what-when-how
In Depth Tutorials and Information
C h a p t e r
2
Chapter contents
The impact of
aging and
systemic diseases
on foot and lower
limb mechanics
Introduction 15
The aging foot - structure and
mobility 16
Impact of diabetes on foot
structure, foot pressure and
gait 17
Impact of rheumatoid arthritis
on foot structure, foot
pressure and gait 20
Summary 25
Review questions 25
Reflection 25
Self-assessed questions 26
References 26
Further reading 27
“I don't like my feet much…they are the
thing that stop me walking normally…I
have learned to fight the pain to try and
walk better…then that shows in your
face…”
Rose
Introduction
The impact of systemic diseases on feet cannot
be underestimated in respect of pain, limitation
of activities and body image. There are many
factors that affect normal foot structure and
gait, ranging from genetic tendencies for spe-
cific foot types to systemic diseases. Addition-
ally, the normal aging process contributes to
alteration in normal foot structure and gait.
Some individuals experience the impact of a
combination of factors, for example an older
person with diabetes and abnormal foot func-
tion associated with a familial tendency for the
foot type that develops hallux rigidus. In cases
such as this, orthoses are a particularly impor-
tant aspect of management in the prevention
of pressure-induced problems such as foot
ulceration. Although this chapter is divided into