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

Abstract

Postural and walking instabilities contribute to falls in older adults. Given that shoes affect human locomotor stability and that visual, cognitive and somatosensory systems deteriorate during aging, we aimed to: (1) compare the effects of footwear type on stability and mobility in persons with a history of falls, and (2) determine whether the effect of footwear type on stability is altered by the absence of visual input or by an additional cognitive load. Thirty participants performed standing and walking trials in three footwear conditions, i.e. conventional shoes, minimal shoes, and barefoot. The outcomes were: (1) postural stability (movement of the center of pressure during eyes open/closed), (2) walking stability (Margin of Stability during normal/dual-task walking), (3) mobility (the Timed Up and Go test and the Star Excursion Balance test), and (4) perceptions of the shoes (Monitor Orthopaedic Shoes questionnaire). Participants were more stable during standing and walking in minimal shoes than in conventional shoes, independent of visual or walking condition. Minimal shoes were more beneficial for mobility than conventional shoes and barefoot. This study supports the need for longitudinal studies investigating whether minimal footwear is more beneficial for fall prevention in older people than conventional footwear.

Characterization of Anticipatory Postural Adjustments in Lateral Stepping: Impact of Footwear and Lower Limb Preference

“…Previous studies on forward step initiation highlighted that shoes do not impact postural preparation along the AP axis [32,33]; consistently, our results showed no significant effects of footwear along the AP direction. A possible explanation is that, although shoes modify dynamic postural control and foot stability [35][36][37]50,51], they do not influence the mechanism underlying the AP CoP displacement as much (i.e., ankle dorsiflexion) [13,15,52]. On the contrary, and in line with the literature on forward step [32,33], footwear significantly affected APAs along the ML direction.…”

“…APAs are known to be modulated by the central nervous system based on environmental factors [53][54][55] as well as tactile, kinesthetic, and proprioceptive information [2,3,56]. The literature shows that footwear may represent a constraint for ankle and foot joints [35,37,38] and may also interfere with afferent information gathered by the feet soles, due to the interposition of cushioning elements (e.g., midsole). In addition, larger postural preparation along the ML direction may result in smaller velocities and accelerations of the body during the movement [21,27].…”

“…For instance, footwear and limb preference play a relevant role, especially when considering everyday life conditions [31][32][33]. Footwear is present in most of the steps people take every day, providing sanitary and mechanical protection, yet at the same time modifying body kinematics [34][35][36][37]. Research has shown that footwear induces alteration of gait either by altering the ankle range of motion [38] or by influencing somatosensory information [39,40].…”

Prevalence of Sarcopenia and Its Association with Quality of Life, Postural Stability, and Past Incidence of Falls in Postmenopausal Women with Osteoporosis: A Cross-Sectional Study

“…Several randomized controlled trials (RCTs) have demonstrated the efficacy of resistance exercise in stimulating osteoblastogenesis and muscle protein synthesis, leading to improvements in the bone microarchitecture, muscle mass and strength, and functional capacity in osteoporotic and sarcopenic seniors [ 71 , 72 , 73 ]. Selection of appropriate footwear should also be considered as it affects postural and gait stability [ 74 ]. Regarding the nutritional approach, it is well established that intake of dietary protein containing abundant levels of leucine, and sufficient vitamin D levels are recommended for muscle and bone health, as well as muscle strength, balance, and functional capacity [ 75 ].…”

Effects of human variation on foot and ankle pain in rural Madagascar

“…. Although we now have a better understanding of the mismatch between these conventional shoes and the limitations they put on foot biomechanics and proprioception (Boyle et al, 2019;Cudejko et al, 2020;Holowka et al, 2018;Holowka et al, 2019;Lieberman et al, 2010;Willems et al, 2020), the reasons why societies would want to adopt such footwear have yet to be thoroughly examined. Style (Riello & McNeil, 2006), protection from trauma (Engle & Morton, 1931), and comfort (Lieberman et al, 2010;Nigg, 1986) are notable benefits.…”