A systematic review of the effect of foot orthoses and shoe characteristics on balance in healthy older subjects

Aboutorabi, Atefeh; Bahramizadeh, Mahmood; Arazpour, Mokhtar; Fadayevatan, Reza; Farahmand, Farzam; Curran, Sarah; Hutchins, Stephen W

doi:10.1177/0309364615588342

Cited by 56 publications

(65 citation statements)

References 53 publications

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“…Recent evidence suggests that custom-made footplates (e.g., custom foot orthoses) could realign the foot and increase the surface area contact between the foot and the ground, enhancing tactile stimulation of the plantar surface of the foot and further improving postural stability [13]. Moreover, the use of custom foot orthoses can effectively reduce foot pain and increase spontaneous physical activity [14], potentially increasing older adults’ adherence and acceptability to foot orthoses in their free-living environment.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses on Balance, Fear of Falling, and Physical Activity in Older Adults: A Randomized Controlled Trial

et al. 2018

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Background: Foot problems are prevalent in older adults, which may increase the risk and concern for falls. Ankle-foot orthoses (AFO) have been shown to be effective in the stabilization of lower extremities, but their long-term effectiveness in improving balance and their potential to encourage older adults to become more physically active are still debated. Objective: This randomized controlled trial investigated the effectiveness of daily use of a custom-made AFO on balance, fear of falling, and physical activity in older adults. Study Design: Forty-four older adults with concern about or at risk for falling were randomly allocated to either the control group (CG; 77.3% female, age 75.6 ± 6.5 years, BMI 29.3 ± 6.4) or the intervention group (IG; 63.6% female, age 73.7 ± 6.3 years, BMI = 27.8 ± 4.8). The IG received walking shoes and bilateral custom-made AFO. The CG received only walking shoes. At the baseline and 6-month follow-ups, balance and physical activity were assessed using validated wearable instrumentation and fear of falling was assessed using the Fall Efficacy Scale-International (FES-I). Adherence and acceptability toward wearing the AFO were assessed using self-reported questionnaires at the 6-month follow-up. Results: No significant between-group difference was observed at baseline (p = 0.144–0.882). Compared to baseline and the CG, hip, ankle, and center-of-mass (COM) sways were significantly reduced at the 6-month follow-up in the IG while standing with the feet together during the eyes-open condition (p = 0.005–0.040). Within the IG, the FES-I was reduced significantly (p = 0.036) and there was an increasing trend in the number of walking bouts with a medium effect size (d = 0.52, p = 0.440) compared to baseline. However, there were no significant changes in FES-I and physical activity measures in the CG (p = 0.122–0.894). The reduction in COM sway in the IG was moderately correlated with adherence (r = –0.484, p = 0.047) and strongly correlated with baseline COM sway (r = –0.903, p < 0.001). Conclusion: Results suggest that bilateral custom-made AFO plus walking shoes is effective in improving balance compared to walking shoes alone, and it significantly reduces the fear of falling, with a nonsignificant but noticeable positive trend in physical activity, compared to baseline. The results also suggest that older adults with poor balance at baseline and higher daily adherence to using the AFO will gain more benefit from the AFO intervention.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses on Balance, Fear of Falling, and Physical Activity in Older Adults: A Randomized Controlled Trial

et al. 2018

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“…The enclosed slippers were specifically selected as they incorporate several features considered beneficial to balance (i.e. a low, firm sole, a rigid heel counter, and Velcro ® fastening) [5,6] . Our findings indicate that balance ability -as evidenced by performances on tests of postural sway, limits of stability, and tandem walkingwas optimised when wearing the enclosed slipper.…”

Section: Discussionmentioning

confidence: 99%

“…These slippers incorporate several design features which are considered to be beneficial to balance, such as a relatively thin, firm rubber sole, a firm heel counter, and sturdy fixation provided by the Velcro ® straps [5,6] . Our findings therefore confirm the observations of previous laboratory studies using outdoor footwear.…”

Section: Discussionmentioning

confidence: 99%

“…Up to 15% of falls result in serious injury such as head trauma, fractures, disloca-tions, and lacerations [3] , making falls the leading cause of injury-related hospitalisation and mortality in older people [4] . Although falls are complex and multifactorial, several studies have shown that footwear influences balance and may therefore play a role in increasing the risk of falls in this age group [5,6] . Specifically, footwear with elevated or narrow heels, soft midsoles, and lack of fixation is considered to be detrimental [5,6] .…”

Section: Introductionmentioning

confidence: 99%

“…Although falls are complex and multifactorial, several studies have shown that footwear influences balance and may therefore play a role in increasing the risk of falls in this age group [5,6] . Specifically, footwear with elevated or narrow heels, soft midsoles, and lack of fixation is considered to be detrimental [5,6] .…”

Section: Introductionmentioning

confidence: 99%

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Effects of Indoor Footwear on Balance and Gait Patterns in Community-Dwelling Older Women

2016

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(walking speed, cadence, and step length). No footwear effects were observed for maximum excursion when performing the limits of stability test or for speed when performing the tandem walk test. Post hoc tests indicated that performances were best while wearing the enclosed slippers, intermediate with socks, and worst with backless slippers. The enclosed slippers were perceived to be more attractive, comfortable, and well fitted, but heavier than the backless slippers. Most participants (n = 23; 77%) reported that they would consider wearing the enclosed slippers to reduce their risk of falling. Conclusion: Indoor footwear with an enclosed heel, Velcro ® fastening, and a firm sole optimises balance and gait compared to backless slippers, and is therefore recommended to reduce the risk of falling.

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Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review

Horstink

Woude

Hijmans

2021

Rev Endocr Metab Disord

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Patients with diabetic peripheral neuropathy (DPN) usually have reduced somatosensory information and altered perception in feet and ankles. Somatosensory information acts as feedback for movement control and loss of somatosensation leads to altered plantar pressure patterns during gait and stance. Offloading devices are used to reduce peak plantar pressure and prevent diabetic foot ulcers. However, offloading devices can unfortunately have negative effects on static and dynamic balance. It is important to investigate these unwanted effects, since patient with DPN already are at high risk of falling and offloading devices could potentially increase this risk. The aim of this systematic review is to investigate the effects of plantar offloading devices used for ulcer prevention on their role in static and dynamic balance control in patients with DPN. PubMed and Embase were systematically searched using relevant search terms. After title selection, abstract selection, and full-text selection only five articles could be included for further analysis. Two articles included static balance measurements, two articles included dynamic balance measurements, and one article included both. Results suggested that static balance control is reduced when rocker bottom shoes and different insole configurations are used, however, toe-only rockers showed less evidence for reduced static balance control. There was no evidence for reduced dynamic balance control in combination with offloading devices. However, these results should be interpreted with care, since the number of studies was very small and the quality of the studies was moderate. Future research should evaluate balance in combination with different offloading devices, so that clinicians subscribing them are more aware of their potential unwanted consequences.

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A systematic review of the effect of foot orthoses and shoe characteristics on balance in healthy older subjects

Cited by 56 publications

References 53 publications

Effectiveness of Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses on Balance, Fear of Falling, and Physical Activity in Older Adults: A Randomized Controlled Trial

Effectiveness of Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses on Balance, Fear of Falling, and Physical Activity in Older Adults: A Randomized Controlled Trial

Effects of Indoor Footwear on Balance and Gait Patterns in Community-Dwelling Older Women

Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review

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