Toe flexor strength and foot morphology in older people requiring long-term care due to changes in their means of mobilizing in daily life: a cross-sectional study

Abstract

Background: Hallux valgus and lesser toe deformity reduce the strength of the toe flexors and are a cause of falls in older people. This study aimed to examine the differences in toe flexor strength and foot morphology in older people requiring long-term care due to changes in the way they mobilize in everyday life.

Methods: Eighty-four people aged ≥70 without motor paralysis who are undergoing or had undergone ambulatory rehabilitation. They were divided into those who could mobilize without a wheelchair (walking group, n=54) and those who used a wheelchair to mobilize (wheelchair group, n=30). Presence of diseases, hand grip strength, toe flexor strength, and foot morphology were compared between the two groups.

Results: No significant between-group difference in foot morphology was found. Factors related to differences in the means used to mobilize in daily life were a history of fracture, heart disease, and toe flexor strength. In muscle strength of the wheelchair group compared with the mean values of the walking group, the toe flexor strength was significantly more decreased in relation to hand grip strength.

Conclusions: Older people who use a wheelchair to mobilize have significantly less toe flexor strength than those who do not despite having no significant difference in foot morphology. Use of a wheelchair is associated with a reduction in toe flexor strength.