Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-12T22:11:53.324Z Has data issue: false hasContentIssue false

The management of foot problems in the older person through podiatry services

Published online by Cambridge University Press:  07 April 2011

Wesley Vernon*
Affiliation:
Sheffield Primary Care Trust, UK
Alan Borthwick
Affiliation:
School of Health Sciences, University of Southampton, UK
Jeremy Walker
Affiliation:
Sheffield Primary Care Trust, UK
*
Address for correspondence: Professor Wesley Vernon OBE, Jordanthorpe Health Centre, 1 Dyche Close, Sheffield S8 8DJ. Email: wesley.vernon@nhs.net

Summary

The scale of foot problems in the population is high, and highest in older people. Whilst podiatry is solely concerned with the foot, other professions with a broader remit are also involved in foot care, as not only the foot may be at risk but also there may be serious systemic sequelae. Foot problems can be usefully viewed from a functional, hierarchical perspective. The interventions required are suggested by considering problems according to this hierarchy. Many approaches exist for the management of foot conditions from educated self-care to surgery. In managing such conditions, multi-disciplinary approaches are required. Podiatry has developed considerably over the years, has a growing research base, an extensive scope of practice and anticipated developments. The profession can develop further, particularly in its preventative role, in terms of professional autonomy and in further increasing its evidence base.

Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Munro, BR, Steele, JR. Foot-care awareness. A survey of persons aged 65 years and older. J Am Diabetic Assoc 1998; 88: 242–48.Google Scholar
2Cartwright, A, Henderson, G. More Trouble with Feet. A Survey of the Foot Problems and Chiropody Needs of the Elderly. Institute for Social Studies in Medical Care; 1986.Google Scholar
3Clarke, M.Trouble with Feet: Occasional Papers on Social Administration. Bell, Report Number: 29; 1969.Google Scholar
4Black, JR, Hale, WE. Prevalence of foot complaints in the elderly. J Am Podiatric Med Assoc 1987; 77: 308–11.Google Scholar
5Dunn, JE, Link, CL, Felson, DT, Crincoli, MG, Keysor, JJ, McKinlay, JB. Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol 2004; 159: 491–98.Google Scholar
6Menz, HB, Tiedemann, A, Kwan, MMS, Plumb, K, Lord, SR. Foot pain in community-dwelling older people: an evaluation of the Manchester foot pain and disability index. Rheumatology 2006; 45: 863–67.CrossRefGoogle ScholarPubMed
7Hill, CL, Gill, TK, Menz, HB, Taylor, AW. Prevalence and correlates of foot pain in a population-based study: the North West Adelaide health study. J Foot Ankle Res 2008; 1: 17.CrossRefGoogle Scholar
8Office for National Statistics. Population Estimates: UK population grows to 61.8 million. Available at: http://www.statistics.gov.uk (accessed 17 January 2011).Google Scholar
9Office for National Statistics. Ageing: Fastest increase in the ‘oldest old’. Available at: http://www.statistics.gov.uk/ (accessed 17 January 2011).Google Scholar
10Diabetes, UK. Key statistics on diabetes. Available at: http://www.diabetes.org.uk/ (accessed 4 February 2010).Google Scholar
11Abbott, CA, Vileikyte, L, Williamson, S, Carrington, AL, Boulton, AJ. Multicenter study of the incidence of and predictive risk factors for diabetic neuropathic foot ulceration. Diabetes Care 1998; 21: 1071–75.Google Scholar
12DiMaggio, J. Forensic podiatry: An emerging new field. J Forensic Identification 1995; 45: 495–97.Google Scholar
13The Society of Chiropodists and Podiatrists. Careers. Available at: www.feetforlife.org/ (accessed 25 January 2011).Google Scholar
14Farndon, LJ.The function and purpose of core podiatry: an in-depth analysis of practice. PhD thesis, Sheffield Hallam University; 2006.Google Scholar
15Moore, M, Farndon, L, MacMillan, S, Walker, S, Storey, H, Vernon, W. Patient Empowerment: A strategy to eradicate podiatry waiting lists – the Sheffield Experience. Br J Podiatry 2003; 6: 1720.Google Scholar
16Farndon, L, Vernon, W, Parry, A. What is the evidence for the continuation of core podiatry services in the NHS?: A review of foot surveys. Br J Podiatry 2006; 9: 8994.Google Scholar
17Borthwick, A. Challenging Medicine: the case of podiatric surgery. Work, Employment and Society 2000; 14: 369–83.Google Scholar
18Dagnall, J. A history of chiropody–podiatry and foot care. Br J Chiropody 1983; 48: 137–83.Google Scholar
19Levy, LA. The Evolution of Podiatric Medical Practice and Formal Education: Chronological History. In Principles and Practice of Podiatric Medicine, 2nd edn, ed. Levy, LA and Hetherington, VJ. Brooklandville, Data Trace Publishing Company; 2007.Google Scholar
20Seelig, W. Studies in the history of chiropody – the beginnings of chiropody in England: notes on seventeenth century chiropodists. The Chiropodist 1953; 8: 381–97.Google Scholar
21Larkin, G. Occupational Monopoly and Modern Medicine. London: Tavistock Publications; 1983.Google Scholar
22Dagnall, J. Fiftieth anniversary of the first British Chiropodial Society: the National Society of Chiropodists, 1913. The Chiropodist 1963; 18: 4147.Google Scholar
23Lorimer, D. The development of Degree education in podiatry in the United Kingdom. J Br Podiatric Med 1995; 51: 5255.Google Scholar
24Welshman, J. Growing old in the city: public health and the elderly in Leicester, 1948–1974. Medical History 1996; 40: 7489.Google Scholar
25Sibbald, B, Shen, J, McBride, A. Changing the skill mix of the health care workforce. J Health Service Res Policy 2004; 9: 2838.Google Scholar
26Borthwick, AM, Short, A, Nancarrow, SA, Boyce, R. Non-medical prescribing in Australasia and the UK: the case of podiatry. J Foot Ankle Res 2010; 3: 37.Google Scholar
27Department of Health. Final Report of the Review of Prescribing, Supply and Administration of Medicines (Crown Report). London, Department of Health; 1999.Google Scholar
28Department of Health. Allied health professions, prescribing and medicines supply scoping project report. London, Department of Health; 2009.Google Scholar
29Pickstone, C, Nancarrow, S, Cooke, J, Vernon, W, Mountain, G, Boyce, RA. Building research capacity in the allied health professions. Evidence & Policy: A Journal of Research, Debate and Practice 2008; 4: 5368.Google Scholar
30Kilmartin, T. Critical review: the surgical management of hallux valgus. Br J Podiatry 2006; 9: 425.Google Scholar
31Kilmartin, TE, O'Kane, C. Correction of valgus second toe by closing wedge osteotomy of the proximal phalanx. Foot Ankle Internat 2007; 28: 1260–64.Google Scholar
32Tagoe, M, Brown, HA, Rees, SM. Total sesamoidectomy for painful hallux rigidus: a medium-term outcome study. Foot Ankle Internat 2009; 30: 640–46.Google Scholar
33Menz, H.Foot Problems in Older People: Assessment and Management. London: Churchill Livingstone; 2008.Google Scholar
34Rome, K. Podiatric research – the last 20 years. Br J Podiatry 2006; 9: 103.Google Scholar
35Borthwick, AM. A Study of the Professionalisation Strategies of British Podiatry 1960–1997. PhD thesis, University of Salford, Public Health Research and Resource Centre; 1997.Google Scholar
36Vernon, W. The functional analysis of shoe wear patterns: theory and application. PhD thesis, Sheffield Hallam University; 2000.Google Scholar
37Yapp, R. Footsore for style. London Evening Standard. Thursday 22 April 2004.Google Scholar
38Campbell, JA. Modelling deterioration of foot health in older people following discharge from NHS podiatry services. The Foot 2007; 17: 7683.CrossRefGoogle Scholar
39Campbell, JA, Bradley, A, Milns, D, White, D, Turner, W, Luxton, DEA. Do ‘low-risk’ older people need podiatry care?: preliminary results of a follow-up study of discharged patients. Br J Podiatry 2000; 3: 3945.Google Scholar
40Campbell, JA, Patterson, A, Gregory, D et al. What happens when older people are discharged from NHS podiatry services? The Foot 2002; 12: 3242.Google Scholar
41ScHARR. Clinical Guidelines for Type 2 Diabetes: Prevention and management of foot problems (revised version). Sheffield, School of Health and Related Research, 2004.Google Scholar
42Wall, B, Lorimer, D, French, G, O'Donnell, M, Burrow, JG. Neale's Disorders of the Foot. Edinburgh: Churchill Livingstone; 2006.Google Scholar
43Scuffham, P, Chaplin, P. The Incidence and Costs of Accidental Falls in the UK. Final Report. York, Health Economic Form Consortium; 2002.Google Scholar
44Tinetti, ME, Speechley, M, Ginter, SF. Risk factors for falls among elderly persons living in the community. New Engl J Med 1988; 319: 1701–7.Google Scholar
45Department of Health. National Service Frameworks, Older People. London, Stationery Office; 2001.Google Scholar
46Koski, K, Luukinen, H, Laippala, P, Kivela, S-L. Physiological factors and medications as predictors of injurious falls by elderly people: a prospective population-based study. Age Ageing 1996; 25: 2938.Google Scholar
47Menz, H, Morris, M, Lord, S. Foot and ankle risk factors for falls in older people: A prospective study. J Gerontol 2006; 61A: 866–70.Google Scholar
48NICE. Type 2 Diabetes: Prevention and Management of Foot Problems. London, NICE; 2004.Google Scholar