Unstable Footwear Affects Magnitude and Structure of Variability in Postural Control

This study evaluated the amount, and particularly, the structure of variability in postural control accompanying an unstable shoe (US) application. Mediolateral and anterior-posterior center of pressure signals plus electromyographic profiles of the tibialis anterior and gastrocnemius medialis were recorded in 29 asymptomatic men while wearing both US and flat shoes. Statistical analysis included common measures of dispersion as well as sample entropy and largest Lyapunov exponent estimates. Data were compared by two-way repeated-measures analysis of variance. Corresponding main effects of footwear revealed that, in contrast to the flat shoes condition, the US intervention consistently increased center of pressure and electromyographic net fluctuations and rendered the overall system less complex, as reflected by the lower sample entropy and higher Lyapunov exponent values observed throughout. Accordingly, employing US in stance should be functional concerning motor development; however, the greater sensitivity of US users to external perturbations must not be overlooked and warrants further investigation.