Influence of foot pain on frailty symptoms in an elderly population

a case-control study

Authors

Keywords:

Frail elderly, Aged, Surveys and questionnaire, Foot deformities, Foot diseases

Abstract

BACKGROUND: Frailty is a condition that can increase the risk of falls. In addition, foot disorders can negatively influence elderly people, thus affecting their condition of frailty. OBJECTIVE: To determine whether foot pain can influence a greater degree of frailty. DESIGN AND SETTING: Cross-sectional descriptive study conducted at the University of Valencia, Valencia, Spain. METHODS: A sample older than 60 years (n = 52), including 26 healthy subjects and 26 foot pain patients, was recruited. Frailty disability was measured using the 5-Frailty scale and the Edmonton Frailty scale (EFS). RESULTS: There were statistically significant differences in the total EFS score and in most of its subscales, according to the Mann-Whitney U test (P < 0.05). In addition, foot pain patients presented worse scores (higher 5-Frailty scores) than did healthy patients, regarding matched-paired subjects (lower EFS scores). With regard to the rest of the measurements, there were no statistically significant differences (P > 0.05). The highest scores (P < 0.001) were for fatigue on the 5-Frailty scale and the EFS, and for the subscale of independence function in EFS. CONCLUSIONS: These elderly patients presented impairment relating to ambulation and total 5-Frailty score, which seemed to be linked to the presence of frailty syndrome and foot disorders.

Downloads

Download data is not yet available.

Author Biographies

Emmanuel Navarro-Flores, University of Valencia

MSc, PhD, DPM. Assistant Professor, Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia; and Frailty Research Organized Group (FROG), University of Valencia, Valencia, Spain.

Ricardo Becerro-de-Bengoa-Vallejo, University of Valencia

RN, BSc, MLIS, DPM, DHL, PhD. Full Professor, Department of Physiotherapy and Podiatry, School of Nursing, Universidad Complutense de Madrid, Madrid, Spain.

César Calvo-Lobo, University of Valencia

PT, MSc, PhD. Assistant Professor, Department of Physiotherapy and Podiatry, School of Nursing, Universidad Complutense de Madrid, Madrid, Spain.

Marta Elena Losa-Iglesias, University of Valencia

RN, MSc, PhD, DPM. Full Professor, Department of Nursing and Stomatology, School of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain

Patricia Palomo-López, University of Valencia

MSc, PhD, DPM. Senior Lecturer, Department of Nursing, University Center of Plasencia, Universidad de Extremadura, Spain

Victoria Mazoteras-Pardo, University of Valencia

RN, MSc, PhD. Assistant Professor, Department of Nursing, Physiotherapy and Occupational Therapy, School of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain.

Carlos Romero-Morales, University of Valencia

PT, MSc, PhD. Senior Lecturer, Department of Sport Sciences, School of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain.

Daniel López-López, University of Valencia

MSc, PhD, DPM. Senior Lecturer and Researcher, Health and Podiatry Group, Department of Health Sciences, School of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain

References

López-López D, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, et al. Evaluation of foot health related quality of life in individuals with foot problems by gender: a cross-sectional comparative analysis study. BMJ Open. 2018;8(10):e023980. PMID: 30341140; https://doi.org/10.1136/bmjopen-2018-023980.

Kamiya K, Hamazaki N, Matsue Y, et al. Gait speed has comparable prognostic capability to six-minute walk distance in older patients with cardiovascular disease. Eur J Prev Cardiol. 2018;25(2):212-9. PMID: 28990422; https://doi.org/10.1177/2047487317735715.

Bernhard FP, Sartor J, Bettecken K, et al. Wearables for gait and balance assessment in the neurological ward - study design and first results of a prospective cross-sectional feasibility study with 384 inpatients. BMC Neurol. 2018;18(1):114. PMID: 30115021; https://doi.org/10.1186/s12883-018-1111-7.

Thiede R, Toosizadeh N, Mills JL, et al. Gait and balance assessments as early indicators of frailty in patients with known peripheral artery disease. Clin Biomech (Bristol, Avon). 2016;32:1-7. PMID: 26775227; https://doi.org/10.1016/j.clinbiomech.2015.12.002.

