Gait, balance and plantar pressures in older people with toe deformities

Older people with toe deformities have been identified as having an increased risk of falling. Little is known, however, about the biomechanical changes that might contribute to this increased risk. Therefore, the purpose of this study was to determine whether older people with hallux valgus and lesser toe deformities displayed different gait, balance and plantar pressure characteristics compared to individuals without toe deformities. The presence of hallux valgus and lesser toe deformities were assessed for 312 community-dwelling older men and women. Spatiotemporal gait parameters were measured using the GAITrite(®) system, postural sway was assessed on two surfaces using a sway-meter and dynamic plantar pressure distribution was measured using an Emed-AT4 pressure plate. The results indicated that, although there were no effects of toe deformities on spatiotemporal gait characteristics or postural sway, older people with hallux valgus (n=36) and lesser toe deformities (n=71) were found to display altered forefoot plantar pressure patterns. These findings suggest that toe deformities alter weight distribution under the foot when walking, but that the relationship between toe deformities and falls may be mediated by factors other than changes in spatiotemporal gait parameters or impaired postural sway.