Foot Strengthening to Improve Balance and Gait in Older Adults

Change From Baseline in Hallux Flexion Strength (Curl)

Change in maximal hallux (big toe) flexion strength assessed using a standardized hallux curl test (i.e., flexion at the metatarsal interphalangeal joints) with a dynamometer. Participants perform brief maximal voluntary contractions, and peak force output is recorded. Higher values indicate greater hallux curl strength.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Lesser Toes Flexion Strength (Curl)

Change in maximal lesser toes flexion strength assessed using a standardized lesser toes curl test (i.e., flexion at the metatarsal interphalangeal joints) with a dynamometer. Participants perform brief maximal voluntary contractions, and peak force output is recorded. Higher values indicate greater lesser toes curl strength.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Hallux Flexion Strength (Press)

Change in maximal hallux flexion strength assessed using a toe press test that isolates hallux flexion at the metatarsophalangeal joint. Strength is measured using a force-instrumented platform, with higher values indicating greater hallux press strength.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Lesser Toe Flexion Strength (Press)

Change in maximal lesser toes flexion strength assessed using a toe press test that isolates flexion at the metatarsophalangeal joints. Strength is measured using a force-instrumented platform, with higher values indicating greater lesser toes press strength.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Gait Kinetic Variables

Change in gait kinetic variables derived from motion capture and force measurement systems during walking. Measures include ground reaction force variables such as peak vertical force. Values reflect loading patterns during gait.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Joint Angles during Gait

Change in lower-limb and foot joint angles measured during walking using motion capture. Joint angles are calculated across the gait cycle and represent segmental motion of the foot and lower extremity.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Joint Range of Motion During Gait

Change in joint range of motion (ROM) of the foot and lower extremity measured during walking using motion capture. ROM is calculated as the difference between maximum and minimum joint angles during the gait cycle.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Stance Time During Gait

Change in stance time measured during walking using motion capture. Stance time represents the duration the foot remains in contact with the ground during each gait cycle.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Step Length During Gait

Change in step length measured during walking using motion capture. Step length is defined as the anterior-posterior distance between successive foot contacts.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Cadence During Gait

Change in walking cadence measured during gait analysis using motion capture. Cadence is expressed as steps per minute.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Step Width During Gait

Change in step width measured during walking using motion capture. Step width reflects the mediolateral distance between foot placements and is used as an indicator of gait stability.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in 6-Minute Walk Test Distance

Change in distance walked during the 6-Minute Walk Test (6MWT), measured in meters. Greater distance indicates better functional walking capacity.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in 30-Second Sit-to-Stand Test Performance

Change in functional lower-extremity performance assessed using the 30-Second Sit-to-Stand Test. Outcomes include the total number of completed sit-to-stand repetitions, with higher values indicating better performance.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in 4-Stage Balance Test Performance

Change in standing balance performance assessed using the 4-Stage Balance Test. Outcomes include the ability to successfully complete progressively challenging standing positions for the required duration.

Time frame: From enrollment to the end of the intervention at 8 weeks

Change From Baseline in Single-Leg Heel-Raise Test Performance

Change in plantar flexor endurance assessed using the single-leg heel-raise test. Outcomes include the number of consecutive heel raises completed with proper form, with higher values indicating greater muscular endurance.

Time frame: From enrollment to the end of the intervention at 8 weeks