Abstract：
BACKGROUND: Footwear, orthoses, and insoles have been shown to influence balance in older adults; however, it remains unclear which features, singular or in combination, are considered optimal. The aim of this scoping review was to identify and synthesise the current evidence regarding how footwear, orthoses, and insoles influence balance in older adults. Four electronic databases (MEDLINE, CINAHL, Embase, and AMED) were searched from inception to October 2023. Key terms such as \"shoe*,\" \"orthoses,\" \"postural balance\" and \"older people\" were employed in the search strategy. Studies meeting the following criteria were included: (i) participants had a minimum age ≥60 years, and were free of any neurological, musculoskeletal, and cardiovascular diseases; (ii) an active intervention consisting of footwear, foot orthoses, or insoles was evaluated; and (iii) at least one objective outcome measure of balance was reported.
CONCLUSIONS: A total of 56 studies from 17 different countries were included. Three study designs were utilised (cross-sectional study, n = 44; randomised parallel group, n = 6; cohort study n = 6). The duration of studies varied considerably, with 41 studies evaluating immediate effects, 14 evaluating effects from 3 days to 12 weeks, and 1 study having a duration of 6 months. Seventeen different interventions were evaluated, including/consisting of textured insoles (n = 12), heel elevation (n = 8), non-specific standardised footwear and changes in sole thickness or hardness (n = 7 each), sole geometry or rocker soles, contoured or custom insoles and high collar height (n = 6 each), insole thickness or hardness and vibrating insoles (n = 5 each), outsole tread (n = 4), minimalist footwear and slippers (n = 3 each), balance-enhancing shoes, footwear fit, socks, and ankle-foot orthoses (n = 2 each), and eversion insoles, heel cups, and unstable footwear (n = 1 each). Twenty-three different outcomes were assessed, and postural sway was the most common (n = 20), followed by temporo-spatial gait parameters (n = 17). There was uncertainty regarding intervention effectiveness. Overall, features such as secure fixation, a textured insole, a medium-to-hard density midsole and a higher ankle collar, in isolation, were able to positively impact balance. Conversely, footwear with an elevated heel height and the use of socks and slippers impaired balance.
CONCLUSIONS: There is a substantial body of literature exploring the effects of footwear, orthoses, and insoles on balance in older adults. However, considerable uncertainty exists regarding the efficacy of these interventions due to variability in methodological approaches. Further high-quality research is necessary to determine whether a singular intervention or a combination of interventions is most effective for enhancing balance in older adults.
CONCLUSIONS: A total of 56 studies from 17 different countries were included. Three study designs were utilised (cross-sectional study, n = 44; randomised parallel group, n = 6; cohort study n = 6). The duration of studies varied considerably, with 41 studies evaluating immediate effects, 14 evaluating effects from 3 days to 12 weeks, and 1 study having a duration of 6 months. Seventeen different interventions were evaluated, including/consisting of textured insoles (n = 12), heel elevation (n = 8), non-specific standardised footwear and changes in sole thickness or hardness (n = 7 each), sole geometry or rocker soles, contoured or custom insoles and high collar height (n = 6 each), insole thickness or hardness and vibrating insoles (n = 5 each), outsole tread (n = 4), minimalist footwear and slippers (n = 3 each), balance-enhancing shoes, footwear fit, socks, and ankle-foot orthoses (n = 2 each), and eversion insoles, heel cups, and unstable footwear (n = 1 each). Twenty-three different outcomes were assessed, and postural sway was the most common (n = 20), followed by temporo-spatial gait parameters (n = 17). There was uncertainty regarding intervention effectiveness. Overall, features such as secure fixation, a textured insole, a medium-to-hard density midsole and a higher ankle collar, in isolation, were able to positively impact balance. Conversely, footwear with an elevated heel height and the use of socks and slippers impaired balance.
CONCLUSIONS: There is a substantial body of literature exploring the effects of footwear, orthoses, and insoles on balance in older adults. However, considerable uncertainty exists regarding the efficacy of these interventions due to variability in methodological approaches. Further high-quality research is necessary to determine whether a singular intervention or a combination of interventions is most effective for enhancing balance in older adults.
