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Using Multivariate Statistics

Lincoln, Yvonna, and Egon Guba, "Postpositivism and the Naturalist Paradigm," pp. 14-46 in Yvonna Lincoln and Egon Guba, Naturalistic Inquiry . Beverly Hills, CA: Sage, 1985.*

25. Multiple Imputation for Nonresponse in Surveys. By D. B. Rubin. ISBN 0 471 08705 X. Wiley, Chichester, 1987. 258 pp. £30.25.

Multiple Imputation for Nonresponse in Surveys

As people get older, they may fall more often for a variety of reasons including problems with balance, poor vision, and dementia. Up to 30% may fall in a year. Although one in five falls may require medical attention, less than one in 10 results in a fracture.
This review looked at the healthcare literature to establish which fall prevention interventions are effective for older people living in the community, and included 159 randomised controlled trials with 79,193 participants.  
Group and home-based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures.
Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow-up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined.  
Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti-slip shoe device worn in icy conditions can also reduce falls.
Taking vitamin D supplements does not appear to reduce falls in most community-dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment.  
Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls.
Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure.
In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling.
The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.

Interventions for preventing falls in older people living in the community

The Pharmacological Basis of Therapeutics A Textbook of Pharmacology, Toxicology and Therapeutics for Physicians and Medical Students. By Prof. Louis Goodman and Prof. Alfred Gilman. Pp. xiii + 1383. (New York: The Macmillan Company, 1941.) 50s. net.

The Pharmacological Basis of Therapeutics

Manipulation method for the treatment of ankle equinus.

Despite the wide range of publication opportunities in podiatric medicine, little is known about how podiatric authors select journals in which to publish or their perceptions of journals currently available. To investigate these issues, a survey of publication patterns and perceptions of full- and part-time academic staff members at podiatric medical schools in Australia was undertaken. Most of the papers by Australian podiatric medical faculty members have been published in “local” journals, such as the Australasian Journal of Podiatric Medicine (38%) and the British Journal of Podiatry (17%). However, an increasing number of papers are being published in JAPMA (14%). In addition, a large proportion of papers have been published in a variety of journals that are not specific to podiatric medicine, particularly in the areas of biomechanics and diabetic medicine. The number of publications per faculty member was associated with the highest qualification obtained, academic rank, and the number of years of ...

Publication Patterns and Perceptions of the Australian Podiatric Medical Faculty

Age-related changes in midfoot mobility have the potential to influence success with foot orthoses intervention in people with patellofemoral pain (PFP). The aim of this study was to determine whether older people with PFP demonstrate less foot mobility than younger adults with PFP. One hundred ninety four participants (113 (58%) women, age 32 ± 7 years, BMI 25 ± 4.9 kg/m2) with PFP (≥ 6 weeks duration) were included, with foot mobility quantified using reliable and valid methods. K-means cluster analysis classified participants into three homogenous groups based on age. After cluster formation, univariate analyses of co-variance (covariates: sex, weight) were used to compare midfoot height mobility, midfoot width mobility, and foot mobility magnitude between age groups (significance level 0.05). Cluster analysis revealed three distinct age groups: 18–29 years (n = 70); 30–39 years (n = 101); and 40–50 years (n = 23). There was a significant main effect for age for midfoot height mobility (p   0.05). Individuals with PFP aged 40–50 years have less foot mobility than younger adults with PFP. These findings may have implications for evaluation and treatment of older individuals with PFP.

/pdf/age-related-differences-in-foot-mobility-in-individuals-with-34i569ufav.pdf

Age-related differences in foot mobility in individuals with patellofemoral pain

Shoe-stiffening inserts for first metatarsophalangeal joint osteoarthritis: a randomised trial.

Objectives Although mental health is related to the persistence of musculoskeletal pain, our understanding of the relationship between mental health and foot pain is limited. Subsequently, we conducted a three year longitudinal study to examine the relationship between mental health and foot pain in a community based population. Methods Eighty-three community dwelling participants (mean body mass index 35.3 kg/m2 ± 9.0) who had foot pain at study inception in 2008, and for whom measures of mental health (Mental Component Summary of the Short Form-36) were available, were invited to take part in this follow-up study in 2011. Change in foot pain was determined by the difference between the Manchester Foot Pain and Disability Index score at baseline and follow up; therefore, a decrease in the score indicates improved foot pain and an increase indicates deterioration in foot pain. Linear regression was used to determine the factors affecting change in foot pain. Results Of the 62 respondents (75% response rate, 49 females and 13 males), there were 27 (44%) whose foot pain deteriorated. A higher Mental Component Summary score of the Short Form-36 at baseline was associated with a slower progression of foot pain (beta coefficient -0.29, 95% confidence interval -0.42 to -0.01); adjusted for age, sex, body mass index and physical health. Conclusion Mental health is associated with changes in foot pain. Clinicians dealing with this population should consider the contribution of mental health in their management and treatment of foot pain.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/acr.22292

Hylton B. Menz

Papers

Manipulation method for the treatment of ankle equinus.

Publication Patterns and Perceptions of the Australian Podiatric Medical Faculty

Age-related differences in foot mobility in individuals with patellofemoral pain

Shoe-stiffening inserts for first metatarsophalangeal joint osteoarthritis: a randomised trial.

Relationship between mental health and foot pain.