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

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  • Wylie, G. et al (2019) Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis

    Rights statement: © The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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Original languageEnglish
Article numberafy189
Number of pages10
JournalAge and Ageing
DOIs
StatePublished - 7 Jan 2019

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.

Keywords

  • podiatry, systematic literature review, intervention, falls prevention, care homes, community dwelling, older people