The goals of this observational study are to investigate the following: * If there is a relationship between prior falls, single leg stance time, and plantar cutaneous sensitivity as measured by monofilaments. * Plantar sensitivity across a broad range of ages. * Self-reported physical function related to balance and mobility using the PROMIS® PROWalk™ questionnaire. Participants will answer questions about themselves and their balance and falls. Their plantar (bottom of their feet) sensation will also be tested using monofilaments, and they will attempt to stand on one leg as long as they can up to 30 or 60 seconds.
Research has consistently shown that plantar insensitivity is strongly associated with an increased risk of falls and impaired balance in older adults (Richardson \& Hurvitz, 1995). Recent evidence supports a significant association between plantar sensation insufficiencies, as indicated by monofilament testing (10g), and the risk of falls and fractures in older adults (Hicks et al., 2023). As such, monofilament testing serves as a diagnostic tool and a predictor of fall risk, emphasizing the critical role of sensory feedback in maintaining stability and preventing injury in aging populations. We will expand on existing research by examining plantar sensitivity across ages and exploring links between fall history, single leg stance time, and plantar cutaneous sensation. This investigation will also evaluate how well the PROMIS PROWalk questionnaire reflects or relates to an individual's balance and mobility capabilities. The PROMIS PROWalk questionnaire is a subset of questions from the PROMIS databank, focused on a person's self-reported ability to walk and perform lower body tasks, including walking various distances, climbing stairs, and navigating different terrains. The PROMIS Physical Function assessment has proven to be a reliable and valid tool for evaluating mobility and physical function in clinical settings. It shows excellent internal consistency (mean marginal reliability of 0.94-0.96; Cronbach's alpha = 0.96), strong correlations with other physical function measures (ranging from 0.70 to 0.87), and is sensitive to patient clinical status changes over time (Rothrock et al., 2019).
Study Type
OBSERVATIONAL
Enrollment
1,000
This is an observational study that does not involve any intervention.
Driven to Discover Research Facility at the Minnesota State Fair
Saint Paul, Minnesota, United States
Monofilament Testing
The Centers for Medicare \& Medicaid Services (CMS) identifies the monofilament test as the means of diagnosing loss of protective sensation (https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=171). To conduct the test, a clinician applies pressure with various sizes of monofilament to selected parts of the foot and asks the participant to indicate when he/she feels the filament. Including catch trials helps to ensure accurate test results. Per CMS, inability to feel a 10-gram monofilament on at least two of five test sites on either foot indicates loss of protective sensation (LOPS).
Time frame: About 5 minutes of a single 20-minute session
Single Leg Stance
The Single Leg Stance Test (also called the unipedal stance test) "is a simple test for measuring static aspects of balance." It "is related to conditions such as peripheral neuropathy and intermittent claudication" and "is also associated with an increased risk for falls" (Spring et al., 2007) Participants stand unassisted on one leg with their hands on their hips. Timing begins when they lift one leg off the floor and ends when it touches the ground or the standing leg or an arm leaves the hips
Time frame: About 5 minutes of a single 20-minute session
PROMIS® Physical Function v2.0 PROWalk
Nine items were selected from the 165 items comprising the PROMIS Item Bank v2.0 - Physical Function. Specifically, the selected items measure an individual's ability to perform various activities that involve upright mobility (balance, standing, and walking). Participants rate the nine items on a scale of 1 to 5; the raw scores are converted to T-scores for comparison to national norms.
Time frame: About 5 minutes of a single 20-minute session
Demographic Information
We will continue to collect information about the participants: age, sex, race, ethnicity, fall history, diagnosis of diabetes, diagnosis of peripheral neuropathy, etc. No Protected Health Information (PHI) will be collected.
Time frame: About 5 minutes of a single 20-minute session
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