Shoe closure technologies for persons with reduced mobility: a narrative review

Area of Science:

• Biomechanics and Rehabilitation Engineering
• Materials Science in Footwear Design
• Human-Computer Interaction in Adaptive Technologies

Background:

• Shoe donning and doffing present significant daily challenges for older adults and individuals with conditions like diabetes, stroke, arthritis, and Parkinson's disease.
• Existing research and development in footwear primarily focus on sole design and slip resistance, overlooking the critical role of closure mechanisms.
• Limited attention has been given to the mechanical performance and functional accessibility of shoe closures for individuals with reduced mobility.

Purpose of the Study:

• To conduct a narrative review of seven distinct shoe closure technologies.
• To evaluate these technologies based on mechanical performance and functional accessibility for individuals with reduced mobility.
• To identify the limitations of current shoe closure systems and suggest future research directions.

Main Methods:

• A comprehensive narrative review synthesizing information from peer-reviewed literature, patents, and industry sources.
• Literature search conducted across major databases including Scopus, Web of Science, PubMed, Google Scholar, and patent databases (USPTO, EPO, WIPO).
• Selection criteria focused on relevance to shoe closure design, footwear functional limitations, and adaptive footwear technology, resulting in the synthesis of 44 sources.

Main Results:

• Seven closure categories were analyzed: traditional lacing, hook-and-loop, buckle/strap, elastic/slip-on, magnetic, dial-wire (BOA), and bistable hinge/hands-free.
• Assessment criteria included engagement force, holding security, release controllability, durability, cost accessibility, and hands-free operability.
• No single technology currently fulfills all six performance criteria; recent hands-free designs are advanced but prohibitively expensive for many.

Conclusions:

• No existing shoe closure technology simultaneously offers hands-free operation, adequate security, durability, and affordability for low- and middle-income countries (LMICs).
• Passive mechanical closures utilizing geometric interference show promise but require empirical validation.
• A significant barrier to evidence-based clinical prescription is the lack of standardized test protocols for evaluating closure performance.