Abstract
Foot disorders are common in older adults and associated with impaired lower extremity function. Reduced muscle mass may play a role in the etiology of foot disorders and consequent poor function. We examined the association of leg lean mass with foot pain, posture and function among 1,795 individuals (mean age 67 years) from the population-based Framingham Foot Study (2002-2008). Pain was assessed via questionnaire, and a pressure mat classified foot posture (arch: high, low, referent) during standing and function (pronation, supination, referent) during gait. Leg lean mass was measured by whole body dual energy x-ray absorptiometry. In age- and body mass index-adjusted logistic (pain) and multinomial logistic (posture, function) regression models, a 1-standard deviation increase in leg lean mass was associated with lower odds of foot pain (OR = 0.76, 95% CI: 0.68, 0.86) and pronation (OR = 0.76, 95% CI: 0.67, 0.85), and higher odds of supination (OR = 1.17, 95% CI: 1.04, 1.31). Adjustment for sex attenuated these associations. Higher leg lean mass was associated with lower odds of high arch, even after adjustment for sex (OR = 0.73, 95% CI: 0.60, 0.89). Though not related to foot pain or function, reduced leg lean mass was associated with extreme foot posture in older adults. Loss of muscle mass with aging may thus play a role in the etiology of functional impairment due to foot disorders.
Highlights
Foot disorders are common in older adults and associated with impaired lower extremity function
Among our population of older adults, we found that in the overall population higher leg lean mass was associated with lower odds of foot pain, lower odds of pronation, and higher odds of supination, but that these associations were completely explained by sex
dual-energy x-ray absorptiometry (DXA) lean mass is, unable to assess specific muscles in the leg, we are unable to determine if it is an imbalance in antagonist pairs, rather than general decreased muscle mass, which was associated with pes cavus in our study population
Summary
Foot disorders are common in older adults and associated with impaired lower extremity function. There is growing evidence that foot pain is associated with impaired lower extremity function [2,3], balance and gait disorders [4,5], mobility disability [6,7], and falls [8,9,10] Despite these observed associations, the mechanistic pathways linking foot pain with poor function and disability have not been fully elucidated. Evidence from studies of runners suggests that weakness in lower leg [19] and hip-stabilizing muscles [20] can lead to disturbed lower extremity mechanics, resulting in over-pronation of the foot Such atypical foot posture and foot function have been associated with foot pain in population-based studies [21,22,23]
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