The effects of plantar surface stimulation on neuromuscular responses during standing balance and gait in healthy and clinical populations: A systematic review

Enhanced sensory input applied to the plantar surface of the feet, through innovative sensory-stimulating footwear devices, has the potential to improve standing balance and gait. However, the underlying mechanisms by which sensory-stimulating footwear devices bring about their effects on balance and gait remain unclear: changes in neuromuscular control are one possible option. This systematic review aimed to synthesize the effects of enhanced plantar surface stimulation, via footwear, shoe inserts, or floor surfaces, on neuromuscular responses during standing balance and walking gait in healthy and clinical populations. Four databases were selected to identify studies of plantar stimulation devices designed to alter neuromuscular responses during balance or gait. 2773 articles were screened for eligibility based on title and abstract. Thereafter, 37 articles underwent full text review, of which 17 articles were included in the review. The evidence that enhanced plantar sensory stimulation alters muscle activity during standing balance is limited, and during gait is moderate. The effects of sensory-stimulating footwear devices also appear to be dependent on factors such as the target population, the location of the sensory stimuli under the foot, or the complexity of the postural or walking task.