Navarro-Flores E, Pérez-Ros P, Martínez-Arnau FM, Julían-Rochina I, Cauli O. Neuro-Psychiatric Alterations in Patients with Diabetic Foot Syndrome. CNS Neurol Disord Drug Targets. 2019;18(8):598-608. PMID: 31577209; https://doi.org/10.21741871527318666191002094406.

Faller JW, Pereira DDN, de Souza S, et al. Instruments for the detection of frailty syndrome in older adults: A systematic review. PLoS One. 2019;14(4):e0216166. PMID: 31034516; https://doi.org/10.1371/journal.pone.0216166.

Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc. 2012;60(8):1487-92. PMID: 22881367; https://doi.org/10.1111/j.1532-5415.2012.04054.x

Hawke F, Burns J. Understanding the nature and mechanism of foot pain. J Foot Ankle Res. 2009;2:1. PMID: 19144200; https://doi.org/10.1186/1757-1146-2-1.

Rodríguez-Sanz D, Tovaruela-Carrión N, López-López D, et al. Foot disorders in the elderly: A mini-review. Dis Mon. 2018;64(3):64-91. PMID: 28826743; https://doi.org/10.1016/j.disamonth.2017.08.001.

Menz HB, Jordan KP, Roddy E, Croft PR. Characteristics of primary care consultations for musculoskeletal foot and ankle problems in the UK. Rheumatology (Oxford). 2010;49(7):1391-8. PMID: 20403912; https://doi.org/10.1093/rheumatology/keq092.

Benvenuti F, Ferrucci L, Guralnik JM, Gangemi S, Baroni A. Foot pain and disability in older persons: an epidemiologic survey. J Am Geriatr Soc. 1995;43(5):479-84. PMID: 7730527; https://doi.org/10.1111/j.1532-5415.1995.tb06092.x.A

Navarro-Flores E, Losa-Iglesias ME, Becerro-de-Bengoa-Vallejo R, et al. Translation and Test-Retest of the Spanish Podiatry Health Questionnaire (PHQ-S). Int J Environ Res Public Health. 2018;15(10):2205. PMID: 30308957; https://doi.org/10.3390/ijerph15102205.

Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. Cross-sectional analysis of foot function, functional ability, and health-related quality of life in older people with disabling foot pain. Arthritis Care Res (Hoboken). 2011;63(11):1592-8. PMID: 22034121; https://doi.org/10.1002/acr.20578.

Kaoulla P, Frescos N, Menz HB. A survey of foot problems in community-dwelling older Greek Australians. J Foot Ankle Res. 2011;4(1):23. PMID: 22014069; https://doi.org/10.1186/1757-1146-4-23.

Aprahamian I, Cezar NOC, Izbicki R, et al. Screening for Frailty With the FRAIL Scale: A Comparison With the Phenotype Criteria. J Am Med Dir Assoc. 2017;18(7):592-6. PMID: 28279607; https://doi.org/10.1016/j.jamda.2017.01.009.

Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing. 2006;35(5):526-9. PMID: 16757522; https://doi.org/10.1093/ageing/afl041.

Aygör HE, Fadıloğlu Ç, Şahin S, Aykar FŞ, Akçiçek F. Validation of edmonton frail scale into elderly Turkish population. Arch Gerontol Geriatr. 2018;76:133-7. PMID: 29499529; https://doi.org/10.1016/j.archger.2018.02.003.

Vandenbroucke JP, von Elm E, Altman DG, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg. 2014;12(12):1500-24. PMID: 25046751; https://doi.org/10.1016/j.ijsu.2014.07.014.

Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001 Dec;8(12):1153-7. PMID: 11733293; https://doi.org/10.1111/j.1553-2712.2001.tb01132.x.

Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-56. PMID: 11253156; https://doi.org/10.1093/gerona/56.3.m146.

Perna S, Francis MD, Bologna C, et al. Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools. BMC Geriatr. 2017;17(1):2. PMID: 28049443; https://doi.org/10.1186/s12877-016-0382-3.

Woo J, Yu R, Wong M, et al. Frailty Screening in the Community Using the FRAIL Scale. J Am Med Dir Assoc. 2015;16(5):412-9. PMID: 25732832; https://doi.org/10.1016/j.jamda.2015.01.087.

