Can Insoles Be Used to Improve Static and Dynamic Balance of Community-Dwelling Older Adults? A Systematic Review on Recent Advances and Future Perspectives

Zong-Hao, Christina; Lam, Wing-Kai; Chang, Bao Chi; Lee, Winson C.C.

doi:10.1123/japa.2019-0293

Cited by 8 publications

(4 citation statements)

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“…By examining the hip adductor/abductor, hip flexor/extensor, knee flexor/extensor, and ankle dorsiflexor/plantarflexor simultaneously, this study identified the essential importance of ankle muscles' rapid activation in resisting horizontal pertur-bations for young adults. It is also expected that this study's more comprehensive and in-depth investigation in the eight leg muscles' activities could facilitate the future development of programs and assistive devices to improve balance and prevent falls in older adults [53][54][55][56][57][58][59][60][61][62][63][64].…”

Section: Faster Activation Existed In Agonist Lower-limb Muscles Espa...mentioning

confidence: 99%

Muscular and Kinematic Responses to Unexpected Translational Balance Perturbation: A Pilot Study in Healthy Young Adults

et al. 2023

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Falls and fall-related injuries are significant public health problems in older adults. While balance-controlling strategies have been extensively researched, there is still a lack of understanding regarding how fast the lower-limb muscles contract and coordinate in response to a sudden loss of standing balance. Therefore, this pilot study aims to investigate the speed and timing patterns of multiple joint/muscles’ activities among the different challenges in standing balance. Twelve healthy young subjects were recruited, and they received unexpected translational balance perturbations with randomized intensities and directions. Electromyographical (EMG) and mechanomyographical (MMG) signals of eight dominant-leg’s muscles, dominant-leg’s three-dimensional (3D) hip/knee/ankle joint angles, and 3D postural sways were concurrently collected. Two-way ANOVAs were used to examine the difference in timing and speed of the collected signals among muscles/joint motions and among perturbation intensities. This study has found that (1) agonist muscles resisting the induced postural sway tended to activate more rapidly than the antagonist muscles, and ankle muscles contributed the most with the fastest rate of response; (2) voluntary corrective lower-limb joint motions and postural sways could occur as early as the perturbation-induced passive ones; (3) muscles reacted more rapidly under a larger perturbation intensity, while the joint motions or postural sways did not. These findings expand the current knowledge on standing-balance-controlling mechanisms and may potentially provide more insights for developing future fall-prevention strategies in daily life.

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Section: Faster Activation Existed In Agonist Lower-limb Muscles Espa...mentioning

confidence: 99%

Muscular and Kinematic Responses to Unexpected Translational Balance Perturbation: A Pilot Study in Healthy Young Adults

et al. 2023

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“…Numerous risk factors for falls in older adults have been identified, including medical conditions such as stroke and Parkinson's disease, use of psychoactive medications, sensory and neuromuscular factors (reduced vision, peripheral sensory loss, and muscle weakness), and balance disturbances resulting from agerelated decline [8]. Footwear, orthotic devices, and insoles are modifiable factors that have been shown to influence balance performance and gait patterns in older individuals [9][10][11]. While certain footwear features, such as elevated heels have been shown to adversely affect balance [9], others, such as a high collar, lower heel height, thin and firm midsole, and slip resistant outer sole with tread, have been shown to be beneficial for improving balance [12].…”

Section: Introductionmentioning

confidence: 99%

“…Systematic reviews published previously have explored the effects of insoles alone or the effects of orthotics combined with specific shoe features on balance in older adults [11][12][13]. However, more recent studies have been published, prompting the need for this updated review.…”

Section: Introductionmentioning

confidence: 99%

Footwear, Orthoses, and Insoles and Their Effects on Balance in Older Adults: A Scoping Review

