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

Wylie, Gavin; Torrens, Claire; Campbell, Pauline; Frost, Helen; Gordon, Adam Lee; Menz, Hylton B; Skelton, Dawn A; Sullivan, Frank; Witham, Miles D; Morris, Jacqui


Gavin Wylie

Claire Torrens

Pauline Campbell

Helen Frost

Adam Lee Gordon

Hylton B Menz

Dawn A Skelton

Frank Sullivan

Miles D Witham

Jacqui Morris


foot problems are independent risk factors for falls in older people. Podiatrists diagnose and treat a wide range of problems affecting the feet, ankles and lower limbs. However, the effectiveness of podiatry interventions to prevent falls in older people is unknown. This systematic review examined podiatry interventions for falls prevention delivered in the community and in care homes.
systematic review and meta-analysis. We searched multiple electronic databases with no language restrictions. Randomised or quasi-randomised-controlled trials documenting podiatry interventions in older people (aged 60+) were included. Two reviewers independently applied selection criteria and assessed methodological quality using the Cochrane Risk of Bias tool. TiDieR guidelines guided data extraction and where suitable statistical summary data were available, we combined the selected outcome data in pooled meta-analyses.
from 35,857 titles and 5,201 screened abstracts, nine studies involving 6,502 participants (range 40–3,727) met the inclusion criteria. Interventions were single component podiatry (two studies), multifaceted podiatry (three studies), or multifactorial involving other components and referral to podiatry component (four studies). Seven studies were conducted in the community and two in care homes. Quality assessment showed overall low risk for selection bias, but unclear or high risk of detection bias in 4/9 studies. Combining falls rate data showed significant effects for multifaceted podiatry interventions compared to usual care (falls rate ratio 0.77 [95% CI 0.61, 0.99]); and multifactorial interventions including podiatry (falls rate ratio: 0.73 [95% CI 0.54, 0.98]). Single component podiatry interventions demonstrated no significant effects on falls rate.
multifaceted podiatry interventions and multifactorial interventions involving referral to podiatry produce significant reductions in falls rate. The effect of multi-component podiatry interventions and of podiatry within multifactorial interventions in care homes is unknown and requires further trial data.

Journal Article Type Article
Acceptance Date Nov 14, 2018
Online Publication Date Jan 7, 2019
Publication Date 2019-05
Deposit Date Jan 21, 2019
Publicly Available Date Jan 24, 2019
Journal Age and Ageing
Print ISSN 0002-0729
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 48
Issue 3
Pages 327-336
Keywords falls, podiatry, care homes, community dwelling, older people, systematic review,
Public URL
Contract Date Jan 21, 2019


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© 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 Non-Commercial License (, 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

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