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Predictors of adherence to a multifaceted podiatry intervention for the prevention of falls in older people
journal contribution
posted on 2021-05-27, 04:09 authored by MJ Spink, Mohammadreza FotoohabadiMohammadreza Fotoohabadi, E Wee, Karl LandorfKarl Landorf, KD Hill, SR Lord, Hylton MenzHylton MenzBackground: Despite emerging evidence that foot problems and inappropriate footwear increase the risk of falls, there is little evidence as to whether foot-related intervention strategies can be successfully implemented. The aim of this study was to evaluate adherence rates, barriers to adherence, and the predictors of adherence to a multifaceted podiatry intervention for the prevention of falls in older people. Methods. The intervention group (n = 153, mean age 74.2 years) of a randomised trial that investigated the effectiveness of a multifaceted podiatry intervention to prevent falls was assessed for adherence to the three components of the intervention: (i) foot orthoses, (ii) footwear advice and footwear cost subsidy, and (iii) a home-based foot and ankle exercise program. Adherence to each component and the barriers to adherence were documented, and separate discriminant function analyses were undertaken to identify factors that were significantly and independently associated with adherence to the three intervention components. Results: Adherence to the three components of the intervention was as follows: foot orthoses (69%), footwear (54%) and home-based exercise (72%). Discriminant function analyses identified that being younger was the best predictor of orthoses use, higher physical health status and lower fear of falling were independent predictors of footwear adherence, and higher physical health status was the best predictor of exercise adherence. The predictive accuracy of these models was only modest, with 62 to 71% of participants correctly classified. Conclusions: Adherence to a multifaceted podiatry intervention in this trial ranged from 54 to 72%. People with better physical health, less fear of falling and a younger age exhibited greater adherence, suggesting that strategies need to be developed to enhance adherence in frailer older people who are most at risk of falling. Trial registration. Australian New Zealand Clinical Trials Registry ACTRN12608000065392. © 2011 Spink et al; licensee BioMed Central Ltd.
Funding
This study was funded by the National Health and Medical Research Council of Australia and the La Trobe University Central Large Grant Scheme. HBM is currently a National Health and Medical Research Council Fellow (Clinical Career Development Award, ID: 433049). The foot orthoses in this study were provided by Foot Science International Ltd, Christchurch, New Zealand. The study funders played no role in the design, execution, analysis and interpretation of data, or writing of the study.
History
Publication Date
2011-08-30Journal
BMC GeriatricsVolume
11Issue
1Article Number
ARTN 51Pagination
8p.Publisher
BMCISSN
1471-2318Rights Statement
The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.Publisher DOI
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Science & TechnologyLife Sciences & BiomedicineGeriatrics & GerontologyGerontologyWEARING THERAPEUTIC FOOTWEARRANDOMIZED CONTROLLED-TRIALHOME-BASED EXERCISERISK-FACTORSQUESTIONNAIREEFFICACYPROGRAMWOMENRECOMMENDATIONSEXPERIENCESHumansExercise TherapyRisk FactorsPredictive Value of TestsOrthotic DevicesPatient CompliancePodiatryAccidental FallsAgedAged, 80 and overFemaleMaleGeriatrics