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Updated: Mar 23, 2026

Evaluating the Function of the Foot Core System in the Elderly
Published on: March 11, 2022
Intercontinental differences in immediate response to everyday and minimalist footwear on functional mobility in
Marise Carina Breet1, Ranel Venter2, Hylton B Menz3
1Department of Exercise, Sport, and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa; Human Movement Biomechanics, Department of Movement Sciences, KU Leuven, Leuven, Belgium.
Introduction:
Functional mobility, defined as the ability to navigate one's environment safely, is essential for maintaining independence and quality of life in older adults. Footwear can significantly affect gait stability and variability, often enhancing stability and reducing the risk of falling. This study compared the influence of three different footwear conditions on the functional mobility of older adults across different continents.
Methods:
Community-dwelling adults (n = 70; ≥60 years; mean age: 72 ± 8.4 years) were recruited from Flanders, Belgium, and Western Cape, South Africa. An expanded 10-meter (m) Instrumented Timed Up and Go (iTUG) test, employing a wearable Inertial Measurement Unit, was utilized to assess spatiotemporal parameters, including completion time, step time, number of steps, and impact under (i) barefoot, (ii) everyday footwear, and (iii) minimalist footwear conditions. The analysis identified immediate responses between footwear conditions, cohorts, and their interactions.
Results:
Both Flemish and South African participants completed the iTUG-test faster, with fewer steps and lower impact, while wearing everyday footwear compared to the other conditions. Flemish participants displayed significant differences across footwear conditions for all spatiotemporal parameters, whereas South African participants demonstrated consistent responses across footwear conditions, with the exception of impact scores. In comparison to the Flemish cohort, South African participants required more time to complete the test, had shorter step times, and exhibited a greater number of steps across all footwear conditions. The effect of footwear differed between cohorts concerning iTUG time and impact scores for barefoot, everyday footwear, and minimalist footwear, respectively.
Significance:
Everyday footwear appeared optimal for both cohorts based on iTUG-test metrics. However, the Flemish cohort exhibited significant immediate responses to different footwear conditions, whereas the responses of the South African cohort remained consistent. Consequently, immediate responses to footwear conditions differ across cohorts, and intercontinental variations should be considered when evaluating functional mobility in healthy older populations.
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