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Sole solution - How physiotherapy research is stepping up to reduce falls

Physiotherapy researcher Dr Anna Hatton (right)
Photo: Physiotherapy researcher Dr Anna Hatton (right)
Novel shoe insoles that enhance the sensory input on the soles of the feet may boost stability and reduce the risk of falls in older people, including those with neurological conditions.

A Queensland physiotherapy researcher is trialling the use of textured shoe insoles designed to enhance the plantar sensory information in older people, people with Multiple Sclerosis (MS) and people with Parkinson’s disease, as part of an international research collaboration.

Falls in older people is a major public health issue that’s expected to escalate in line with our rapidly ageing population.

Australian Institute of Health and Welfare (AIHW) statistics show 96,385 people aged 65 and over were hospitalised for a fall-related injury in 2011-12. Of those, 68 per cent (65,965 people) were female and 32 per cent were male (30,420 people).
Dr Anna Hatton, a physiotherapy lecturer and Postdoctoral Early-Career Researcher at the University of Queensland (UQ), hopes her decade-long work in the field will improve the balance and gait in older people, preventing falls and serious injuries.

Falls prevention is an issue that resonates on a personal level for Dr Hatton, whose grandmother died in the wake of a fall, prompting her early career interest in gerontology and balance performance.

“She had fallen in her home and then been put into hospital and never came out of hospital,” she says.

“It’s something that was quite personal but falls prevention is something quite pertinent in the health sphere and around the world as well.”

Originally from the United Kingdom, Dr Hatton was recently awarded an Australian Institute of Policy and Science’s Young Tall Poppy Science Award 2016 for the state of Queensland, for her work showcasing intellectual and scientific excellence in the research field.

While older people develop sensory deficits on the soles of their feet as part of natural ageing, people with neurological conditions also experience decreased sensation on their soles through the disease process.

Studies around the globe are now trialling unique foot interventions, including insoles that electrically stimulate feet with vibrations, to improve sensory information.

Dr Hatton is leading the largest trial examining the use of specially-designed textured insoles in people with MS.

The randomised controlled trial of 176 people living in the community in Brisbane will trial the shoe insoles on gait, foot sensation and proprioception over a 12 week period.

“It will also be the most comprehensive trial conducted in terms of analysing the effects of wearing textured insoles on walking patterns,” she says.

“We’re looking at walking on two different surfaces, so a flat surface and also on an uneven surface. We’re collecting measures using electronic walkway systems and also 3D motion capture systems - there haven’t been any studies that have collected this amount of information previously.”

Dr Hatton says researchers hope to see an improvement in gait patterns, such as the length of the participants’ steps and their walking speed.

“We would like to see some improvements in those measures which gives us some sort of indication that these people are more stable when they’re walking and they are showing improvements in their walking patterns.”

Dr Hatton is a core investigator on a similar trial using textured insoles on people with Parkinson’s disease and she’s involved in several smaller studies examining balance.

The research is part of an international collaboration with researchers at Teesside University, Middlesbrough UK, New Zealand’s Auckland University of Technology, the Queensland University of Technology and UQ.

Dr Hatton says physiotherapists have a crucial role to play in falls prevention.

“Physiotherapists can look at the body in a more holistic sense, we can manipulate what’s happening at the feet and look at what’s happening up towards the hips, the upper body and look at the whole body in its entirety.”

Dr Hatton hopes her work will lead to the development of a new evidence-based treatment technique that can enhance sensory information, and improve balance and walking for older people - boosting their mobility and independent living.

This innovative research may also shed light on whether wearing textured insoles can improve the sensation in people’s feet.

“It could be that if you enhance someone’s sensory input on the soles of the feet, that that could be the underlying mechanism as to why someone’s walking patterns have improved,” Dr Hatton says.

“So, it could bring them back - not halt the disease progression - but bring them back to a walking level that they may have had a couple of years previously.”

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords