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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.

Authors

G. Wylie

J. Morris

M. Witham

P. Campbell

H. Frost

C. Torrens

ADAM GORDON Adam.Gordon@nottingham.ac.uk
Professor of The Care of Older People



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.

Journal Article Type Article
Publication Date 2019-05
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
APA6 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
DOI https://doi.org/10.1093/ageing/afy189
Keywords Falls; Podiatry; Care homes; Community dwelling
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.

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