The Balance and Foot Health Program for Older Adults: A Randomized Study

The change in the Timed Up and Go test time, expressed in seconds

The Timed Up and Go is a commonly used screening tool to assess mobility in older adults. The participant must stand up from a chair, walk a distance of three meters, turn around, then walk back to the chair and sit down. These tasks must be performed in a comfortable and safe pace. A practice trial is allowed to help the individual become familiar with the task. The individual wears their usual shoes. The use of a walking aid is permitted, but its use must be noted on the data collection form. No physical assistance is provided. The TUG is also sensitive to changes, detecting improvements or deteriorations in functional mobility. It has high validity, being able to correctly identify fallers and non-fallers with a sensitivity and specificity of 87%. Finally, this test is accurate, simple to administer, and useful for assessing functional mobility, particularly in older or medically compromised populations.

Changes in the position of the center of pressure during static stance

Changes in the movement of the center of pressure in a static position, measured using a stabilometry platform, with eyes open and closed, at baseline assessment (T0), after the foot care intervention (T1), and at the end of the study (T2). Postural control is generally assessed by analyzing the length of the center of pressure trajectory, which quantifies the extent of body sway and stability while standing. The displacement of the center of pressure is widely recognized as one of the most reliable indicators of postural stability 43. When the eyes are open, postural control relies primarily on the visual system, whereas when the eyes are closed, the vestibular system, proprioceptive inputs, and plantar mechanoreceptors play a more significant role in maintaining balance.

Changes in the muscle strength of the flexors of the big toes (hallux)

Changes in muscle strength of the big toe flexors (hallux) measured using a dynamometer (The Toe Strength Dynamometer) at baseline assessment (T0) and after the foot care intervention (T1) and the end of the study (T2). In older adults, muscle strength loss has recently emerged as a risk factor for falls. The dynamometer used in this study demonstrated moderate to excellent intra-rater reliability, as well as good to excellent inter-rater reliability for all measurements.

Changes in ankle joint range of motion during dorsiflexion and plantar flexion

Changes in ankle joint range of motion in dorsiflexion and plantar flexion, measured using a digital goniometer, at baseline assessment (T0) and after the foot care intervention (T1) and the end of the study (T2). The Weight-Bearing Lunge test is commonly used to assess the range of dorsiflexion of the ankle. However, during our feasibility study, it proved difficult to perform in a population of very elderly individuals. To overcome this difficulty, we will use a digital goniometer.

Changes in participants' fear of falling

Changes in participants' fear of falling, measured using a 0-10 numerical rating scale at baseline assessment (T0) and after the foot care intervention (T1) and the end of the study (T2). The use of a binary question to assess fear of falling is reliable and easy to use in research and clinical practice, particularly in nursing homes.