Monday, September 14, 2009
Footwear and falls prevention
Footwear characteristics such as shoe type, heel height, heel counter height, heel width, critical tipping angle, method of fixation, heel counter stiffness, sole rigidity and flexion point, tread pattern and sole hardness have all been subject to research in the prevention of falls. Other footwear features such as heel collar height, sole hardness, and tread and heel geometry are also considered influential aspects likely to influence balance and gait. Shoe measurements related to lateral stability (heel height and width, critical tipping angle), foot position sense (heel-collar height, sole thickness, and sole flexibility), and the shoe/surface interface (fore-sole material, shoe-to-ground coefficient of friction, sole contact area) have all been subject to extensive research in a bit to prevent falls.
Tencer et al (2009) reported certain measurable properties of shoes were found to be significantly related to risk of falls in older adults.
Wearing shoes with low heels and large contact area may help older adults reduce the risk of a fall in everyday settings and activities. Other studies undertaken to determine the relationships between footwear characteristics and the falls risk of indoor and outdoor incidents in older people have revealed no significant association (Menz, Morris and Lord (2009). Instead they found indoor falls were associated more with going barefoot or wearing socks only.
Menant et al (2008) have proffered elevated heels of 4.5 cm height did significantly impair balance in older people and researchers generally agree the potential benefits of wearing shoes with a hard sole or a high heel-collar on balance in older people warrant further research in ambulatory tasks. 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. Further findings suggest older adults are slower stopping gait rapidly than their younger counterparts and that footwear is likely to influence whole-body stability during challenging postural tasks on wet surfaces. It is evident that bare feet provide better slip resistance than non-slip socks and therefore might represent a safer foot condition. However, previous studies have associated barefoot mobilisation with increased falls.
However it is generally accepted wearing good fitting shoes should be encouraged. In another study Chari et al (2009) discovered wearing athletic and canvas shoes (sneakers) were the styles of footwear associated with lowest risk of a fall in older adults during everyday activities.