Does ankle support of safety shoes increase trip-related risk of falling? - A randomized crossover study

Occupational footwear offers multiple safety features like ankle support. Although designed to protect the ankle joint, the added mass and structural rigidity may restrict ankle range of motion and hinder natural gait adaptations essential for balance, potentially increasing trip severity and fall risk.

Does ankle support in occupational footwear increase the trip related-fall risk?

Twenty asymptomatic individuals (11 females and nine males) participated in this randomized cross-over study. The participants wore two types of mass-matched safety shoes, with and without ankle support, while walking on a treadmill, where unexpected trips were induced by obstacles (heights: 31 mm and 75 mm). This study evaluated differences in safety shoes on external support (i.e., using handrails or engaged with the safety harness), toe clearance, recovery strategy, and ankle angles in the sagittal plane.

Safety shoes with ankle support, compared with those without, increased reliance on external support during unexpected trips, indicating a higher fall risk, particularly when tripping over the low obstacle.

These findings highlight that ankle-supported occupational footwear, although designed to protect, may increase trip-related fall risks and most likely impaired gait robustness. The study highlights the importance of exploring design features that could mitigate the fall risk in occupational settings.