Nor Azhar,

Bergin,

Munteanu

et al. 2024

Gerontology

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Background: Footwear, orthoses, and insoles have been shown to influence balance in older adults, however it remains unclear which features, singular or in combination, are considered optimal. The aim of this scoping review was to identify and synthesise the current evidence regarding how footwear, orthoses, and insoles influence balance in older adults. Four electronic databases (MEDLINE, CINAHL, Embase and AMED) were searched from inception to October 2023. Key terms such as “shoe*”, “orthoses”, “postural balance” and “older people” were employed in the search strategy. Studies meeting the following criteria were included: (i) participants had a minimum age ≥ 60 years, and were free of any neurological, musculoskeletal, and cardiovascular diseases, (ii) an active intervention consisting of either footwear, foot orthoses or insoles was evaluated, and (iii) at least one objective outcome measure of balance was reported. Summary: A total of 56 studies from 17 different countries were included. Three study designs were utilised (cross-sectional study, n=44; randomised parallel group, n=6; cohort study n=6). The duration of studies varied considerably, with 41 studies evaluating immediate effects, 14 evaluating effects from three days to 12 weeks, and 1 study having a duration of 6 months. 17 different interventions were evaluated, including/consisting of textured insoles (n=12), heel elevation (n=8), non-specific standardised footwear and changes in sole thickness or hardness (n=7 each), sole geometry or rocker soles, contoured or custom insoles and high collar height (n=6 each), insole thickness or hardness and vibrating insoles (n=5 each), outsole tread (n=4), minimalist footwear and slippers (n=3 each), balance-enhancing shoes, footwear fit, socks, and ankle-foot orthoses (n=2 each), and eversion insoles, heel cups, and unstable footwear (n=1 each). 23 different outcomes were assessed, and postural sway was the most common (n=20), followed by temporo-spatial gait parameters (n=17). There was uncertainty regarding intervention effectiveness. Overall, features such as secure fixation, a textured insole, a medium-to-hard density midsole and a higher ankle collar, in isolation, were able to positively impact balance. Conversely, footwear with an elevated heel height and use of socks and slippers impaired balance. Key Messages: There is a substantial body of literature exploring the effects of footwear, orthoses, and insoles on balance in older adults. However, considerable uncertainty exists regarding the efficacy of these interventions due to variability in methodological approaches. Further high-quality research is necessary to determine whether a singular intervention or a combination of interventions is most effective for enhancing balance in older adults.

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“…However, the effectiveness of non-slip socks on slip-prevention remains unclear [ 9 ]. A recent systematic review reported that insoles (e.g., orthopedic, textile, or vibrating insoles) generally improve static and dynamic balance, but may not be able to address the environmental risk factor of a slippery floor [ 10 ]. Slip-resistant shoes can increase friction between footwear and ground surfaces, and reduce the severity of the slip [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Reducing Slip Risk: A Feasibility Study of Gait Training with Semi-Real-Time Feedback of Foot–Floor Contact Angle

Zong-Hao

Bao

DiCesare

et al. 2022

Sensors

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Slip-induced falls, responsible for approximately 40% of falls, can lead to severe injuries and in extreme cases, death. A large foot–floor contact angle (FFCA) during the heel-strike event has been associated with an increased risk of slip-induced falls. The goals of this feasibility study were to design and assess a method for detecting FFCA and providing cues to the user to generate a compensatory FFCA response during a future heel-strike event. The long-term goal of this research is to train gait in order to minimize the likelihood of a slip event due to a large FFCA. An inertial measurement unit (IMU) was used to estimate FFCA, and a speaker provided auditory semi-real-time feedback when the FFCA was outside of a 10–20 degree target range following a heel-strike event. In addition to training with the FFCA feedback during a 10-min treadmill training period, the healthy young participants completed pre- and post-training overground walking trials. Results showed that training with FFCA feedback increased FFCA events within the target range by 16% for “high-risk” walkers (i.e., participants that walked with more than 75% of their FFCAs outside the target range) both during feedback treadmill trials and post-training overground trials without feedback, supporting the feasibility of training FFCA using a semi-real-time FFCA feedback system.

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Can Insoles Be Used to Improve Static and Dynamic Balance of Community-Dwelling Older Adults? A Systematic Review on Recent Advances and Future Perspectives

Cited by 8 publications

References 81 publications

Muscular and Kinematic Responses to Unexpected Translational Balance Perturbation: A Pilot Study in Healthy Young Adults

Muscular and Kinematic Responses to Unexpected Translational Balance Perturbation: A Pilot Study in Healthy Young Adults

Footwear, Orthoses, and Insoles and Their Effects on Balance in Older Adults: A Scoping Review

Reducing Slip Risk: A Feasibility Study of Gait Training with Semi-Real-Time Feedback of Foot–Floor Contact Angle

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