Effect of painful keratoses debridement on foot pain, balance and function in older adults

Background Painful feet in older people can detrimentally affect balance and are a risk factor for falls. Pain is often associated with plantar hyperkeratoses, which are easily treated by podiatrists. Currently, there is no data defining the effect this treatment has on balance or functional ability. Objective To determine the effects of scalpel debridement of painful plantar hyperkeratoses on pain, balance and functional ability in older people aged 65 years and over. Subjects Nineteen men and women aged 65–84 years (mean age 72, standard deviation 5.6). Methods Pain resulting from plantar hyperkeratoses was measured using a visual analogue scale. Static balance and functional ability were measured using tests of postural sway, co-ordinated stability and timed walking and stepping tests. Painful plantar hyperkeratoses were debrided with a scalpel then all tests were repeated, immediately and 7 days later. Results Following scalpel debridement, pain levels (sensory and afferent) were significantly reduced (P < 0.0001) and functional ability was significantly increased (P < 0.0001). There was no change in static balance ability. One week after debridement the improved performance in functional ability tests was maintained. Conclusions Debridement of painful plantar hyperkeratoses reduces pain and improves functional ability in older people. Its effect on static balance was inconclusive.