A predictive model for falls in podiatry practice

Falls are a global health problem amongst older people living at home. Emerging evidence suggests that foot problems increase the risk of falling, so the podiatrist can play a crucial role in detecting foot-related fall risks. However, no screening tool is currently available for use in podiatry practice. The predictive value of existing tools is limited and their implementation is poor. The development of a predictive model for specific clinical populations could improve predictive accuracy and implementation

We conducted a prospective study involving older people living at home (>65 years) who consult a podiatrist. General fall risk variables, as well as foot-related and function-related variables, were considered as predictors of falls occurring during the 12-month follow-up period. Logistic regression analysis was used to build the model, and bootstrap resampling was performed for internal validation.

This study has shown that a model comprising four factors (history of falls, feeling of instability, walking speed and toe muscle strength) can be easily used in podiatry practice and is capable of predicting falls within 12 months.

The rationale, design and (preliminary) results of this study have also been visualised and summarised in the information booklet on fall assessment en poster on fall research.

In 2022, following the publication of the research, steps were taken towards implementation. This began with the creation of the ‘Fall Risk Test’ and ‘Fall Risk Assessment’ sections in the Electronic Patient Record (EPD), and the development of an information sheet to support podiatrists in clinical practice. In June 2022, internal training took place to support podiatrists in implementing the fall risk model and to enable them to carry out the follow-up (the assessment). In 2022, this expanded to include external training to support the profession, offered via KIPZ. In November 2023, the 2023 Podiatry Guideline on Fall Prevention was published and presented at the ‘Congres in de Wetenschap Dat(a)’ conference. View here the fall prevention guideline.

Podiatry, assessment tool, falls, feet

Collaborating partners: Researchers from Amsterdam UMC

Funding bodies: NVvP, Rondom Podotherapists

Link to publication: https://karger.com/ger/article/68/11/1214/823873/A-Prediction-Model-for-Falls-in-Community-Dwelling