Efficacy of a progressive resistance exercise program to increase toe flexor strength in older people

  • Author Footnotes
    1 Permanent address: Institute of Sport Exercise and Active Living, Victoria University, Melbourne, VIC 8001, Australia.
    Karen J. Mickle
    Correspondence
    Corresponding author at: Institute of Sport Exercise and Active Living, Victoria University, PO Box 14428, Melbourne, VIC 8001, Australia.
    Footnotes
    1 Permanent address: Institute of Sport Exercise and Active Living, Victoria University, Melbourne, VIC 8001, Australia.
    Affiliations
    Biomechanics Research Laboratory, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia
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  • Peter Caputi
    Affiliations
    School of Psychology, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia
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  • Jan M. Potter
    Affiliations
    Division of Aged Care, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, NSW 2500, Australia
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  • Julie R. Steele
    Affiliations
    Biomechanics Research Laboratory, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia
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  • Author Footnotes
    1 Permanent address: Institute of Sport Exercise and Active Living, Victoria University, Melbourne, VIC 8001, Australia.

      Highlights

      • We compared a progressive strengthening program to a simple home-based foot exercise program.
      • Adherence to supervised, group exercise classes focussed on the feet was very high.
      • 12 week progressive resistance training increases toe strength in older people.
      • General foot exercises ( e.g. picking up marbles) do not increase toe strength.
      • Foot exercises improve balance in older people.

      Abstract

      Background

      Reduced toe flexor strength is an independent predictor of falls in older people. However it is unknown whether strengthening programs can restore toe flexor strength in older individuals. The aim of this study was to investigate whether a progressive resistance training program, focused specifically on the foot muscles, could improve toe flexor strength in community-dwelling older people.

      Methods

      After baseline testing, 85 men and women (age range 60–90 years) were randomized to either a supervised, progressive resistance training (n = 43) or a home-based exercise (n = 42) group for 12 weeks. A further 32 participants were recruited for a control group. The primary outcome measures were hallux and lesser toe flexor strength pre- and post-intervention. Secondary outcome measures were exercise compliance, components of the Foot Health Status Questionnaire and single-leg balance time.

      Findings

      Average class attendance was 89% with 68 participants from the two intervention groups (80%) completing the follow-up assessments. Participants in the supervised, progressive resistance training group significantly increased their toe strength (up to 36%; P < 0.02), whereas there was no change in toe strength in either the home-based or control groups. This increased toe strength was accompanied by a significant improvement in perceived general foot health and single-leg balance time compared to the other groups ( P < 0.05).

      Interpretation

      Progressive resistance exercises are a viable intervention to increase toe flexor strength in older adults. A clinical trial is now required to determine whether this intervention can reduce the number of falls suffered by older adults.

      Keywords

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