The Effect of Foot Functional Training on Gait Ability in Older Adults with Activities of Daily Living Disability: A Randomized Controlled Trial

Background: Physical training can prevent gait ability decline in older adults. However, it is unknown whether foot functional training improves gait ability in older adults with activities of daily living (ADL) disability. Therefore, this study aimed to investigate the effects of foot functional training on gait ability in older adults with ADL disability. Methods: We conducted a single-center randomized controlled study involving 27 older Japanese adults (≥ 75 years) with ADL disability between December, 2017 and March, 2018. Participants were randomly assigned to an intervention group or a control group. The intervention group underwent 60-min foot functional training twice weekly for 4 months, in addition to routine activities that the nursing home typically offered to attendees. Results: Gait speed and speed of sound significantly increased after the 4-month training in the intervention group (gait speed: before vs. after, 0.61 ± 0.22 m/s vs. 0.84 ± 0.26 m/s, p ＜ 0.001; speed of sound: before vs. after, 1536 ± 16 m/s vs. 1550 ± 19 m/s), but not in the control group. The change in the peak pressure of the forefoot at the propulsive phase of gait was significantly higher in the intervention group than in the control group (p = 0.003). Gait speed was significantly correlated with the peak pressures of the forefoot (r = 0.27, p = 0.048) in the propulsive phase. Conclusion: The foot functional training significantly improved gait speed, bone strength, and plantar pressure distribution in older adults with ADL disability.