Original article
Effects of Shoe Characteristics on Dynamic Stability When Walking on Even and Uneven Surfaces in Young and Older People

Presented to Australian Falls Prevention, November 5–7, 2006, Brisbane, Australia, and the International Society of Posture and Gait Research. July 14–18, 2007, Burlington, VT.
https://doi.org/10.1016/j.apmr.2008.02.031Get rights and content

Abstract

Menant JC, Perry SD, Steele JR, Menz HB, Munro BJ, Lord SR. Effects of shoe characteristics on dynamic stability when walking on even and uneven surfaces in young and older people.

Objective

To systematically investigate the effects of various shoe features (sole hardness, heel height, heel collar height, tread pattern) on dynamic balance control and perceptions of comfort and stability in young and older people walking over even and uneven surfaces.

Design

A mixed-design 3-way repeated measures with age as a between-subjects factor and surface and shoe conditions as within-subjects factors.

Setting

Gait laboratory.

Participants

Young adults (n=11) and community-dwelling older adults (n=15).

Interventions

Not applicable.

Main Outcome Measures

Center of mass (COM)−base of support (BOS) margins, vertical and braking loading rates, and subjective ratings of perceived shoe comfort and stability.

Results

Overall, compared with the standard shoes, the soft sole shoes led to greater lateral COM-BOS margin (P<.001), whereas the elevated heel shoes caused reductions in posterior COM-BOS margin (P=.001) and in vertical and braking loading rates (both, P<.001). Subjects rated the elevated heel shoes as significantly less comfortable (P<.001) and less stable (P<.001) than the standard shoes. Only the young subjects perceived the soft-sole shoes to be less stable than the standard shoes (P=.003).

Conclusions

Both young and older subjects adopted a conservative walking pattern in the elevated heel shoes and exhibited impaired mediolateral balance control in the soft-sole shoes. In contrast, increased sole hardness (above that found in a standard shoe), a tread sole, and a raised collar height did not improve walking stability in either group. It is concluded that shoes with elevated heels or soft soles should not be recommended for older people and that a standard laced shoe with a low collar and a sole of standard hardness with or without a tread provides optimal dynamic stability when walking on even and uneven surfaces.

Section snippets

Participants

Eleven young adults (7 women, mean age ± SD, 22.5±2.5y; height range, 157–183cm; mass range, 50–93kg) and 15 older adults (7 women; mean age ± SD, 73.7±4.2y; height range, 152–188cm; mass range, 53–98kg) volunteered to participate in this study. To be eligible to participate, the older adults were required to be community dwelling, aged over 65 years, and be able to walk 800m without assistance. Participants were excluded from the study if they suffered from any cognitive, neurologic,

Age-Related Effects on the Sensorimotor Tests

Mean data characterizing the sensorimotor ability of the young and older subjects are presented in table 1. The older subjects performed poorer than their younger counterparts in the tests of visual contrast sensitivity (F1,24=26.36, P<.001; partial η2=.523), knee-extension strength (F1,24=8.96, P=.006; partial η2=.272), and plantar tactile sensitivity at the first MPJ (F1,24=6.48, P=.018; partial η2=.213).

Age-related effects

Table 2 displays the mean values obtained for the temporospatial, COM-BOS, and loading

Discussion

This is the first study to systematically investigate the effects of salient shoe features (an elevated heel, a high collar, a tread sole, a soft sole, a hard sole) on walking stability. We found that in addition to age-related differences, specific shoe features significantly affected walking stability in both young and older people.

Walking on the uneven surface increased the proximity of the COM to the edge of the BOS in both young and older subjects, which indicates that the uneven surface

Conclusions

The findings of this study suggest that increased shoe heel height and sole softness caused a more conservative walking pattern and impaired ML balance control, respectively, in both young and older subjects. In contrast, increased sole hardness (above that found in a standard shoe), a tread sole, and a raised collar height did not improve walking stability in either group. Thus, although shoes with elevated heels and soft soles should not be recommended for older people, a laced shoe with a

Acknowledgment

We thank Sarah Rabley for her assistance with data collection and processing.

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    Supported by Prevention of Older People's Injuries through the National Health and Medical Research Council (NHMRC) Health Research Partnership Scheme; (grant no. 209799), the Canadian Institutes of Health Research (operating grant no. MOP-77772); the Canadian Foundation for Innovation/Ontario Innovation Trust/Wilfrid Laurier University (new opportunities equipment grant no. 5141); and an NHMRC Clinical Research Fellow (no. 433049).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

    Published online August 29, 2008 at www.archives-pmr.org.

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    Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.