Assessment of the toes flexor musculature in institutionalized and community-dwelling older adults: biomechanical aspects, mobility and falls
DOI:
https://doi.org/10.1590/1809-2950/17342225012018Keywords:
Aging, Muscle Strength, Foot, Accidents by Falls, Hallux ValgusAbstract
Morphological, biomechanical and functional changes in the feet may increase the risk of fall in older adults. Institutionalized older adults have less mobility and greater risk of falling. The aim of this study is to check the relationship of the feet’s characteristics with the mobility and falls of institutionalized or active community-dwelling older adults. A total of 15 institutionalized and 15 community-dwelling older adults participated in this study. They were assessed considering the incidence of falls and through the Timed Up and Go Test; presence of hallux valgus; and strength peak of the muscles of the hallux and toes measured by a pressure platform. The variance analysis was used to compare the groups. As a result, the community-dwelling older adults showed greater muscle strength of the toe flexor muscles than institutionalized older adults (p<0.05) and better functional mobility. We observed the risk of fall in institutionalized older adults. Hallux valgus of mild degree was the most common deformity. The Pearson’s correlation coefficient showed no correlation between the analyzed variables and incidence of falls. We concluded that the strength of toe flexor muscles is greater in community-dwelling older adults, as well as the functional mobility, when compared with institutionalized older adults.Downloads
References
Rao SS. Prevention of falls in older patients. Am Fam Physician.
;72(1):81-8.
Alves NB, Scheicher ME. Equilíbrio postural e risco para quedas
em idosos da cidade de Garça, SP. Rev Bras Geriatr Gerontol.
;14(4):763-68. doi: 10.1590/S1809-98232011000400015
Lord SR, Menz HB, Tiedemann A. A physiological profile
approach to falls risk assessment and prevention. Phys Ther.
;83(3):237-52. doi: 10.1093/ptj/83.3.237
King GW, Abreu, EL, Cheng AL, Chertoff KK, Brotto L, Kelly
PJ, et al. A multimodal assessment of balance in elderly and
young adults. Oncotarget. 2016;7(12):13297-306. doi: 10.18632/
oncotarget.7758
Thapa TB, Gideon P, Brockman KG, Fought RL, Ray AW. Clinical
and biomechanical measures of balance as fall predictors in
ambulatory nursing home residents. J Gerontol A Biol Sci Med
Sci. 1996;51(5):M239-46. doi: 10.1093/gerona/51A.5.M239
Teixeira AR, Wender MH, Gonçalves AK, Freitas CLR, Santos
AMPV, Soldera CLC. Dizziness, physical exercise, falls, and
depression in adults and the elderly. Int Arch Otorhinolaryngol.
;20(2):124-31. doi: 10.1055/s-0035-1566304
Hammerschmidt KSA, Avila JBG, Santos SSC. Princípios
básicos de geriatria e gerontologia. Ciênc Saúde Coletiva.
;15(6):2997-8 doi: 10.1590/S1413-81232010000600038
Puerro Neto J, Raso W, Brito CAF. Mobilidade funcional em
função da força muscular em mulheres idosas fisicamente
ativas. Rev Bras Med Esporte. 2015;21(5):369-71. doi:
1590/1517-869220152105112756
Menz HB, Morris, ME. Determinants of disabling foot pain
in retirement village residents. J Am Podiatr Med Assoc.
;95(6):573-9. doi: 10.7547/0950573
Magee, DJ. Avaliação musculoesquelética. 4th ed. Baueri:
Manole; 2005.
Menz HB, Lord SR. Gait instability in older people with
hallux valgus. Foot Ankle Int. 2005;26(6):483-9. doi:
/10710070502600610
Kirchner M, Schubert P, Getrost T, Haas CT. Effect of altered
surfaces on postural sway characteristics in elderly subjects. Hum
Mov Sci. 2013;32(6):1467-79. doi: 10.1016/j.humov.2013.05.005
Buatois S, Perret-Guillaume C, Gueguen R, Vançon G, Perrin P,
Benetos A. A simple clinical scale to stratify risk of recurrent
falls in community-dwelling adults aged 65 years and older.
Phys Ther. 2010;90(4):550-60. doi: 10.2522/ptj.20090158
Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto
IH. Sugestões para o uso do mini-exame do estado mental.
Arq Neuro-Psiquiatr. 2003;61(3B):777-81. doi: 10.1590/
S0004-282X2003000500014
Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte
MJ, Lee IM, et al. American College of Sports Medicine position
stand. Quantity and quality of exercise for developing and
maintaining cardiorespiratory, musculoskeletal and neuromotor
fitness in apparently healthy adults: guidance for prescribing
exercise. Med Sci Sports Exerc. 2011;43(7):1334-59. doi: 10.1249/
MSS.0b013e318213fefb
Lamb SE, Jorstad-Stein EC, Hauer K, Becker C, Prevention
of Falls Network Europe and Outcomes Consensus Group.
