Footwear width and balance-recovery reactions: A new approach to improving lateral stability in older adults

Yamaguchi, Takeshi; Cheng, Kan; McKay, Susan; Maki, Brian E.

doi:10.4017/gt.2015.13.3.008.00

Cited by 5 publications

(7 citation statements)

References 28 publications

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“…Furthermore, postural sway was significantly reduced at the completion of the task, indicating better balance recovery in response to the lateral instability induced by tandem walking. Several features of the prototype footwear may have been responsible for this improvement, including the supportive heel collar (by providing mechanical resistance to excessive ankle movement [ 39 ] and enhanced tactile feedback of ankle position [ 40 ]), the large surface area of the sole [ 41 , 42 ], and the textured insole providing tactile feedback relating to lateral displacement of the centre of mass [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Preliminary evaluation of prototype footwear and insoles to optimise balance and gait in older people

2017

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BackgroundFootwear has the potential to influence balance in either a detrimental or beneficial manner, and is therefore an important consideration in relation to falls prevention. The objective of this study was to evaluate balance ability and gait patterns in older women while wearing prototype footwear and insoles designed to improve balance.MethodsOlder women (n = 30) aged 65 – 83 years (mean 74.4, SD 5.6) performed a series of laboratory tests of balance ability (postural sway on a foam rubber mat, limits of stability and tandem walking, measured with the Neurocom® Balance Master) and gait patterns (walking speed, cadence, step length and step width at preferred speed, measured with the GAITRite® walkway) while wearing (i) flexible footwear (Dunlop Volley™), (ii) their own footwear, and (iii) prototype footwear and insoles designed to improve dynamic balance. Perceptions of the footwear were also documented using a structured questionnaire.ResultsThere was no difference in postural sway, limits of stability or gait patterns between the footwear conditions. However, when performing the tandem walking test, there was a significant reduction in step width and end sway when wearing the prototype footwear compared to both the flexible footwear and participants’ own footwear. Participants perceived their own footwear to be more attractive, comfortable, well-fitted and easier to put on and off compared to the prototype footwear. Despite this, most participants (n = 18, 60%) reported that they would consider wearing the prototype footwear to reduce their risk of falling.ConclusionThe prototype footwear and insoles used in this study improve balance when performing a tandem walk test, as evidenced by a narrower step width and decreased sway at completion of the task. However, further development of the design is required to make the footwear acceptable to older women from the perspective of aesthetics and comfort.Trial registrationAustralian New Zealand Clinical Trials Registry. ACTRN12617001128381, 01/08/2017 (retrospectively registered).

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Section: Discussionmentioning

confidence: 99%

Preliminary evaluation of prototype footwear and insoles to optimise balance and gait in older people

2017

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“…Cheng & Maki (2015) [86] found that a small increase in sole width improved postural stability during lateral perturbation and step reactions. Menant et al (2008a) [65] call for further studies to investigate the potential benefits of tread soled shoes for preventing slips.…”

Section: Figure 5 Pathway For Use Of Footwear Linked To Fallsmentioning

confidence: 99%

Lower-Limb Factors Associated with Balance and Falls in Older Adults: A Systematic Review and Clinical Synthesis

Neville¹,

Nguyen²,

Ross³

et al. 2020

Journal of the American Podiatric Medical Association

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Background: Despite evidence suggesting that lower-limb related factors may contribute to fall-risk in older adults, lower-limb and footwear influences on fall-risk have not been systematically summarized. This study was undertaken to systematically review the literature related to lower-limb and footwear factors that may increase fall-risk among community-dwelling older adults. To facilitate the transfer of findings to clinical care, the literature was synthesized and used to inform recommendations as well as the development of clinical pathways for each factor found to be an influence on fall risk. Methods: PubMed, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Library, and AgeLine were searched for articles pertaining to age-related changes in the lower-limb and their association with fall-risk. To describe the trajectory leading or potentially leading to increased fall-risk, we examined articles that linked age-related changes in the lower-limb, footwear and orthoses to evidence-based fall-risk factors (e.g., balance impairment) or prospectively demonstrated a relationship with falls. Results: The systematic review consisted of 81 articles that met the inclusion criteria. Our results reflect a narrative review of the appraised literature for 8 pathways of lower-limb related influences on fall-risk in older adults. Six out of the eight pathways, including range of motion, orthoses, strength, footwear, pain, and deformity support a direct link with fall-risk. The two other pathways, including plantar skin/soft-tissue and sensory-loss, are connected via intermediate factors but lack studies that provide evidence of a direct link. The overall strength of the evidence available varied considerably for the 8 pathways presented. Conclusions: Findings provide much needed guidance supporting the identification and management of lower-limb and footwear-related influences on fall risk among older adults. Due to the lack or low quality of the evidence in specific areas, some recommendations should be applied with caution until more robust evidence is available.

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“…Greater sole/surface contact area was found to be associated with a significantly lower risk of a fall [36]. Shoes with a widened base of support improve lateral stability [43].…”

Section: Sole Width Hardness and Sole Resiliencementioning

confidence: 92%

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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Footwear width and balance-recovery reactions: A new approach to improving lateral stability in older adults

Cited by 5 publications

References 28 publications

Preliminary evaluation of prototype footwear and insoles to optimise balance and gait in older people

Preliminary evaluation of prototype footwear and insoles to optimise balance and gait in older people

Lower-Limb Factors Associated with Balance and Falls in Older Adults: A Systematic Review and Clinical Synthesis

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

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