Footwear influences balance and the subsequent risk of slips, trips, and falls by altering somatosensory feedback to the foot and ankle and modifying frictional conditions at the shoe/floor interface. Walking indoors barefoot or in socks and walking indoors or outdoors in high-heel shoes have been shown to increase the risk of falls in older people. Other footwear characteristics such as heel collar height, sole hardness, and tread and heel geometry also influence measures of balance and gait. Because many older people wear suboptimal shoes, maximizing safe shoe use may offer an effective fall prevention strategy. Based on findings of a systematic literature review, older people should wear shoes with low heels and firm slip-resistant soles both inside and outside the home. Future research should investigate the potential benefits of tread sole shoes for preventing slips and whether shoes with high collars or flared soles can enhance balance when challenging tasks are undertaken.

/pdf/optimizing-footwear-for-older-people-at-risk-of-falls-5fxmxaa8yz.pdf

Optimizing footwear for older people at risk of falls.

Effects of walking surfaces and footwear on temporo-spatial gait parameters in young and older people.

PURPOSE OF REVIEW: Falls are a serious problem for the elderly and others prone to fall. In particular, those over 65 years of age will suffer at least one fall a year and as a result will need cost-intensive medical treatment. Under these circumstances, an optimal clinical pathway should first identify those with a tendency to fall, second, pinpoint the disease-specific deficits in balance control and walking patterns, and third, offer the possibility through focused biofeedback training to reduce the number of falls suffered. This review describes new methods of assessing balance control in both static and dynamic balance conditions and their applications for balance rehabilitation. RECENT FINDINGS: Technological advances and applied research have shown that body-worn sensors measuring angular velocity (gyroscopes) or the acceleration of the trunk can effectively quantify balance during stance and gait tasks, and can be used to detect potential fallers and discriminate between different balance disorders. Standing on foam support reveals balance deficits regardless of the underlying disease. Disease-specific balance deficits can be characterized by the pattern of trunk movements between various semi-stance and gait tasks. Angular velocity sensors have recently been shown to provide highly relevant information for use as biofeedback, or as an ambulatory device to record balance and gait performance over long periods of time in both clinical and natural living conditions. SUMMARY: Angular velocity sensors can provide balance-relevant information directly to the clinician, and provide an important improvement on the complicated and time/cost-intensive techniques of traditional balance measurement systems.

A speedy solution for balance and gait analysis: angular velocity measured at the centre of body mass.

Center of pressure displacement characteristics differentiate fall risk in older people: A systematic review with meta-analysis.

This article explores relevant full-text literature to reveal the effects of heel height on gait and posture and the kinetics and kinematics of the foot, ankle, knee, hip, and spine. Furthermore, special attention will be given to the implications of increased heel height for clinicians treating locomotor disorders and provide information to aid clinical decision making. Full-text articles accessed from databases including AMED, ASSIA, Blackwell Synergy, BNI, Voyager, CINAHL, ScienceDirect, and Taylor Francis inform the review.

/pdf/the-effect-of-heel-height-on-gait-and-posture-a-review-of-65a1ju4oau.pdf

The effect of heel height on gait and posture: a review of the literature.

Footwear is supposed to have influence on postural control and is a potential aspect to address in the prevention of falls in the elderly. This study aimed to show whether measurements of static balance and gait are different with habitual shoes compared to new special senior shoes with different heel height and whether these results change after adaptation. In a randomized controlled intervention study, 26 subjects (median age 87 years) were recruited from two nursing homes and one facility of assisted living. Measurements of static balance and gait were performed with habitual shoes and two types of new special senior shoes differing in heel height. Measurements were repeated after five weeks. There was no difference in static balance and gait with habitual shoes compared to either of the new footwear offered. Results of performance with higher heels were not different compared to lower heels. No further effect of adaptation after wearing a new shoe over five weeks could be demonstrated. With respect to static and dynamic balance, there seems to be a wide range of acceptable footwear as long as the heel height is below a critical value. A standardized shoe can be used in the assessment of balance because the effect of adaptation can be neglected.

Elevated heels and adaptation to new shoes in frail elderly women

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Elevated heels and adaptation to new shoes in frail elderly women