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Sneakers Best, Barefoot Worst in Preventing Falls by
Elderly
Sept. 2, 2004 – Senior citizens wearing canvas
athletic shoes (sneakers) were the least likely to suffer falls, while
those going shoeless fell the most, in a study aimed at lowering the
risk of damaging and fatal falls by the elderly.
Falls are the most frequent cause of fatal injury
to older Americans, and non-fatal falls, which are also common, can
curtail mobility and quality of life for older adults.
The choice of footwear for adults aged 65 and older
may be an important factor in preventing these falls, according to this
new research by investigators at the Harborview Injury Prevention &
Research Center and Group Health Cooperative of Puget Sound.
The study involved
monitoring 1,371 Group Health Cooperative enrollees aged 65 and older
over a two-year period. "Footwear Style and Risk of Falls in Older
Adults" is published in the September issue of the Journal of the
American Geriatrics Society.
A total of 327
qualifying falls occurred during this period, with most falls taking
place inside or near the home.
Fallers were asked
to call a telephone hotline as soon as possible after their falls. After
a telephone screening, two-person field teams visited the faller to
gather information on the circumstances of the fall, including the type
of shoes worn at the time. A control group was asked a similar set of
questions, apart from questions about a fall, including such topics as
socio-demographics, health status, mobility, and footwear habits.
Footwear was
divided into several categories based on shoe design and the kinds of
activities for which of different styles are commonly worn. In one
analysis, for example, five categories were compared: athletic/canvas
shoes, lace-up oxfords, loafers/flats, other shoe styles (including
boots, high heels, sandals and slippers), and going shoeless (barefoot
or stocking feet).
Athletic and canvas
shoes (also known as sneakers) -- the styles of footwear most commonly
worn by this sample of older adults -- were associated with the lowest
risk of falling, while older adults going shoeless had the highest risk.
Compared to athletic and canvas shoes, other footwear was associated
with a 30 percent greater risk of a fall.
Athletic shoes and
canvas shoes have a relatively wide rubber or crepe sole, low heel
height, and a large area of contact between the shoe sole and the
walking surface. While being barefoot has been associated with good
balance performance in the laboratory, walking without shoes leaves the
foot more vulnerable to painful injury, and stocking feet provide a poor
coefficient of friction and thus are more prone to slipping.
"Falls among older
adults can lead to hip and other fractures, head injuries,
hospitalization, or limited mobility and quality of life," says Dr.
Thomas Koepsell, a University of Washington (UW) professor of
epidemiology, and the study's principal investigator. "Our research
indicates that the risk of a fall varies significantly depending on the
type of footwear an older person chooses. This information may be useful
to older adults in their decisions about what kinds of shoes to buy and
wear."
In addition to
Koepsell, the study was conducted by Marsha Wolf, Ph.D., formerly of the
Harborview Injury Prevention & Research Center (HIPRC); Dr. David
Buchner of the National Center for Chronic Disease Prevention and Health
Promotion at the Centers for Disease Control and Prevention; Walter
Kukull, Ph.D., a UW professor of epidemiology; Andrea LaCroix, Ph.D., a
UW professor of epidemiology affiliated with Group Health Cooperative;
Allan Tencer, Ph.D., a UW professor of orthopaedics and sports medicine;
Cara Frankenfeld, M.S., formerly of the HIPRC; Milda Tautvydas, M.F.A,
of the HIPRC; and Dr. Eric Larson of the Center for Health Studies at
Group Health Cooperative.
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