Toe Plantarflexion Exercise for Prevention of Falls

Abstract

Category: Other Introduction/Purpose: Toe plantarflexion weakness has been suggested to be associated with a range of disorders and dysfunction. Although toe plantar strength (TPS) clearly contributes to the balance and gait problem, relationship between toe plantarflexion weakness and the prevention of falls is poorly understood. Therefore, we developed a new device that measures toe plantarflexion strength as strength to press the floor. The aim of this study was to assess the hypothesis that toe plantarflexion exercise can be the prevention of falls in elderly persons. Methods: A single-blinded randomized controlled trial was conducted in community-dwelling older adults (N = 99, mean age 74.4±6) without major cognitive impairment. The subjects were divided into two groups: 47 females in the toe plantarflexion exercise (Ex) group and 52 in the control (Cr) group by the simple random sampling method. Ex group participated toe exercise program under the supervision of a physiotherapist. The maximum toe plantarflexion forces of all participants were measured by using push-type toe grip strength meter in both upright and sitting position. The number of falls, Timed Up and Go Test (TUGT), one-legged stance time, Functional Reach Test (FRT), Fall Efficacy Score (FES) were assessed at baseline and 2 months, 6 months. All participants were prospectively followed up for one year to count the number of falls. Results: There was no difference in the total falls incidence between groups (p = 0.18). Ex group showed significantly improved maximum plantarflexion strength at 6 months assessment (left sitting; p = 0.03, left upright; P = 0.157, right sitting; P = 0.007, right upright; P = 0.047). One-legged stance time, FRT, FES did not differ between groups. Conclusion: Although the toe exercise program enhanced toe plantarflexion forces, the total falls incidence, one-legged stance time, FRT, FES did not differ between groups. Future research is needed to determine the role of toe plantarflexion force in the enhancement of strength, balance, and mobility.