Session Information
Date: Thursday, June 8, 2017
Session Title: Other
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: This study explored balance and gait performance in people with Parkinson’s (PwP) in their usual indoor in comparison to outdoor shoes.
Background: Falls are a major issue that negatively impacts on the health of PwP. Most falls happen indoors during walking, turning and sit to stand activities [1]. Footwear has been implicated as a risk factor for falls; research to data has focused on the general elderly population [2].
Methods: Thirty PwP (15 men, mean age 69, 16 fallers , Hoehn and Yahr stage 1-3, mean freezing of gait score 7 (SD: 7.3) attended a single assessment at the gait laboratory. Time since diagnosis ranged from 7 to 192 months (mean 64 months). Balance and gait was assessed in usual indoor and outdoor footwear (shoe order was randomised) using clinical tests (5 meter walk, timed get up and go test and the Mini-BESTest) and instrumented movement analysis (Coda motion, force plate and F-Scan).
Results: Indoors most wore slippers (n=17, 57%), socks/barefoot (n=4), sandals (n=4), walking shoes (n=2), moccasins, ballerina or athletic shoes (all n=1). Outdoors most wore walking shoes (n=15, 50%), boots (n=3), oxford shoes (n=6), surgical bespoke (n=1) moccasins (n=1) or court shoes (n=4). Both clinical tests and instrumented movement analysis generally favored balance and gait performance in outdoor shoes. In comparison to outdoor shoes, walking in indoor shoes resulted in significantly slower walking speeds (five meter walk time p=0.007, walking speed m/s (p=0.012) and reduced stride length (p<0.001). When stepping over an obstacle participants’ second foot got closer to the obstacle (p=0.022) and participants took more steps during turning (p=0.001). During the sit to stand task increased rear foot peak pressures were observed (p=0.015).
Conclusions: Balance and gait performance was worse in indoor shoes. Improved balance performance in outdoor shoes suggested that it may be possible to improve indoor balance performance in PwP through improved indoor shoe choices. Data from this study will inform a future trial to evaluate the effectiveness of fit-for-purpose footwear in the home.
References: 1. Ashburn A, Stack E, Ballinger C, Fazakerley L, Fitton C. The circumstances of falls among people with Parkinson’s disease and the use of Falls diaries to facilitate reporting. Disabil Rehabil. 2008; 30: 1205-1212. 2.Menant JC, Steele JR, Menz HB, Munro BJ, Lord SR. Effects of footwear features on balance and stepping in older people. Gerontology. 2008; 54: 18-23.
To cite this abstract in AMA style:
D. Kunkel, M. Burnett, L. Mamode, R. Pickering, C. Bowen, D. Bader, J. Robison, M. Donovan-Hall, M. Cole, A. Ashburn. The effects of wearing usual indoor and outdoor footwear on balance and gait performance in people with Parkinson’s disease using clinical tests and instrumented movement analysis. [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/the-effects-of-wearing-usual-indoor-and-outdoor-footwear-on-balance-and-gait-performance-in-people-with-parkinsons-disease-using-clinical-tests-and-instrumented-movement-analysis/. Accessed June 14, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effects-of-wearing-usual-indoor-and-outdoor-footwear-on-balance-and-gait-performance-in-people-with-parkinsons-disease-using-clinical-tests-and-instrumented-movement-analysis/