Pijpers E, Ferreira I, Stehouwer CD, Nieuwenhuijzen Kruseman AC. The frailty dilemma. Review of the predictive accuracy of major frailty scores. Eur J Intern Med. 2012;23(2):118-23. PMID: 22284239; https://doi.org/10.1016/j.ejim.2011.09.003.

Toosizadeh N, Mohler J, Najafi B. Assessing Upper Extremity Motion: An Innovative Method to Identify Frailty. J Am Geriatr Soc. 2015;63(6):1181-6. PMID: 26096391; https://doi.org/10.1111/jgs.13451.

Díaz de León González E, Gutiérrez Hermosillo H, Martinez Beltran JA, et al. Validation of the FRAIL scale in Mexican elderly: results from the Mexican Health and Aging Study. Aging Clin Exp Res. 2016;28(5):901-8. PMID: 26646253; https://doi.org/10.1007/s40520-015-0497-y.

Navarro-Flores E, de Bengoa Vallejo RB, Losa-Iglesias ME, et al. The reliability, validity, and sensitivity of the Edmonton Frail Scale (EFS) in older adults with foot disorders. Aging (Albany NY). 2020;12(24):24623-32. PMID: 33349621; https://doi.org/10.18632/aging.202140.

Navarro-Flores E, Romero-Morales C, Becerro de Bengoa-Vallejo R, et al. Sex Differences in Frail Older Adults with Foot Pain in a Spanish Population: An Observational Study. Int J Environ Res Public Health. 2020;17(17):6141. MID: 32847063; https://doi.org/10.3390/ijerph17176141.

Martínez-Amat A, Hita-Contreras F, Lomas-Vega R, et al. Effects of 12-week proprioception training program on postural stability, gait, and balance in older adults: a controlled clinical trial. J Strength Cond Res. 2013;27(8):2180-8. PMID: 23207891; https://doi.org/10.1519/JSC.0b013e31827da35f.

Pérez-Ros P, Vila-Candel R, Martínez-Arnau FM. A home-based exercise program focused on proprioception to reduce falls in frail and pre-frail community-dwelling older adults. Geriatr Nurs. 2020;41(4):436-44. PMID: 32199736; https://doi.org/10.1016/j.gerinurse.2020.01.017.

Fabrício-Wehbe SCC, Cruz IR, Haas VJ, et al. Reprodutibilidade da versão brasileira adaptada da Edmonton Frail Scale para idosos residentes na comunidade. Rev Lat Am Enfermagem. 2013;21(6):1330-6. http://dx.doi.org/10.1590/0104-1169.2933.2371.

Hilmer SN, Perera V, Mitchell S, et al. The assessment of frailty in older people in acute care. Australas J Ageing. 2009;28(4):182-8. PMID: 19951339; https://doi.org/10.1111/j.1741-6612.2009.00367.x.

Braun T, Grüneberg C, Thiel C. German translation, cross-cultural adaptation and diagnostic test accuracy of three frailty screening tools : PRISMA-7, FRAIL scale and Groningen Frailty Indicator. Z Gerontol Geriatr. 2018;51(3):282-92. PMID: 28795247; https://doi.org/10.1007/s00391-017-1295-2.

Fabrício-Wehbe SCC, Schiaveto FV, Vendrusculo TRP, et al. Adaptación cultural y validez de la Edmonton frail scale - EFS en una muestra de ancianos Brasileños. Rev Lat Am Enfermagem. 2009;17(6):1043-9. https://doi.org/10.1590/S0104-11692009000600018.

Downloads

Published

2021-07-01

How to Cite

1.
Navarro-Flores E, Becerro-de-Bengoa-Vallejo R, Calvo-Lobo C, Losa-Iglesias ME, Palomo-López P, Mazoteras-Pardo V, Romero-Morales C, López-López D. Influence of foot pain on frailty symptoms in an elderly population: a case-control study. Sao Paulo Med J [Internet]. 2021 Jul. 1 [cited 2025 Mar. 14];139(4):319-24. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/464

Issue

Section

Original Article