title: Efficacy of a progressive resistance exercise program to increase toe flexor strength in older people.
abstract: BACKGROUND
  Reduced toe flexor strength is an independent predictor of falls in older people. However it is unknown whether strengthening programs can restore toe flexor strength in older individuals. The aim of this study was to investigate whether a progressive resistance training program, focused specifically on the foot muscles, could improve toe flexor strength in community-dwelling older people.
  
  
  METHODS
  After baseline testing, 85 men and women (age range 60-90years) were randomized to either a supervised, progressive resistance training (n=43) or a home-based exercise (n=42) group for 12weeks. A further 32 participants were recruited for a control group. The primary outcome measures were hallux and lesser toe flexor strength pre- and post-intervention. Secondary outcome measures were exercise compliance, components of the Foot Health Status Questionnaire and single-leg balance time.
  
  
  RESULTS
  Average class attendance was 89% with 68 participants from the two intervention groups (80%) completing the follow-up assessments. Participants in the supervised, progressive resistance training group significantly increased their toe strength (up to 36%; P<0.02), whereas there was no change in toe strength in either the home-based or control groups. This increased toe strength was accompanied by a significant improvement in perceived general foot health and single-leg balance time compared to the other groups (P<0.05).
  
  
  CONCLUSIONS
  Progressive resistance exercises are a viable intervention to increase toe flexor strength in older adults. A clinical trial is now required to determine whether this intervention can reduce the number of falls suffered by older adults.
authors: Biomechanics Research Laboratory, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia. Electronic address: Karen.mickle@vu.edu.au.
authors: Karen J
authors: KJ
authors: Mickle
authors: School of Psychology, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.
authors: Peter
authors: P
authors: Caputi
authors: Division of Aged Care, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, NSW 2500, Australia.
authors: Jan M
authors: JM
authors: Potter
authors: Biomechanics Research Laboratory, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.
authors: Julie R
authors: JR
authors: Steele
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005528:Foot / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D004856:Postural Balance / Q000502:physiology; D055070:Resistance Training / Q000379:methods*; D014034:Toes / Q000502:physiology*
keywords: Elderly; Falls; Resistance exercise; Toe strength