摘要：
背景：鞋类，矫形器,鞋垫已经被证明会影响老年人的平衡，然而，尚不清楚哪些功能，单数或组合，被认为是最优的。本次范围审查的目的是确定和综合当前关于鞋类，矫形器,鞋垫影响老年人的平衡。四个电子数据库(MEDLINE，CINAHL,Embase和AMED)从成立之初到2023年10月进行了搜索。关键术语，如“鞋子*”，“矫形器”，搜索策略中采用了“姿势平衡”和“老年人”。符合以下标准的研究包括：（i）参与者的最低年龄≥60岁，并且没有任何神经系统，肌肉骨骼，和心血管疾病，(ii)由任何一种鞋类组成的积极干预，评估了足部矫形器或鞋垫，和(iii)报告了至少一个平衡的客观结果量度。
结论：共纳入来自17个不同国家的56项研究。使用了三项研究设计(横断面研究，n=44；随机平行组，n=6；队列研究n=6）。研究的持续时间差异很大，有41项研究评估了立竿见影的效果，14评估从三天到12周的效果，1项研究持续时间为6个月。评估了17种不同的干预措施，包括/由纹理鞋垫组成（n=12），脚跟标高（n=8），非特定标准化鞋类和鞋底厚度或硬度的变化（每个n=7），鞋底几何形状或摇杆鞋底，轮廓或自定义鞋垫和高领高度（每个n=6），鞋垫厚度或硬度和振动鞋垫（每个n=5），外底胎面（n=4），简约的鞋类和拖鞋（每个n=3），增强平衡的鞋子，鞋类合身，袜子,和踝足矫形器（每个n=2），外翻鞋垫，鞋跟杯,和不稳定的鞋类（每个n=1）。评估了23种不同的结果，姿势摇摆是最常见的(n=20)，其次是时空步态参数(n=17)。干预效果存在不确定性。总的来说,安全固定等功能，有纹理的鞋垫，中硬密度的中底和较高的脚踝领子，孤立地,能够积极影响平衡。相反，鞋跟高度较高的鞋类以及袜子和拖鞋的使用损害了平衡。
结论：有大量文献探索鞋类的影响，矫形器,老年人的鞋垫平衡。然而,由于方法学方法的可变性，这些干预措施的有效性存在相当大的不确定性。需要进一步的高质量研究来确定单一干预措施或干预措施的组合是否最有效地增强老年人的平衡。
结论：共纳入来自17个不同国家的56项研究。使用了三项研究设计(横断面研究，n=44；随机平行组，n=6；队列研究n=6）。研究的持续时间差异很大，有41项研究评估了立竿见影的效果，14评估从三天到12周的效果，1项研究持续时间为6个月。评估了17种不同的干预措施，包括/由纹理鞋垫组成（n=12），脚跟标高（n=8），非特定标准化鞋类和鞋底厚度或硬度的变化（每个n=7），鞋底几何形状或摇杆鞋底，轮廓或自定义鞋垫和高领高度（每个n=6），鞋垫厚度或硬度和振动鞋垫（每个n=5），外底胎面（n=4），简约的鞋类和拖鞋（每个n=3），增强平衡的鞋子，鞋类合身，袜子,和踝足矫形器（每个n=2），外翻鞋垫，鞋跟杯,和不稳定的鞋类（每个n=1）。评估了23种不同的结果，姿势摇摆是最常见的(n=20)，其次是时空步态参数(n=17)。干预效果存在不确定性。总的来说,安全固定等功能，有纹理的鞋垫，中硬密度的中底和较高的脚踝领子，孤立地,能够积极影响平衡。相反，鞋跟高度较高的鞋类以及袜子和拖鞋的使用损害了平衡。
结论：有大量文献探索鞋类的影响，矫形器,老年人的鞋垫平衡。然而,由于方法学方法的可变性，这些干预措施的有效性存在相当大的不确定性。需要进一步的高质量研究来确定单一干预措施或干预措施的组合是否最有效地增强老年人的平衡。
