Karen R Balanowski1, Lynne M Flynn. 1. Department of Podiatry, Lothian Primary Care NHS Trust, Springwell House, Ardmillan Terrace, Edinburgh EH11 2JL, UK. KRBalanowski@aol.com
Abstract
BACKGROUND: Painful feet in older people can detrimentally affect balance and are a risk factor for falls. Pain is often associated with plantar hyperkeratoses, which are easily treated by podiatrists. Currently, there is no data defining the effect this treatment has on balance or functional ability. OBJECTIVE: To determine the effects of scalpel debridement of painful plantar hyperkeratoses on pain, balance and functional ability in older people aged 65 years and over. SUBJECTS: Nineteen men and women aged 65-84 years (mean age 72, standard deviation 5.6). METHODS: Pain resulting from plantar hyperkeratoses was measured using a visual analogue scale. Static balance and functional ability were measured using tests of postural sway, co-ordinated stability and timed walking and stepping tests. Painful plantar hyperkeratoses were debrided with a scalpel then all tests were repeated, immediately and 7 days later. RESULTS: Following scalpel debridement, pain levels (sensory and afferent) were significantly reduced (P<0.0001) and functional ability was significantly increased (P<0.0001). There was no change in static balance ability. One week after debridement the improved performance in functional ability tests was maintained. CONCLUSIONS: Debridement of painful plantar hyperkeratoses reduces pain and improves functional ability in older people. Its effect on static balance was inconclusive.
BACKGROUND: Painful feet in older people can detrimentally affect balance and are a risk factor for falls. Pain is often associated with plantar hyperkeratoses, which are easily treated by podiatrists. Currently, there is no data defining the effect this treatment has on balance or functional ability. OBJECTIVE: To determine the effects of scalpel debridement of painful plantar hyperkeratoses on pain, balance and functional ability in older people aged 65 years and over. SUBJECTS: Nineteen men and women aged 65-84 years (mean age 72, standard deviation 5.6). METHODS:Pain resulting from plantar hyperkeratoses was measured using a visual analogue scale. Static balance and functional ability were measured using tests of postural sway, co-ordinated stability and timed walking and stepping tests. Painful plantar hyperkeratoses were debrided with a scalpel then all tests were repeated, immediately and 7 days later. RESULTS: Following scalpel debridement, pain levels (sensory and afferent) were significantly reduced (P<0.0001) and functional ability was significantly increased (P<0.0001). There was no change in static balance ability. One week after debridement the improved performance in functional ability tests was maintained. CONCLUSIONS: Debridement of painful plantar hyperkeratoses reduces pain and improves functional ability in older people. Its effect on static balance was inconclusive.
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