Effects of foot orthoses on balance in older adults

Abstract

Study design: Controlled laboratory study using a single-cohort design.

Objectives: To determine if balance in older adults could be significantly improved with foot-orthotic intervention.

Background: Poor balance has been associated with risk for falls. Limited evidence exists indicating that foot orthoses influence balance.

Methods: Thirteen individuals older than 65 years, who reported at least 1 unexplained fall during the past year and demonstrated poor balance, participated in the study. Subjects were tested for 1-leg stance, tandem stance, tandem gait, and alternating step tests during the first (SCREEN) and second (PRE) sessions prior to foot-orthotic intervention. Tests were repeated during the second testing session immediately after custom foot-orthotic intervention (POST) and 2 weeks following foot-orthotic use (FU). SCREEN and PRE measures were compared for stability using absolute difference computations and the Friedman rank test. PRE, POST, and FU data were analyzed using the Friedman rank test (α = .05), with Bonferroni correction for multiple post hoc comparisons.

Results: Each balance measure was statistically equivalent between the SCREEN and PRE measurements. One-leg stance times for PRE were significantly less than POST (P = .002) and FU (P = .013) measurements. Tandem stance times for PRE were significantly less than POST (P = .013) and FU (P = .013) measurements. Steps taken for the tandem gait test during the PRE measurements were significantly fewer than steps taken for the FU test (P = .007). Steps taken during the alternating step test for the PRE test were significantly fewer than steps taken during the POST (P = .002) and FU (P =.001) tests. POST and FU measurements were not significantly different for any of the 4 outcome measures.

Conclusions: The results provide preliminary evidence that foot orthoses can effect improvement in balance measures for older adults.

FIGURE 1.

Schematic that details the 4 times of measurement over 3 testing sessions.

FIGURE 2.

One-leg stance time (n = 13). Values represent median ± interquartile range. PRE = pre-intervention assessment at second visit, POST = post-intervention assessment at second visit, and FU = follow-up assessment at third visit. Values are significantly different (P = 0.003) across the 3 times of measurement. Brackets indicate significant pairwise contrasts with Bonferroni correction.

FIGURE 3.

Tandem stance time (n = 13). Values represent median ± interquartile range. PRE = pre-intervention assessment at second visit, POST = post-intervention assessment at second visit, and FU = follow-up assessment at third visit. Values are significantly different (P= 0.003) across the 3 times of measurement. Brackets indicate significant pairwise contrasts with Bonferroni correction.

FIGURE 4.

Number of steps (median ± interquartile range) for tandem gait test (n = 13). PRE = pre-intervention assessment at second visit, POST = post-intervention assessment at second visit, and FU = follow-up assessment at third visit. Values are significantly different (P = 0.018) across the 3 times of measurement. Brackets indicate significant pairwise contrasts with Bonferroni correction.

FIGURE 5.

Number of steps (median ± interquartile range) for alternating step test (n = 13). PRE = pre-intervention assessment at second visit, POST = post-intervention assessment at second visit, and FU = follow-up assessment at third visit. Values are significantly different (P = 0.001) across the 3 times of measurement. Brackets indicate significant pairwise contrasts with Bonferroni correction.