Minimal footwear improves stability and physical function in middle-aged and older people compared to conventional shoes

Abstract

Background: Effects of minimal shoes on stability and physical function in older people are under-researched. No studies have systematically explored effects of a range of minimal footwear features on these factors in older people. Methods: A within-participant repeated-measures design was used. Participants were subjected to thirteen footwear conditions: (i) barefoot, (ii) a conventional shoe, (iii) a control minimal shoe, (iv-xiii) minimal shoes differing from the control minimal shoe by one design feature. The outcomes were: (i) postural stability expressed with movement of the center of pressure (CoP) during standing (ii) dynamic stability expressed with the CoP movement during walking, (iv) physical function assessed with the Timed Up and Go test (TUG), and (iv) perceptions of footwear assessed with the Monitor Orthopaedic Shoes questionnaire. Linear Mixed Models were applied for statistical analyses. Findings: Twenty-two people participated in the study. Compared to the conventional shoe, participants: (i) were more stable during standing and walking in the majority of minimal shoes, and (ii) completed the TUG test faster when wearing the minimal shoe with wider sole. Compared to the control minimal shoe, participants: (i) completed the TUG test faster when wearing the minimal shoe with wider sole; and (ii) perceived features such as a split toe and a higher ankle collar as less fashionable and wearable. Interpretation: Wearing minimal shoes might be more beneficial for stability and physical function in older adults than wearing conventional shoes. The results will be highly valuable for the design of minimal footwear for older adults.

Minimal shoes improve stability and mobility in persons with a history of falls

“…First, we show that wearing minimal shoes and being barefoot is more beneficial for postural stability than wearing conventional shoes (Table 1 , Supplementary Table S1 ). This is in line with our previous study in healthy middle-aged and older people 13 and extends it to persons with a history of falls. This is in contrast to Broscheid and Zech 17 who reported negative effects on postural control during barefoot and minimal shoe conditions compared to conventional shoes.…”

“…Finally, we demonstrate, that using minimal shoes is more beneficial for mobility in persons with a history of falls than barefoot and conventional shoes. Participants completed the TUG test approximately 0.3 s faster when in minimal shoes compared to barefoot or when wearing conventional shoes (Table 3 , Supplementary Table S3 ), which is comparable to our previous results in healthy middle-aged and older people 13 . In addition, we observe that participants performed better during the SEB test, when in minimal shoes than in barefoot or conventional shoes (difference in reach distance ranged 1–4.4 cm) (Table 3 , Supplementary Table S3 ).…”

“…We showed that independent of the design features, wearing minimal shoes was not different than barefoot for postural and walking stability, but was more beneficial than wearing conventional shoes. We also observed that prototypes with wider and harder soles were more beneficial for stability and mobility than prototypes with narrower and softer soles 13 .…”

“…We have previously compared multiple prototypes of a minimal shoe (Supplementary Fig. S1 C) with barefoot and conventional shoes in middle-aged and older people 13 . We showed that independent of the design features, wearing minimal shoes was not different than barefoot for postural and walking stability, but was more beneficial than wearing conventional shoes.…”

“…Therefore, building on the results of our previous research 13 , we here test the performance of the market-available minimal shoes by comparing its effects on stability, mobility, and design perceptions with conventional shoes and barefoot among persons with a history of falls. We hypothesise that wearing minimal shoes will be more beneficial for stability than wearing conventional shoes.…”