Although footwear has been recognised as a risk factor for falls in older people, it remains unclear as to which features of shoes are beneficial or detrimental to balance. This project aimed to systematically investigate the effects of common shoe features, namely: an elevated heel, a soft sole, a hard sole, a flared sole, a bevelled heel, a high-collar and a tread sole, on balance and gait in older community-dwelling people. The experimental shoes were compared to standard shoes in three studies examining: (i) standing balance, leaning balance and stepping in 29 older people, (ii) centre of mass (COM)-base of support (BOS) margins, vertical and braking loading rates, and perceived shoe comfort and stability in 11 young and 15 older people walking on even and uneven surfaces, and (iii) temporal-spatial gait variables, pelvis acceleration, and gait termination in 10 young and 26 older people, on level, irregular and wet surfaces. Elevated heel shoes impaired overall performance in functional tests of balance and stepping. They were also perceived as lacking comfort and stability and led to a conservative walking pattern characterised by increased step width and double-support time, reduced braking and vertical loading rates and medio-lateral (ML) pelvis accelerations on various surfaces. Soft sole shoes increased lateral COM-BOS margin and step width, indicating reduced ML walking stability. When wearing these shoes, subjects had longer total stopping times and on the wet surface, smaller step lengths and shoe/floor angles at heel strike, suggesting a potential risk of slipping. When wearing high-collar shoes, subjects had better balance as demonstrated by small but significant increases in lateral COM-BOS margin, double-support time and step width, and decreases in ML pelvis accelerations on varying surfaces and in total stopping time on the wet surface. Shoes with hard, flared or tread soles or a bevelled heel did not affect balance. In conclusion, providing that they are fitted, have adequate fastening and perhaps a slip-resistant sole, shoes with a low square heel, a sole of medium hardness (shore A-40) and a high-collar provide the greatest stability for older people when walking on dry, wet and irregular surfaces.
| Identifer | oai:union.ndltd.org:ADTP/215746 |
| Date | January 2008 |
| Creators | Menant, Jasmine Charlotte Christiane, Public Health & Community Medicine, Faculty of Medicine, UNSW |
| Publisher | Publisher:University of New South Wales. Public Health & Community Medicine |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | http://unsworks.unsw.edu.au/copyright, http://unsworks.unsw.edu.au/copyright |
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