Biomechanics of the Ageing Foot and Ankle: A Mini-Review

Abstract

Foot pain is highly prevalent in older people and has a significant detrimental impact on mobility and quality of life. In recent years, there has been increased interest in exploring the biomechanical factors that may contribute to the development of foot disorders and the associated impairment of mobility in this age group. Studies have shown that with advancing age, there is a general tendency for the foot to exhibit increased soft tissue stiffness, a decreased range of motion, decreased strength and a more pronated posture as well as to function in a more pronated position with reduced joint mobility and less efficient propulsion when walking. These changes may contribute to the development of foot pain, impair performance in functional weight-bearing activities and increase the risk of falls. However, plantar pressure analysis technology has considerable potential to assist in optimising the design of interventions to redistribute load away from high-pressure areas, thereby alleviating foot symptoms and improving mobility in older people.

Effectiveness of Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses on Balance, Fear of Falling, and Physical Activity in Older Adults: A Randomized Controlled Trial

“…Foot and ankle problems are common in older adults [1], and they have been shown to be associated with a decreased ability to undertake activities of daily living [2], deterioration in balance and gait [3], an increased risk of falls [4], and a poorer health-related quality of life [5]. The biomechanical, physiological, and functional declines with age in the lower extremities (e.g., dryness and hardness of plantar skin and soft tissues, reduction in joint range of motion, and loss of foot strength and plantar sensation) have been linked to a high plantar pressure, poor gait efficiency, foot deformity (e.g., hammer toes, overlapping toes, and hallux valgus), foot pain, impaired balance, and poor functional ability, ultimately leading to falls or a reduction in the level of physical activity [3, 6].…”

“…The biomechanical, physiological, and functional declines with age in the lower extremities (e.g., dryness and hardness of plantar skin and soft tissues, reduction in joint range of motion, and loss of foot strength and plantar sensation) have been linked to a high plantar pressure, poor gait efficiency, foot deformity (e.g., hammer toes, overlapping toes, and hallux valgus), foot pain, impaired balance, and poor functional ability, ultimately leading to falls or a reduction in the level of physical activity [3, 6]. …”

Chronic foot pain in older people

“…When walking, the foot contributes to shock absorption, adapts to uneven terrain, and facilitates the forward propulsion of the body. In the presence of foot pain, this important biomechanical function is disrupted, leading to impaired balance, difficulty ambulating and ultimately a loss of independence [1]. Despite this, management of foot pain is a largely undervalued aspect of geriatric health care.…”

Effects of Foot Deformities on Gait, Balance and Functional Mobility in Older Women

“…There is a general belief for the aging foot to exhibit increased soft-tissue stiffness, a decreased range of motion, decreased strength and a more pronated posture, and to function in a more pronated position with a reduced range of motion and less efficient propulsion when walking. 1 These changes can directly affect individual's mobility and quality of life and may be caused by genetic predisposition, systemic illness, inadequate foot care, inappropriate footwear, long-term physical activity, trauma or abnormal gait pattern. [2][3][4][5] More severe pes planus and hallux valgus and lesser toe deformities have been observed with aging.…”