of motion, posture, and deformity are associated with balance and functional ability in older adults.
abstract: OBJECTIVE
  To determine the extent to which measures of foot and ankle strength, range of motion, posture, and deformity are associated with performance in a battery of balance and functional ability tests in older adults.
  
  
  METHODS
  Cross-sectional study of people over 65 years.
  
  
  METHODS
  Community.
  
  
  METHODS
  Participants (N=305; age range, 65-93y) recruited for a randomized trial investigating the efficacy of a podiatry intervention to prevent falls.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Clinical measures of foot and ankle strength (using hand-held dynamometry), range of motion, posture, and deformity, and a battery of balance tests (postural sway, maximum balance range, lateral stability, coordinated stability) and functional ability tests (alternate step test, sit-to-stand, timed 6-m walk).
  
  
  RESULTS
  Most (67/88) of the correlations between the foot and ankle tests and performance on the balance and functional tests were statistically significant. Hierarchic linear regression analysis identified hallux plantar flexion strength and ankle inversion-eversion range of motion to be the most consistent significant and independent predictors of balance and functional test performance, explaining up to 25% of the variance in the test scores.
  
  
  CONCLUSIONS
  Foot and ankle characteristics, particularly plantar flexor strength of the hallux and ankle inversion-eversion range of motion, are important determinants of balance and functional ability in older people. Further research is required to establish whether intervention programs that include strengthening and stretching exercises for the foot and ankle may achieve improvements in balance and functional ability and reduce the risk of falls in older people.
authors.affiliation: Musculoskeletal Research Centre, Department of Podiatry, La Trobe University, Bundoora, Australia. m.spink@latrobe.edu.au
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Spink
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Fotoohabadi
authors.forename: Elin
authors.initials: E
authors.lastname: Wee
authors.forename: Keith D
authors.initials: KD
authors.lastname: Hill
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Hylton B
authors.initials: HB
authors.lastname: Menz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005528:Foot / Q000502:physiology*; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D053581:Muscle Strength Dynamometer; D004856:Postural Balance; D011187:Posture; D016059:Range of Motion, Articular