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dc.contributor.authorWylie, Gavin
dc.contributor.authorMenz, Hylton B.
dc.contributor.authorMcFarlane, Sarah
dc.contributor.authorOgston, Simon
dc.contributor.authorSullivan, Frank
dc.contributor.authorWilliams, Brian
dc.contributor.authorYoung, Zoe
dc.contributor.authorMorris, Jacqui
dc.identifier.citationWylie , G , Menz , H B , McFarlane , S , Ogston , S , Sullivan , F , Williams , B , Young , Z & Morris , J 2017 , ' Podiatry intervention versus usual care to prevent falls in care homes : pilot randomised controlled trial (the PIRFECT study) ' , BMC Geriatrics , vol. 17 , 143 .
dc.identifier.otherPURE: 250512435
dc.identifier.otherPURE UUID: 6eb15254-d76a-46f7-9112-ed64646142ea
dc.identifier.otherRIS: Wylie2017
dc.identifier.otherScopus: 85023188376
dc.identifier.otherWOS: 000405860600002
dc.descriptionThis study was funded by the Chief Scientist Office, Scottish Government Health Department (reference: CZH/4/701).en
dc.description.abstractBackground:  Common foot problems are independent risk factors for falls in older people. There is evidence that podiatry can prevent falls in community-dwelling populations. The feasibility of implementing a podiatry intervention and trial in the care home population is unknown. To inform a potential future definitive trial, we performed a pilot randomised controlled trial to assess: (i) the feasibility of a trial of a podiatry intervention to reduce care home falls, and (ii) the potential direction and magnitude of the effect of the intervention in terms of number of falls in care home residents. Methods:  Informed by Medical Research Council guidance on developing and evaluating complex interventions, we conducted a single blind, pilot randomised controlled trial in six care homes in the East of Scotland. Participants were randomised to either: (i) a three month podiatry intervention comprising core podiatry care, foot and ankle exercises, orthoses and footwear provision or (ii) usual care. Falls-related outcomes (number of falls, time to first fall) and feasibility-related outcomes (recruitment, retention, adherence, data collection rates) were collected. Secondary outcomes included: generic health status, balance, mobility, falls efficacy, and ankle joint strength. Results:  474 care home residents were screened. 43 (9.1%) participants were recruited: 23 to the intervention, 20 to control. Nine (21%) participants were lost to follow-up due to declining health or death. It was feasible to deliver the trial elements in the care home setting. 35% of participants completed the exercise programme. 48% reported using the orthoses ‘all or most of the time’. Completion rates of the outcome measures were between 93% and 100%. No adverse events were reported. At the nine month follow-up period, the intervention group per-person fall rate was 0.77 falls vs. 0.83 falls in the control group. Conclusions:  A podiatry intervention to reduce falls can be delivered to care home residents within a pilot randomised controlled trial of the intervention. Although not powered to determine effectiveness, these preliminary data provide justification for a larger trial, incorporating a full process evaluation, to determine whether this intervention can significantly reduce falls in this high-risk population.
dc.relation.ispartofBMC Geriatricsen
dc.rights© The Author(s). 2017 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.en
dc.subjectOlder peopleen
dc.subjectCare homesen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectRT Nursingen
dc.titlePodiatry intervention versus usual care to prevent falls in care homes : pilot randomised controlled trial (the PIRFECT study)en
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews.School of Medicineen
dc.description.statusPeer revieweden

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