ORCID Profile
0000-0002-4959-7448
Current Organisation
La Trobe University
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Publisher: American Podiatric Medical Association
Date: 11-2013
DOI: 10.7547/1030457
Abstract: Falls are common in older people and are associated with substantial health-care costs. A recent randomized controlled trial of a multifaceted podiatric medical intervention demonstrated a 36% reduction in the fall rate over 12 months. We evaluated the acceptability of and levels of satisfaction with this intervention in the older people who participated in the trial. Participants allocated to the intervention group (which included a home-based program of foot and ankle exercises, assistance with the purchase of safe footwear when necessary, and provision of prefabricated foot orthoses) completed a structured questionnaire 6 months after they had received the intervention. The questions addressed participants’ perceptions of their balance and foot and ankle strength, the perceived difficulty of the exercise program, and the degree of satisfaction with the footwear and orthoses provided. Of 153 participants, 134 (87.6%) attended the 6-month follow-up assessment and completed the questionnaire. Most participants perceived improvements in balance (62.7%) and foot and ankle strength (74.6%) after 6 months of performing the exercises, and 86.6% considered the difficulty level of the exercises to be “about right.” Most participants reported that they were somewhat or very satisfied with the footwear (92.3%) and orthoses (81.6%) provided. The multifaceted podiatric medical intervention used in this trial was generally perceived to be beneficial and demonstrated high levels of satisfaction among participants. Further research is now required to evaluate the feasibility of implementing the intervention in a range of clinical practice settings. (J Am Podiatr Med Assoc 103(6): 457–464, 2013)
Publisher: Springer Science and Business Media LLC
Date: 30-03-2009
Publisher: S. Karger AG
Date: 03-12-2009
DOI: 10.1159/000264655
Abstract: i Background: /i Age-related reduction in lower limb muscle strength has been shown to be related to disability, falls and loss of independence. While there have been a number of studies on age-related changes in muscle strength, they have concentrated on more proximal muscle groups with little research into how ageing affects the muscles of the foot and ankle. i Objective: /i To evaluate the intra- and interrater reliability of hand-held dynamometry for the assessment of foot and ankle strength, and to compare the values obtained between young and older people. i Methods: /i The muscle groups which perform ankle dorsiflexion, plantar flexion, inversion, eversion and plantar flexion of the hallux and lesser digits were recorded for 36 young participants (17 males, 19 females, mean age 23.2 ± 4.3 years) and 36 older people (17 males, 19 females, mean age 77.1 ± 5.7 years) using a Citec hand-held dynamometer. Differences in muscle strength between the groups as well as intrarater and interrater reliability of two assessors were determined. i Results: /i The reliability of the hand-held dynamometry procedure was excellent for both intrarater (ICC sub ,1 /sub = 0.78–0.94) and interrater (ICC sub ,1 /sub = 0.77–0.88) comparisons. There were significant differences between the muscle strength of the young and older participants for all muscle groups tested (p 0.001) with older participants being weaker than the young participants by a magnitude of between 24 and 37%. i Conclusions: /i Hand-held dynamometry is a reliable instrument to measure the foot and ankle strength of young and older adults. Ageing is associated with a reduction in strength of between 24 and 37% for the muscles responsible for movement of the foot and ankle.
