´Feet are second class citizens': exploring the perceptions of Scottish and Portuguese older adults about feet, falls and exercise‐ a qualitative study

Abstract

Introduction Foot problems are likely to contribute to falls risk in older adults. Foot and ankle exercises may be beneficial, but uptake may be influenced by cultural factors. Few studies have explored the views of older adults from different cultural backgrounds about foot-specific falls risk factors, and foot and ankle falls prevention exercises. Objectives To explore the views of Scottish and Portuguese community-dwelling older adults who have experienced a fall, about any foot risk factors for falls, and foot and ankle exercises. Methods Cross-cultural qualitative study with (n = 6) focus groups exploring the perceptions of Scottish (n = 10, mean age 76 yrs) and Portuguese older adults (n = 14, mean age 66 years) aged, applying thematic analysis. Results One main theme `evolving awareness about feet and falls prevention´ and three subthemes; (i) Feet are often forgotten, (ii) the important role of footwear, (iii) need to look at my feet and do the exercises were identified. Scottish participants had more experience of falls prevention but there was a lack of knowledge surrounding foot-specific falls risk factors, and the role of ankle and foot exercise in the prevention of falls. Portuguese participants exhibited a fatalistic approach to falls. Conclusions Older adults from both nations had little knowledge of foot-specific falls risk factors, being initially unaware of the functional status of their feet and of the role of exercise in foot care and falls management. There were differences between national groups that should be accounted for when developing culturally adequate interventions.

Knowledge about foot‐specific foot falls risk factors and exercise among physiotherapists in the UK and Portugal: A cross‐sectional survey

“…It was important to ascertain physiotherapists' views about their older patients' knowledge in their nation as a qualitative study found that British and Portuguese older adults' consider that health professional's (including physiotherapists) messages to them about foot health, footcare, exercise and falls prevention are of the utmost importance for informing their knowledge and preventive behaviours (Conde et al., 2020). Both the UK‐based and Portugal‐based physiotherapists perceived that their older clients had little knowledge about footcare, foot‐specific fall risk factors, or foot and ankle exercise interventions.…”

“…Despite having a very different professional scope landscape, Portugal has published an action plan for Physiotherapy in falls prevention in primary care settings (Barbosa et al, 2020). Since UK guidance and practice informed the Portuguese falls action plan (Barbosa et al, 2020) and a qualitative study pointed that British and Portuguese older adults 'knowledge and preventive behaviours regarding these topics were influenced by healthcare professionals' messages (including physiotherapists) (Conde et al, 2020), comparing physiotherapists from both nations seems relevant and timely. Hence, the main aim of this study was to compare selfreported knowledge, confidence, and practice surrounding general and foot-specific falls risk, exercise for falls prevention among physiotherapists working in the UK and in Portugal.…”