Are toe weakness and deformity associated with falls in older people

Hallux valgus and lesser toe deformities are highly prevalent foot problems in older adults, affecting up to 74% of this population. One suggested cause of these toe deformities is inadequate strength of the intrinsic flexor muscles of the toes [1]. Adequate toe flexor strength is essential to control body weight shifts, propel the body during gait and assist in shock absorption during repeated impacts. Furthermore, a previous study using a qualitative measure of toe flexor strength reported associations between poor toe flexor strength and poor performance in balance and functional tests in elderly people [2]. Of further concern, in a sample of retirement home dwellers, fallers were more likely to have severe hallux valgus and fail a clinical test of toe-flexor strength more often than non-fallers [3]. However, this association has not been investigated in community-dwelling older people or assessed using a quantitative method of toe flexor strength. Therefore, the purpose of this study was to determine whether toe flexor strength or the presence of hallux valgus or lesser toe deformities were associated with the risk of falling in older community dwelling adults.