Predictors of adherence to a multifaceted podiatry intervention for the prevention of falls in older people

BMC Geriatrics

Research Article

Mohammad R Fotoohabadi¹  Elin Wee¹  Hylton B Menz¹  Karl B Landorf²  Martin J Spink²  Keith D Hill³  Stephen R Lord⁴ 

[1] Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia;Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia;Department of Podiatry, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia;Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia;Division of Allied Health, Northern Health, Epping, Victoria, Australia;Preventive and Public Health Division, National Ageing Research Institute, Parkville, Victoria, Australia;Neuroscience Research Australia, Randwick, Sydney, NSW, Australia;School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia;

关键词: Discriminant Function Analysis;    Fall Prevention Program;    Fall Prevention Strategy;    Fall Prevention Intervention;    Physiological Profile Assessment;   

DOI  :  10.1186/1471-2318-11-51

 received in 2011-05-13, accepted in 2011-08-26,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundDespite 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.MethodsThe 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.ResultsAdherence 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.ConclusionsAdherence 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 registrationAustralian New Zealand Clinical Trials Registry ACTRN12608000065392.

【 授权许可】

Unknown   
© Spink et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.