Unraveling the Impact of Destabilizing Shoes on Balance Control and Fall Prevention in Older Adults: A Systematic Review

Overview

Journal Ann Geriatr Med Res

Specialty Geriatrics

Date 2025 Jan 3

PMID 39748493

Authors

In-Ju Kim

Affiliations

Soon will be listed here.

Abstract

Background: Falls pose a significant risk to older adults, often leading to severe injury and disability. One potential contributing factor to falls is footwear, particularly shoes with destabilizing features. This systematic review assessed the effects of destabilizing shoes on stability control and fall prevention in older adults, highlighting their effectiveness in balance control and fall prevention, and the detailing the specific review methodology.

Methods: We thoroughly searched relevant databases and meticulously screened the identified studies based on predetermined inclusion and exclusion criteria. We then extracted data from 30 eligible studies with various study designs and shoe types and synthesized this information to assess the impact of destabilizing shoes on balance and gait measures, fall incidence, and other relevant outcomes.

Results: While certain types of destabilizing shoes may improve specific aspects of balance and proprioception, they can also adversely affect steadiness control and potentially increase the risk of falls if not appropriately used. Therefore, the use of destabilizing shoes should be carefully considered and tailored to individual needs, with proper guidance and training to minimize fall risk.

Conclusion: The findings of this review significantly inform footwear design and selection in older adults and emphasize the need for additional research. By synthesizing the available evidence, this review highlights the potential benefits and risks associated with destabilizing shoes and suggests the need for careful evaluation of their use on a case-by-case basis. This review serves as a basis for future guidelines on the use of destabilizing shoes in older adults with the aim of developing effective fall prevention interventions.

References

Hemmati F, Haghpanah S, Karimi M, Mardani M, Fadayevatan R . Nonlinear analysis of dynamic stability in walking with toe-only rocker sole shoes in elderly. Med Eng Phys. 2022; 99:103738. DOI: 10.1016/j.medengphy.2021.103738. View

Granacher U, Roth R, Muehlbauer T, Kressig R, Laser T, Steinbrueck K . Effects of a new unstable sandal construction on measures of postural control and muscle activity in women. Swiss Med Wkly. 2011; 141:w13182. DOI: 10.4414/smw.2011.13182. View

Menz H, Auhl M, Tan J, Levinger P, Roddy E, Munteanu S . Effectiveness of Foot Orthoses Versus Rocker-Sole Footwear for First Metatarsophalangeal Joint Osteoarthritis: Randomized Trial. Arthritis Care Res (Hoboken). 2015; 68(5):581-9. PMC: 5074253. DOI: 10.1002/acr.22750. View

Nigg B, G K, Federolf P, Landry S . Gender differences in lower extremity gait biomechanics during walking using an unstable shoe. Clin Biomech (Bristol). 2010; 25(10):1047-52. DOI: 10.1016/j.clinbiomech.2010.07.010. View

Kimel-Scott D, Gulledge E, Bolena R, Albright B . Kinematic analysis of postural reactions to a posterior translation in rocker bottom shoes in younger and older adults. Gait Posture. 2013; 39(1):86-90. DOI: 10.1016/j.gaitpost.2013.06.002. View

Hemmati F, Karimi M, Hosseini S, Mardani M, Fadayevatan R . The effect of toe-only rocker sole shoes on gait variability of the elderly. Med Biol Eng Comput. 2022; 60(9):2493-2498. DOI: 10.1007/s11517-022-02605-0. View

Kavros S, Van Straaten M, Coleman Wood K, Kaufman K . Forefoot plantar pressure reduction of off-the-shelf rocker bottom provisional footwear. Clin Biomech (Bristol). 2011; 26(7):778-82. DOI: 10.1016/j.clinbiomech.2011.03.009. View

Thies S, Price C, Kenney L, Baker R . Effects of shoe sole geometry on toe clearance and walking stability in older adults. Gait Posture. 2015; 42(2):105-9. DOI: 10.1016/j.gaitpost.2015.04.011. View

Forghany S, Nester C, Richards B . The effect of rollover footwear on the rollover function of walking. J Foot Ankle Res. 2013; 6(1):24. PMC: 3710509. DOI: 10.1186/1757-1146-6-24. View

10.

Kazanski M, Cusumano J, Dingwell J . How healthy older adults regulate lateral foot placement while walking in laterally destabilizing environments. J Biomech. 2020; 104:109714. PMC: 7188576. DOI: 10.1016/j.jbiomech.2020.109714. View

11.

Hemmati F, Karimi M . The effect of rocker sole shoes on ground reaction force in the elderly. Proc Inst Mech Eng H. 2022; 236(7):988-993. DOI: 10.1177/09544119221098529. View

12.

Mansfield A, Wong J, Bryce J, Knorr S, Patterson K . Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials. Phys Ther. 2014; 95(5):700-9. DOI: 10.2522/ptj.20140090. View

13.

McKeon P, Hertel J, Bramble D, Davis I . The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med. 2014; 49(5):290. DOI: 10.1136/bjsports-2013-092690. View

14.

Kim I, Hegazy F . Enhancing Footwear Safety for Fall Prevention in Older Adults: A Comprehensive Review of Design Features. Ann Geriatr Med Res. 2024; 28(2):121-133. PMC: 11217662. DOI: 10.4235/agmr.23.0167. View

15.

Sobhani S, Sinaei E, Motealleh A, Hooshyar F, Kashkooli N, Yoosefinejad A . Combined effects of whole body vibration and unstable shoes on balance measures in older adults: A randomized clinical trial. Arch Gerontol Geriatr. 2018; 78:30-37. DOI: 10.1016/j.archger.2018.05.016. View

16.

Farzadi M, Nemati Z, Jalali M, Doulagh R, Kamali M . Effects of unstable footwear on gait characteristic: A systematic review. Foot (Edinb). 2017; 31:72-76. DOI: 10.1016/j.foot.2017.04.005. View

17.

Spink M, Menz H, Fotoohabadi M, Wee E, Landorf K, Hill K . Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial. BMJ. 2011; 342:d3411. PMC: 3116775. DOI: 10.1136/bmj.d3411. View

18.

Gusi N, Adsuar J, Corzo H, Del Pozo-Cruz B, Olivares P, Parraca J . Balance training reduces fear of falling and improves dynamic balance and isometric strength in institutionalised older people: a randomised trial. J Physiother. 2012; 58(2):97-104. DOI: 10.1016/S1836-9553(12)70089-9. View

19.

Armand S, Tavcar Z, Turcot K, Allet L, Hoffmeyer P, Genevay S . Effects of unstable shoes on chronic low back pain in health professionals: a randomized controlled trial. Joint Bone Spine. 2014; 81(6):527-32. DOI: 10.1016/j.jbspin.2014.05.006. View

20.

Amiez N, Cometti C, Mouillon E, Teisseire M, Chenut P, Paizis C . Effects of Balance Shoes on Balance and Postural Stability in the Elderly: A Crossover, Controlled, Randomized Single-Blind Study. Healthcare (Basel). 2021; 9(2). PMC: 7915041. DOI: 10.3390/healthcare9020179. View