Shoe Characteristics and Balance in Older Women

OBJECTIVE: To determine whether shoe characteristics affect balance in older women. DESIGN: Randomized order, cross-over, controlled comparison. SETTING: A retirement village. PARTICIPANTS: Thirty women aged 60 to 89 years (mean 78.7 SD = 8.5). Twenty-five subjects were hostel residents, and five were living independently in the community. OUTCOME MEASURES: Postural sway, maximal balance range, and co-ordinated stability. MAIN RESULTS: The subjects underwent assessments of static balance (body sway) and dynamic balance (maximal balance range and co-ordinated stability) under four conditions: (1) barefoot, (2) in standard low-heeled shoes (walking shoes), (3) in standard high-heeled shoes, and (4) in their own shoes. Manova analysis revealed a significant overall shoe condition effect -- subjects performed best in bare feet or low-heeled shoes and worst in high-heeled shoes. There were no significant differences between subjects with and without foot abnormalities in any of the balance measures or test conditions. CONCLUSION: These findings suggest that bare feet and walking shoes maximize balance, whereas high-heeled shoes constitute a needless balance hazard for older women.