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"Skate Shoe" helps older adults walk more stably

16 November 2023
To prevent falls while walking, foot placement control can be trained in healthy older adults.

This is the result of research conducted by a team of Human Movement Scientists from Vrije Universiteit Amsterdam (VU) led by Moira van Leeuwen and Mohammadreza Mahaki. In the study, ten older adults were trained to walk on a special skate-like shoe. As a training effect, foot placement errors were reduced, leading to greater stability in older adults. The results have been published in the scientific journal PloS One.

Stable walking can be challenging for older adults
Aging is associated with decreased balance, even during walking. To walk stably, it is important to place our feet in the right position. With too narrow a step width, there is a higher risk of falling. However, taking steps that are too wide results in a walking pattern that consumes a lot of energy. What is considered "too narrow" or "too wide" varies with each step. To maintain balance, it is crucial for step width to be adjusted with each step according to the body's center-of-mass. As long as the body's center-of-mass remains between both feet, a stable walking pattern is maintained. Fortunately, it seems that precise control of step width can be trained. Van Leeuwen explains, "Falling is a problem, especially for older adults. By placing our feet accurately in relation to our center-of-mass, we can prevent falls while walking."

Training on skate shoes improves stability
Van Leeuwen and Mahaki had 10 older adults undergo two training sessions a week for three weeks, during which they walked on a treadmill wearing a special skate-like shoe called LesSchuh. The narrow but flexible bar under the sole of the "skate shoe" prevented support from being provided across the entire sole of the foot. To adapt to this, the older adults had to learn to place their feet more accurately, not too narrow and not too wide. Each week, the bar under the shoe became slightly narrower to make the training more challenging. After this training, older adults adjusted their step width more accurately to the position of their center-of-mass. After three weeks of training with the "skate shoe," they were able to step more than two millimeters more accurately when walking with regular shoes. Importantly, stability while walking in regular shoes had also improved. Van Leeuwen says, "More accurate foot placement may have led to improved stability."

Based on fundamental research
Van Leeuwen recently completed her research on the fundamental knowledge underlying the "skate shoe." Her main finding is that even during undisturbed walking, muscles are active on each step to maintain stability through adjustments in step width. "Sometimes, however, we take steps that are too wide or too narrow. In such cases, we use ankle movements to find support on different parts of our sole. When we can no longer use the entire surface of our soles, we must step more accurately. Forcing people to step more accurately was the basis for the development of the 'skate shoe,'" according to Van Leeuwen.

Promising intervention
However, it is not yet entirely clear what caused the training effects. "It remains to be determined whether the training effects were the result of walking in the 'skate shoe' or simply from repeatedly walking on the treadmill itself," Van Leeuwen notes. Nonetheless, Van Leeuwen is optimistic about the potential of the "skate shoe" to improve walking stability: "This shoe is based on our fundamental understanding of how people walk, and the results are promising."