Evidence-Based Footwear Recommendations for Older Adults: Enhancing Mobility, Comfort, and Fall Prevention

Area of Science:

• Geriatric Medicine
• Orthopedics
• Physical Therapy

Background:

• Older adults face challenges finding appropriate footwear, impacting mobility, safety, and quality of life.
• Footwear is critical for managing fall risk, balance impairments, knee osteoarthritis (OA), hallux rigidus, plantar fasciitis, diabetic neuropathy, and limb length discrepancies (LLDs).
• Inadequate clinical guidance and patient understanding are persistent barriers to proper footwear selection.

Purpose of the Study:

• To provide updated, evidence-based recommendations for footwear tailored to the specific clinical needs of older adults.
• To synthesize clinical experience and research to guide the selection of footwear that enhances function and safety in the geriatric population.

Main Methods:

• A topic review evaluated shoe wear characteristics relevant to geriatric needs.
• Recommendations were synthesized from over 45 years of physical therapy clinical experience.
• Effective shoe features were identified, including sole properties, heel height, and orthotic modifications.

Main Results:

• For balance and fall risk: Wide soles, medium-firm materials, low heels, and high collars improve stability.
• For specific conditions: Rocker-bottom shoes for hallux rigidus, rigid rocker soles for diabetic neuropathy, and wedged insoles for knee OA are beneficial.
• General recommendations include properly fitted shoes with firm insoles, slip-resistant outsoles, and secure fastenings for improved safety.

Conclusions:

• Appropriate footwear significantly enhances mobility, safety, and well-being in older adults.
• Tailored footwear recommendations can improve pain management, independence, and fall prevention strategies.
• Healthcare providers should involve patients in footwear decisions and advise against inappropriate footwear like slippers or high heels.