Conventional footwear shows the largest effects on gait speed and stride length in older adults: a systematic review and meta-analysis

Falls among older adults are a major public health issue, and footwear has been identified as a modifiable risk factor for falls. However, evidence comparing the effects of specific footwear types on spatiotemporal gait parameters in older adults remains limited. This study aimed to examine the effects of conventional, minimalist, and slipper-type footwear on gait speed, stride length, and cadence in community-dwelling older adults. Web of Science, SPORTDiscus, MEDLINE, CINAHL, and Google Scholar were searched from January to February 2025 for studies comparing spatiotemporal gait parameters between barefoot walking and at least one footwear type (conventional, minimalist, or slipper-type) in community-dwelling adults aged 65 or older. Random- and mixed-effects meta-analysis models were used to estimate pooled effect sizes and examine footwear type and gender as potential moderators of gait outcomes. Eight studies (n = 223 participants) were included. All footwear conditions, regardless of type, resulted in significantly faster gait speeds (g = 0.491, 95% CI [0.346, 0.635]; 7.52% increase) and longer stride lengths (g = 0.699, 95% CI [0.456, 0.941]; 6.16% increase) compared to barefoot walking, with no significant effect on cadence. Conventional footwear showed the largest estimated effects on gait speed (g = 0.574, 95% CI [0.390, 0.757]; 9.22% increase) and stride length (g = 0.817, 95% CI [0.479, 1.155]; 8.09% increase), though footwear type was not a statistically significant moderator across any outcome. These findings suggest that wearing footwear, particularly conventional supportive shoes, may enhance gait speed and stride length in older adults compared to walking barefoot, supporting footwear selection as an accessible and modifiable strategy for optimising mobility.