Development of a common outcome data set for fall injury
prevention trials: the Prevention of Falls Network Europe
consensus. J Am Geriatr Soc. 2005;53(9):1618-22. doi:
1111/j.1532-5415.2005.53455.x
Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic
functional mobility for frail elderly persons. J Am Geriatr Soc.
;39(2):142-8. doi: 10.1590/S0103-05822013000300016
Alexandre TS, Meira DM, Rico NC, Mizuta SK. Accuracy of Timed
Up and Go Test for screening risk of falls among communitydwelling elderly. Rev Bras Fisioter. 2012;16(5):381-8. doi: 10.1590/
S1413-35552012005000041
Menz HB, Fotoohabadi MR, Wee E, Spink MJ. Validity of selfassessment of hallux valgus using the Manchester scale. BMC
Musculoskeletal Disorders. 2010;11:215. doi: 10.1186/1471-2474-11-215
Mickle KJ, Chambers S, Steele JR, Munro BJ. A novel and
reliable method to measure toe flexor strength. Clin Biomech.
;23:683. doi: 10.1016/j.clinbiomech.2008.03.025
Scott G, Menz HB, Newcombe L. Age-related differences in
foot structure and function. Gait Posture. 2007;26(1):68-75.
doi: 10.1016/j.gaitpost.2006.07.009
Mickle KJ, Munro BJ, Lord S, Menz HB, Steele JR. ISB Clinical
Biomechanics Award 2009: toe weakness and deformity
increased the risk of falls in older people. Clin Biomech.
;24(10):787-91. doi: 10.1016/j.clinbiomech.2009.08.011
Goldmann JP, Sanno M, Willwacher S, Heinrich K,
Bruggemann GP. The potential of toe flexor muscles to
enhance performance. J Sports Sci. 2013;31(4):424-33. doi:
1080/02640414.2012.736627
Gonçalvez LHT, Silva AH, Mazo GM, Benedetti TRB, Santos
SMA, Marques S, et al. O idoso institucionalizado: avaliação
da capacidade funcional e aptidão física. Cad Saúde Pública.
;26(9):1738-46. doi: 10.1590/S0102-311X2010000900007
Menz, HB, Morris ME, Lord SR. Foot and ankle risk factors for
falls in older people: a prospective study. J Gerontol A Biol Sci
Med Sci. 2006;61(8):886-70. doi: 10.1093/gerona/61.8.866
Ferreira DCO, Yoshitome AY. Prevalência e caraterísticas das
quedas de idosos institucionalizados. Rev Bras Enfermagem.
;63(6)991-7. doi: 10.1590/S0034-71672010000600019
Couto FBD, Perracini MR. Análise multifatorial do perfil de idosos
ativos com histórico de quedas. Rev Bras Geriatr Gerontol.
;15(4):693-706. doi: 10.1590/S1809-98232012000400010
Kron M, Loy S, Sturm E, Nikolaus T, Becker C. Risk indicators
for falls in institutionalized frail elderly. Am J Epidemiol.
;158(7):645-53. doi:10.1093/aje/kwg203
Lima LCA, Ansai JH, Andrade LP, Takahashi ACM. The
relationship between dual-task and cognitive performance
among elderly participants who exercise regularly. Braz J Phys
Ther. 2015;19(2):159-66. doi: 10.1590/bjpt-rbf.2014.0082
Macedo DO, Freitas LM, Scheicher ME. Preensão palmar
e mobilidade funcional em idosos com diferentes níveis
de atividade física. Fisioter Pesqui. 2014;21(2):151-5. doi:
1590/1809-2950/47321022014
DeSure AR, Peterson K, Gianan FV, Pang L. An exercise program
to prevent falls in institutionalized elderly qith cognitive
deficits: a crossover pilot study. Hawaii J Med Public Health.
;72(11):391-5.
Era P, Sainio P, Koskinen S, Haavisto P, Vaara M, Aromaa A.
Postural balance in a random sample of 7,979 subjects aged
years and over. Gerontology. 2006;52(4):204-13. doi:
1159/000093652
Souza PD, Benedetti TRB, Borges LJ, Mazo GZ, Gonçalvez LHT.
Aptidão funcional de idosos residentes em uma instituição de
longa permanência. Rev Bras Geriatr Gerontol. 2011;14(1):7-16.
doi: 10.1590/S1809-98232011000100002
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