Publisher: Springer Science and Business Media LLC
Date: 26-08-2011
Abstract: Despite emerging evidence that foot problems and inappropriate footwear increase the risk of falls, there is little evidence as to whether foot-related intervention strategies can be successfully implemented. The aim of this study was to evaluate adherence rates, barriers to adherence, and the predictors of adherence to a multifaceted podiatry intervention for the prevention of falls in older people. The intervention group (n = 153, mean age 74.2 years) of a randomised trial that investigated the effectiveness of a multifaceted podiatry intervention to prevent falls was assessed for adherence to the three components of the intervention: (i) foot orthoses, (ii) footwear advice and footwear cost subsidy, and (iii) a home-based foot and ankle exercise program. Adherence to each component and the barriers to adherence were documented, and separate discriminant function analyses were undertaken to identify factors that were significantly and independently associated with adherence to the three intervention components. Adherence to the three components of the intervention was as follows: foot orthoses (69%), footwear (54%) and home-based exercise (72%). Discriminant function analyses identified that being younger was the best predictor of orthoses use, higher physical health status and lower fear of falling were independent predictors of footwear adherence, and higher physical health status was the best predictor of exercise adherence. The predictive accuracy of these models was only modest, with 62 to 71% of participants correctly classified. Adherence to a multifaceted podiatry intervention in this trial ranged from 54 to 72%. People with better physical health, less fear of falling and a younger age exhibited greater adherence, suggesting that strategies need to be developed to enhance adherence in frailer older people who are most at risk of falling. Australian New Zealand Clinical Trials Registry ACTRN12608000065392 .
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: SAGE Publications
Date: 13-02-2015
Abstract: To determine, for adults with chronic low back pain, which exercise interventions are the most effective at reducing pain compared to other treatments. A search of MEDLINE, CINAHL, EMBASE, SPORTDiscus, PsycINFO and The Cochrane Library was conducted up to October 2014. Databases were searched for published reports of randomised trials that investigated the treatment of chronic low back pain of non-specific origin with an exercise intervention. Two authors independently reviewed and selected relevant trials. Methodological quality was evaluated using the Downs and Black tool. Forty-five trials met the inclusion criteria and thirty-nine were included in the meta-analysis. Combined meta-analysis revealed significantly lower chronic low back pain with intervention groups using exercise compared to a control group or other treatment group (Standard Mean Deviation (SMD) =-0.32, CI 95% -0.44 to -0.19, P .01). Separate exploratory subgroup analysis showed a significant effect for strength/resistance and coordination/stabilisation programs. Our results found a beneficial effect for strength/resistance and coordination/stabilisation exercise programs over other interventions in the treatment of chronic low back pain and that cardiorespiratory and combined exercise programs are ineffective.
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.GAITPOST.2011.07.016
Abstract: Foot problems are highly prevalent in older people. To treat such problems in this age-group prefabricated ('off-the-shelf') foot orthoses are frequently prescribed. However, such devices are susceptible to material compression and deformation, which may reduce their effectiveness over time. Therefore, the aim of this study was to compare the pressure-redistributing properties of new prefabricated orthoses to orthoses worn for at least 12 months. Thirty-one adults (10 males, 21 females) aged over 65 years (mean 75.4, SD 5.2) participated. Plantar pressure data were collected under the rearfoot, midfoot and forefoot using the Pedar(®) in-shoe system while participants walked along an 8m walkway wearing shoes only, new orthoses and old orthoses (orthoses were full length, dual-density prefabricated Formthotic™ devices). Compared to the shoe-only condition, both the new and old orthoses produced significant reductions in peak pressure and maximum force in the rearfoot with corresponding increases in force and contact area in the midfoot. Compared to the new orthoses, the old orthoses exhibited small but significant increases in peak pressure in the rearfoot (6%, p=0.001) and maximum force in the rearfoot (5%, p<0.001) and forefoot (2%, p=0.032). These findings indicate that the prefabricated orthoses evaluated in this study are only slightly less effective at redistributing plantar pressure after at least 12 months of wear.
Publisher: BMJ
Date: 16-06-2011
DOI: 10.1136/BMJ.D3411
Publisher: Springer Science and Business Media LLC
Date: 25-11-2008
Publisher: Springer Science and Business Media LLC
Date: 20-09-2010
Publisher: Elsevier BV
Date: 2011
DOI: 10.1016/J.APMR.2010.09.024
Abstract: 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. Cross-sectional study of people over 65 years. Community. Participants (N=305 age range, 65-93y) recruited for a randomized trial investigating the efficacy of a podiatry intervention to prevent falls. Not applicable. 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). 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. 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.
Publisher: Springer Science and Business Media LLC
Date: 29-04-2014
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Martin Spink.