POS1285 FOOT DISORDERS AND FALLS RISK IN OLDER PERSONS

Background:

Falls are major problems in older people, leading to serious morbidity and mortality. Many studies have identified intrinsic and extrinsic fall risk factors in order to develop preventive strategies and guidelines. There are few reports which studied the impacts of aging feet on falls [1].

Objectives:

The present study aimed to explore foot musculoskeletal disorders and their relationship to falls in a healthy aging population.

Methods:

This was a cross-sectional descriptive study involving the patients aged 65 years and over who were independent in self-care and walking followed at the physical medicine and rehabilitation department of the university hospital of sousse over 3 months. The analysed data focused on the epidemiological and clinical characteristics.Trained physicians evaluated health status, foot problems, and fall(s) history of all subjects. Walking performance was assessed using the ‘Timed Get Up & Go’ test and the unipedal stance test was used for the assessment of balance. Footprints were taken from the standing position. Associated factors of foot disorders and falls were analyzed.

Results:

There were 45 subjects: 18 men, 27 women with a mean age of 69.6 [65-86] years. Foot deformities presented in 87% and were a significantly associated with walking performance or falls (p=0.01, p=0.02). The most common foot musculoskeletal disorder were Halux valgus 31%, followed by Mallet toe 15%. Arch of foot classified by physical examination revealed that pes planus was presented in 35% of cases. There was a significant correlation between BMI and an arch index (p=0.04). Foot problems remained significantly associated with impaired timed up and go test and the unipedal stance test. The causes of pain were plantar fasciitis, hallux valgus, callus, metatarsalgia, and inappropriate footwear. Falls were reported in 33.3 of patients. Falls were significantly associated with Hallux valgus, mallet toe and pain (p<0.05).

Conclusion:

Independent of the influence of age, gender, common conditions; foot problems have a significant impact on the ability to perform functional tasks integral to independent living.

References:

[1]Menz HB, Lord SR: Foot problems, functional impairment, and falls in older people. J Am Podiatr Med Assoc 1999;89:458– 467. 3 Americ

Disclosure of Interests:

None declared

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Attention bias toward threat is associated with exaggerated fear expression and impaired extinction in PTSD

BACKGROUND

Post-traumatic stress disorder (PTSD) develops in a minority of traumatized individuals. Attention biases to threat and abnormalities in fear learning and extinction are processes likely to play a critical role in the creation and/or maintenance of PTSD symptomatology. However, the relationship between these processes has not been established, particularly in highly traumatized populations; understanding their interaction can help inform neural network models and treatments for PTSD.

METHOD

Attention biases were measured using a dot probe task modified for use with our population; task stimuli included photographs of angry facial expressions, which are emotionally salient threat signals. A fear-potentiated startle paradigm was employed to measure atypical physiological response during acquisition and extinction phases of fear learning. These measures were administered to a sample of 64 minority (largely African American), highly traumatized individuals with and without PTSD.

RESULTS

Participants with PTSD demonstrated attention biases toward threat; this attentional style was associated with exaggerated startle response during fear learning and early and middle phases of extinction, even after accounting for the effects of trauma exposure.

CONCLUSIONS

Our findings indicate that an attentional bias toward threat is associated with abnormalities in 'fear load' in PTSD, providing seminal evidence for an interaction between these two processes. Future research combining these behavioral and psychophysiological techniques with neuroimaging will be useful toward addressing how one process may modulate the other and understanding whether these phenomena are manifestations of dysfunction within a shared neural network. Ultimately, this may serve to inform PTSD treatments specifically designed to correct these atypical processes.