Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis

Wylie, G.; Morris, J.; Witham, M.; Campbell, P.; Frost, H.; Torrens, C.; Gordon, A.

Abstract

Background: The growing number of trials evaluating podiatry interventions to prevent falls in older people indicates that evidence synthesis to determine effectiveness is timely. This systematic review examined podiatry interventions for falls prevention delivered in the community and in care homes.
Methods: Systematic review and meta-analysis. We searched multiple electronic databases with no language restrictions. Randomised controlled trials (RCTs) or quasi-RCT studies documenting podiatry interventions in older people (aged 60+) were included. Two reviewers independently applied selection criteria and assessed methodological quality. TiDieR guidelines guided data extraction and meta-analysis was conducted where homogeneity allowed.
Results: From 32 717 titles and 3 118 screened abstracts, nine studies involving 6502 participants (range 40-3 727) met the inclusion criteria. Overall, risk of bias was low apart from participant and intervention provider blinding. Podiatry interventions were multifaceted (n=3), single component (n=2) or multifactorial, involving only podiatry assessment or referral (n=4). Seven studies were conducted in the community and two in care homes. Combining falls rate data showed significant effects for multifaceted podiatry interventions compared to usual care (n=3): falls rate ratio 0.77 [95% CI 0.61, 0.99]; and multifactorial interventions including podiatry (n=3): falls rate ratio: 0.73 [95% CI 0.54, 0.98]. Single component podiatry interventions demonstrated no significant effects on falls rate. Heterogeneity in other outcomes precluded meta-analysis.
Conclusions: Evidence suggests multifaceted podiatry interventions and multifactorial interventions involving referral to podiatry provide small but significant reductions in falls rate. Further evaluation of the effectiveness of podiatry within care home settings is required.

Citation

Wylie, G., Morris, J., Witham, M., Campbell, P., Frost, H., Torrens, C., & Gordon, A. (2019). Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis. Age and Ageing, 48(3), 327–336. https://doi.org/10.1093/ageing/afy189

• Journal Article Type: Article
• Acceptance Date: Oct 26, 2018
• Online Publication Date: Jan 7, 2019
• Publication Date: 2019-05
• Deposit Date: Dec 12, 2018
• Publicly Available Date: Jan 8, 2020
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 48
• Issue: 3
• Pages: 327–336
• DOI: https://doi.org/10.1093/ageing/afy189
• Keywords: Falls; Podiatry; Care homes; Community dwelling
• Public URL: https://nottingham-repository.worktribe.com/output/1407788
• Publisher URL: https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afy189/5274645
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Aging following peer review. The version of record Gavin Wylie, Claire Torrens, Pauline Campbell, Helen Frost, Adam Lee Gordon, Hylton B Menz, Dawn A Skelton, Frank Sullivan, Miles D Witham, Jacqui Morris; Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis, Age and Ageing, , afy189 is available online at https://doi.org/10.1093/ageing/afy189.