Footwear and insoles to improve balance and gait in older people

The intervention is a pair of footwear and insoles designed to improve balance. 1. Footwear The prototype footwear is based on an existing model (Dr Comfort® Vigor, Mequon, WI, USA) which was selected as it incorporates many of the features previously shown to be beneficial for balance. Specifically, the footwear had a firm (Shore A hardness 55) rubber sole of 25 mm thickness under the heel and 18 mm under the forefoot, laces plus Velcro® fastening, a high collar to support the ankle, and a firm heel counter. Across the size range, the weight of the prototype footwear is 310 to 360 gm. The outersole has been modified to optimise slip resistance by grinding a 10 degree bevel into the heel region, placing grooves perpendicular to the sole (1.2 mm deep and 2.4 mm wide) across the heel surface area, and placing perpendicular grooves (5 mm deep and 12 mm wide) across the rest of the sole. 2. Insoles The footwear incorporates a textured insole, constructed from 4 mm thick ethyl vinyl acetate (Shore A 25 ) with dome-shaped projections (3 mm high and 8 mm diameter, Shore A 85 ) placed across the forefoot in a 15 mm diamond pattern and along the lateral border, extending to the heel. The design of the textured insole was informed by previous studies reporting improvements on balance in older people when similar insoles were worn. The prototype footwear with the insoles inserted will be worn for a single assessment session. Testing for each of the footwear conditions will take approximately 30 minutes. In between each footwear condition, there will be a brief 10 min washout period.