Variability in inter-segmental coordination of the lower limb in older adults during walking: An analysis with toe-only rocker sole shoes.

Abstract

Older adults have age-related problems in motor performance during walking. Toe-only rocker sole shoes are one of the most common shoe modifications, facilitating forward movement and, thus, affecting mobility and stability. Due to the importance of studying inter-segmental coordination and the lack of investigation of the effect of such shoes in the literature, this study aimed to evaluate the effect of these shoes in older adults. Twenty-four participants walked on a treadmill under two conditions: standard shoes and toe-only rocker sole shoes with 20° rocker angle. The continuous and mean absolute relative phase were used as sensitive indicators to evaluate the inter-segmental coordination, whereas the coordination variability was analyzed using the parameter of deviation phase. Results indicated that these shoes could lead to a reduction in excessive movement variability, which might be advantageous for gait with ease and minimal discomfort or less pain. Statistical analysis also demonstrated a decrease in the variability of coordination patterns, which could lead to a more predictable and stable gait, consequently reducing the risk of falls. The study demonstrated that these shoes enhance gait stability and consistency in older adults, so potentially reducing fall risk as a result and offer a probable shoe choice aiding those with ankle osteoarthritis. These findings highlighted the clinical importance of footwear in managing gait dynamics and therefore preventing falls. The research suggested that proximal joint adaptations and the rocker function's limitation of joint movement were beneficial for forward movement and stability. Findings underscored the potential of shoe modifications as a simple yet effective intervention for improving older adults' mobility and safety.