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

Menz, Hylton B.; Auhl, Maria; Munteanu, Shannon E.

doi:10.1159/000448892

Cited by 29 publications

(33 citation statements)

References 38 publications

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“…A shoe's material and tread design can affect the coefficient of friction on the walking surface, which may influence the risk of slipping [15,16]. Thin, hard-soled footwear with high collars are advised to reduce the risk of falling [17,18]. Heel height and width may affect a shoe's tendency to tip sideways on an uneven surface, as well as gait and posture [6,19].…”

Section: Introductionmentioning

confidence: 99%

Does the shoe really fit? Characterising ill-fitting footwear among community-dwelling older adults attending geriatric services: an observational cross-sectional study

et al. 2020

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Background: Falls in older people are common and can result in loss of confidence, fear of falling, restriction in activity and loss of independence. Causes of falls are multi-factorial. There is a paucity of research assessing the footwear characteristics among older people who are at high risk of falls, internationally and in the Irish setting. The aim of this study was to examine the proportion of older adults attending a geriatric day hospital in Ireland who were wearing incorrectly sized shoes. Methods: A consecutive sample of 111 older adults aged 60 years and over attending a geriatric day hospital in a large Irish teaching hospital was recruited. Demographic data including age, mobility, medications, co-habitation status, footwear worn at home and falls history were recorded. Shoe size and foot length were measured in millimetres using an internal shoe gauge and SATRA shoe size stick, respectively. Participants' self-reported shoe size was recorded. Footwear was assessed using the Footwear Assessment Form (FAF). A Timed Up and Go (TUG) score was recorded. Functional independence was assessed using the Nottingham Extended Activities of Daily Living (NEADL) Scale. The primary outcome of interest in this study was selected as having footwear within the suggested range (10 to 15 mm) on at least one foot. Participants who met this definition were compared to those with illfitting footwear on both feet using Chi-square tests, T-tests or Mann-Whitney U tests. Results: The mean difference between shoe length and foot length was 18.6 mm (SD: 9.6 mm). Overall, 72% of participants were wearing footwear that did not fit correctly on both feet, 90% had shoes with smooth, partly worn or fully worn sole treading and 67% reported wearing slippers at home. Participant age, TUG score and NEADL score were not associated with ill-fitting footwear. Conclusions: Wearing incorrectly fitting shoes and shoes with unsafe features was common among older adults attending geriatric day services in this study. A large number of participants reported wearing slippers at home.

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Section: Introductionmentioning

confidence: 99%

Does the shoe really fit? Characterising ill-fitting footwear among community-dwelling older adults attending geriatric services: an observational cross-sectional study

et al. 2020

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“…Increased muscle activation can lead to muscle fatigue and strain which could be associated with pain and discomfort experienced by high heel shoe wearers [39] Injury to the foot and ankle increases, as the height of the heel increases with fractures, sprains and strains being the most prevalent pathology [44]. The main injury appears to be acute trauma and as a result from a fall in a high heel rather than a long-term deformity, however a heel higher than 2.5 cm in heel height leads to an increase in prevalence of corns and callus in older individuals [45]. Forefoot pathologies are reported to be associated with heel increases, particularly hallux abducto valgus [46,47] Although this is not clear if this is due to the height of the heel or the altered toe box depth and width that is often seen as a design feature of this style of shoe.…”

Section: High Heelsmentioning

confidence: 99%

“…Understanding the impact a stiff heel counter has on function and pain is limited. A stiffer counter does not alter pain in arthritic knees [50] and has no effect on athletic performance [51] but has been shown to reduce the risk of a person falling [45]. Application of when to use a stiff heel counter and how stiff the material should be is still not clear therefore making footwear advice tailored to specific patient complaints difficult.…”

Section: Mythologymentioning

confidence: 99%

Everyday footwear: An overview of what we know and what we should know on ill-fitting footwear and associated pain and pathology

Branthwaite

Chockalingam

2019

The Foot

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Footwear has been used to protect feet for millennia with socially exclusive population adopting stylish and fashionable shoes with expensive materials. In terms of historic timeline, only more recently footwear has been worn by all classes in the western world as an integral part of their apparel. Traditionally, footwear has been constructed from natural materials, mainly leather, but has recently benefitted from the flexibility that technology has provided with a plethora materials and new design innovations. Although it has expanded the availability for a variety of consumers, the choice and fit continue to be problematic with many individuals wearing shoes that are ill-fitting. Provision of specific footwear advice for problem feet is poorly evidenced and is heavily practitioner dependant limiting its efficacy. There is limited understanding as to the changes that can occur from regularly wearing footwear that is unsuitable in shape, style and construction which is referred to as ill-fitting. Current research on the effect that everyday footwear has on foot function and pain focuses mainly on women's shoes, particularly high heels. Defining what is a good fitting shoe, that does not damage the foot or mechanics of walking, may need to be individualised, but best fit is based on loose historical parameters rather than research evidence. The aim of this overview is to highlight aspects of current research, establishing what we know about the effect's shoes have on the feet as well as exploring the mythology around footwear fit and advice that is often historical in nature.

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“…Suboptimal footwear is associated with fall-related hip fractures [13,22]. In a study of the footwear worn at the time of a fall-related hip fracture, the majority of the participants had worn slippers [26]. Walking with openheel shoes reduces gait quality and gait speed [19].…”

Section: Morphological Changes With Ageingmentioning

confidence: 99%

“…A bevelled heel may reduce the risk of slipping, because at heel strike a flatter shoe-floor angle improves grip [38]; therefore a bevelled heel has been advised for older people [26,38,37]. A posterior 10-degree heel bevel is optimal [41].…”

Section: Bevelled Heel and Bevelled Nose Of The Shoementioning

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

Cited by 29 publications

References 38 publications

Does the shoe really fit? Characterising ill-fitting footwear among community-dwelling older adults attending geriatric services: an observational cross-sectional study

Does the shoe really fit? Characterising ill-fitting footwear among community-dwelling older adults attending geriatric services: an observational cross-sectional study

Everyday footwear: An overview of what we know and what we should know on ill-fitting footwear and associated pain and pathology

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

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