Does Footwear Matter When Performing Spatiotemporal Gait Analysis Among Older Women?

PurposeThe aim of this study was to evaluate changes in foot shape of women 5 years after undergoing breast amputation.MethodsEvaluation of foot shape was performed using a non-invasive device for computer analysis of the plantar surface of the foot. Obtained results were compared between feet on the healthy breast side (F1) and on the amputated breast side (F2).Results128 women aged 63.60 ± 8.83, 5–6 years after breast amputation were enrolled in this case–control study. Weight bearing on the lower extremity on the amputated breast side (F1) compared with the healthy breast side (F2) showed statistically significant differences (p < 0.01). Patients put more weight onto the healthy breast side. No statistically significant difference was found with regard to F1 and F2 foot length (p = 0.4239), as well as BETA (p = 0.4470) and GAMMA (p = 0.4566) angles. Highly statistically significant differences were noted with respect to foot width, ALPHA angle, and Sztriter–Godunov index—higher values were observed on the healthy breast side (p < 0.001). Highly statistically significant differences were also noted while comparing Clark’s angles, higher values being observed on the operated breast side (p < 0.001).ConclusionsDifferences in foot shape on the healthy breast side and amputated breast side constitute a long-term negative consequence of mastectomy, and can be caused by unbalanced weight put on feet on the healthy breast side compared to the amputated breast side.

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“…It is a characteristic feature in postmenopausal women. It is partly caused by wearing poorly fitting shoes [27–31]. …”

Section: Discussionmentioning

confidence: 99%

Evaluation of changes to foot shape in females 5 years after mastectomy: a case–control study

Głowacka-Mrotek

Sowa

Siedlecki

et al. 2017

Breast Cancer Res Treat

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“…Several studies found an association between ill-fitting shoes, foot pain and a possible increase in fall risk [8,10]. Ill-fitting shoes and shoes with absent or poor fixation [13] reduce balance and gait and increase fall risk and reduce quality of life and social functioning [16][17][18][19][20]13,14,21].…”

Section: Morphological Changes With Ageingmentioning

confidence: 99%

“…Walking barefoot has a negative effect on balance and gait [22,23,17,24,25] and so sharply increases fall risk [20]. Suboptimal footwear is associated with fall-related hip fractures [13,22].…”

Section: Morphological Changes With Ageingmentioning

confidence: 99%

Shoe design for older adults: Evidence from a systematic review on the elements of optimal footwear

et al. 2019

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Due to changes in foot morphology and the occurrence of foot deformities and foot pain with ageing, older people frequently wear ill-fitting shoes. This can lead to discomfort and reduced mobility. A review of the literature was performed in Medline, Scopus and Embase with three aims: (a) to evaluate the effects of shoes or shoe elements on the comfort and mobility of older adults, (b) to summarise the evidencebased elements of a safe and comfortable shoe for older adults, and (c) from that, to compile those elements into design recommendations for a safe and comfortable shoe for older adults. Safe elements of footwear include proper anatomical fit, a well-fitting toe box, limited heel height, a broad enough heel, a firm insole and midsole, an outsole with sufficient tread, bevelled heel, firm heel counter with snug fit, and an easy and effective closing mechanism. We conclude that there is a need for shoe design specifically aimed at the foot morphology and demands of older people. The shoe market should increase the availability of well-fitting shoes designed for the older foot and person. 1.1. Morphological changes Changes in foot morphology occur with ageing, [2-7], and might differ between men and women [5]. Older adults have a lower medial foot arch but an increased circumference of the forefoot, ankle and instep [2]. For the same foot length, older men have larger foot parameters than women, including foot width, ball girth, upper arch, and toe depth [3]. Flat feet are more common in older women [8] and the first and fifth metatarsophalangeal angles are increased, which might be due to the higher prevalence of hallux valgus in women [4]. For older women, ball width, high instep circumference, and heel instep circumference also increase with age [5]. 1.2. Pain Many older adults are confronted with foot pain when wearing shoes [4,3,9-11]. This may be due to an increased prevalence of foot deformities, such as hallux valgus, mallet toes, hammer toes and claw toes [8]. Hallux valgus is related to the wearing of shoes with small toe boxes at age 20-39 years [12]. 1.3. Doffing and donning, i.e. getting in and out of shoes Ageing frequently leads to problems with doffing and donning, i.e. getting in and out of shoes [10]. Therefore, easy and effective closing mechanisms are usually preferred. 1.4. Ill-fitting shoes and safety aspects As a consequence of the afore-mentioned changes, older people often wear ill-fitting shoes [13,14] or resort to comfort shoes or slippers, especially in and around the home [9,10]. Unsafe or unsuitable shoes affect balance and gait, and might play

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Section: Introductionmentioning

confidence: 99%

“…Footwear has a direct effect on gait performance [ 11 – 13 ], which has led to the popularity of barefoot locomotion (walking and running) in recent years and has evoked an increasing scientific interest in its benefits and limitations [ 14 ]. Typically, a well-fitting standard shoe with laces, a low and wide heel, a firm heel collar, and a grooved, moderately hard sole is recommended for older adults in rehabilitation and daily use [ 11 ]. However, footwear interferes with balance and, as a result, the risk of slipping, tripping, and falls by varying somatosensory feedback to the foot and ankle and altering frictional conditions at the shoe/floor interface [ 15 ], which has been demonstrated to hinder kinesthesia [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Barefoot walking is more stable in the gait of balance recovery in older adults

et al. 2022

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Background Perturbation-based balance training on a treadmill is an emerging method of gait stability training with a characteristic task nature that has had positive and sustained effects on balance recovery strategies and fall reduction. Little is known about the effects produced by shod and barefoot walking. We aimed to investigate which is more appropriate, shod or barefoot walking, for perturbation-based balance training in older adults. Methods Fourteen healthy older adults (age: 68.29 ± 3.41 years; body height: 1.76 ± 0.10 m; body mass: 81.14 ± 14.52 kg) performed normal and trip-like perturbed walking trials, shod and barefoot, on a treadmill of the Gait Real-time Analysis Interactive Lab. The marker trajectories data were processed by Human Body Model software embedded in the Gait Offline Analysis Tool. The outcomes of stride length variability, stride time variability, step width variability, and swing time variability were computed and statistically analyzed by a two-way repeated-measures analysis of variance (ANOVA) based on gait pattern (normal gait versus perturbed recovery gait) and footwear condition (shod versus barefoot). Results Footwear condition effect (p = 0.0310) and gait pattern by footwear condition interaction effect (p = 0.0055) were only observed in swing time variability. Gait pattern effects were detected in all four outcomes of gait variability. Conclusions Swing time variability, independent of gait speed, could be a valid indicator to differentiate between footwear conditions. The lower swing time variability in perturbed recovery gait suggests that barefoot walking may be superior to shod walking for perturbation-based balance training in older adults.

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Does Footwear Matter When Performing Spatiotemporal Gait Analysis Among Older Women?

Cited by 8 publications

References 45 publications

Evaluation of changes to foot shape in females 5 years after mastectomy: a case–control study

Evaluation of changes to foot shape in females 5 years after mastectomy: a case–control study

Shoe design for older adults: Evidence from a systematic review on the elements of optimal footwear

Barefoot walking is more stable in the gait of balance recovery in older adults

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