Francis Anthony B.

Losloso, RN
MAN-AHN
APRIL 2019

Article: Improvements in lower-limb muscle strength and foot pressure distribution with foot care in
frail elderly adults: a randomized controlled trial from Japan

Source: https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-019-1097-z

Synthesis:

Patient safety according to WHO is the absence of preventable harm to a patient during the
process of health care and reduction of risk of unnecessary harm associated with health, care to an
acceptable minimum. Patient safety is very important especially in geriatric patients in which they are
very vulnerable to falls and injuries. It may be caused by a disease process or natural occurrence due to
aging, however this issue still needs to be addressed.

Risk for fall and injuries are common with elderly with abnormalities in the feet and toenails
such as toenail thickening, wounds and curvature and formation of calluses on the soles of the feet. It
can also be caused by use of incorrect shoe size. These causes can diminish lower-limb muscle strength
and balance as a consequence of increasing life expectancy, incidence of foot problems also increases. It
may also be associated with dementia or other cognitive impairment.

A study conducted in Japan wherein 74 elderly adults with mean age of 80.3 + 7.5 years with
foot problems undergone a randomized controlled trial in which they are divided into three groups
based on their nursing care insurance system levels: certified ineligible for support, eligible for support,
or eligible for long-term care. A control group of 106 elderly adults in good health was recruited. This
study aimed to investigate the changes in toe-gap force, knee-gap force, foot pressure distribution, the
ability to perform activities of daily living, subjects’ feelings and behaviors and physical functioning
resulting from daily lifestyle modification and foot care.

The participants were given foot and toenail care by nurses whom are expert in providing such
treatment. Before the intervention, subjects were unable to move their toes. Positive outcomes of foot
care that is exhibited and expressed by the elderly involves being able to perform activities of daily living
such as putting socks or stockings independently. They are likely to walk without anxiety caused by foot
pain. They tend to be cheerful and become engaged socially with family and friends frequently. They
even asked if they can be provided with foot care monthly. Foot care is important in prevention of frailty
and long-term supportive care. As a result of the study, abnormalities in the participant’s feet and
toenails improved and it has been observed that there is a significant increase in their lower-limb muscle
strength and foot pressure distribution has improved decreasing their risk of falling.

Simple interventions can enhance patient’s well-being on how they can live their lives safely.
Foot care is not a difficult intervention, even lay-people can provide it to themselves. Giving health
education with this evidence-based practices are the key to promote simple interventions that are
meant to change and create a huge impact in one’s daily life especially the elderly.