Abstract
Ankle function declines with age. The objective of this study was to investigate the association between ankle function and balance in older adults, with a focus on range of motion (ROM) and strength. This was a cross-sectional study that included 88 healthy community-dwelling older adults. Ankle mobility was measured while bearing weight (lunge test) and not bearing weight. The plantar-flexor muscle strength was assessed using a hand-held dynamometer. Balance was measured in terms of dynamic balance and mobility (timed up and go test), monopodal and bipodal static balance with open and closed eyes (single-leg stand test and platform measures), and margins of stability (functional reach test). Linear correlation and multiple regression analyses were conducted with a 95% CI. Most participants had limited ankle mobility (n = 75, 86%). Weight-bearing ankle dorsiflexion ROM was the strongest predictor of dynamic balance and included general mobility and stability ([Formula: see text] = [0.34]; β = [-0.50]). In contrast, plantar-flexor muscle strength was a significant predictor of static standing balance with open eyes ([Formula: see text] = [0.16-0.2]; β = [0.29-0.34]). Overall, weight-bearing ankle dorsiflexion ROM was a more representative measure of balance and functional performance; however, a non-weight-bearing mobility assessment provides complementary information. Therefore, both measures can be used in clinical practice. This study supports the concept that ankle mobility contributes to the performance of dynamic tasks, while the plantar-flexor muscle strength helps to develop a standing static balance. Identification of alterations in ankle function is warranted and may assist in the design of tailored interventions. These interventions can be used in isolation or to augment conventional balance training in order to improve balance performance in community-dwelling older adults.
Highlights
Feet are the base of support for the body, while the ankle plays a key role in primary movements [1, 2]
Balance was measured in terms of dynamic balance and mobility, monopodal and bipodal static balance with open and closed eyes, and margins of stability
Weight-bearing ankle dorsiflexion range of motion (ROM) was the strongest predictor of dynamic balance and included general mobility and stability (R2adj = [0.34]; β = [-0.50])
Summary
Feet are the base of support for the body, while the ankle plays a key role in primary movements [1, 2]. Loss of strength and limited ankle mobility are both common with aging. Loss of ankle strength has been associated with altered postural sway, decreased walking speed, and reduced capacity to develop other functional movements [8,9,10]. It is well established that limited balance is a direct cause of falls and is a leading cause of morbidity and mortality. This results in social and economic costs for patients, families, and community services [7]. The objective of this study was to investigate the association between ankle function and balance in older adults, with a focus on range of motion (ROM) and strength.
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