Background/Purpose: The purpose of this cross-sectional study was to examine the relation between self reported physical limitations and foot pain, foot structure and foot function in older men and women of the Framingham Foot Study (FFS).

Methods: 1860 participants in the FFS completed the foot questionnaire, which included foot pressure measurements and questions on physical limitations.  The presence of foot pain was defined (y/n) using the question “On most days, do you have pain, aching, or stiffness in either of your feet?” Foot structure and foot function were defined using standing and walking foot pressure scans from a Tekscan Matscan system, respectively.  The modified arch index describes foot structure as planus, cavus or referent using sex-specific quintiles from the population distribution. The center of pressure excursion index measures dynamic foot function as pronated, supinated, or referent using sex-specific quintiles from the population distribution. 

An overall physical limitations score was derived from items assessing difficulty (none vs. any [little, some, a lot, unable]) for 9 activities such as remaining balanced while standing; standing in one place; getting in/out of a car, a chair, or bed; putting on socks/stockings; and up/down 1 flight of stairs. We created an overall score by summing the number of tasks with limitations (range 0-9) and also a mean difficulty score across all levels of difficulty in the 9 items, range 0-4. Linear regression estimated the association between physical limitation score and foot pain, foot structure and foot function, adjusting for age, height, weight and sex

Results: Of the 1860 participants, 55% were women and mean age was 65 yrs (SD=10.6). 37% had no physical limitation. The average overall physical limitations score was 2 (SD=2.4) and average mean difficulty score was 0.36 (SD=0.50). 27% reported foot pain, 34% were pronators, 27% were supinators, 24% had cavus foot and 29% had planus foot. 

Those with foot pain reported more physical limitations than those without (p<.0001).  Foot structure and foot function were not associated with the overall physical limitation score in adjusted models (Table).  Remarkably similar results were seen for the mean difficulty score as seen with the overall physical limitations score.

Conclusion: Foot pain is strongly associated with self-reported physical limitations, but foot structure and foot function are not. Persons may adapt to their own foot structure and foot function so that it does not limit physical activity.  Objective measures of physical limitations are needed to provide other insights into the links with foot pain.