Unlike all other age cohorts, there is evidence that barefoot locomotion presents a hazard to the elderly cohort due to greater risk of falling. There is significant decline in plantar tactile sensibility that commences in the fifth decade of life. This includes SA II receptors which humans use in making foot position judgements that account for superior stability when barefoot. In addition normally shod populations have been shown to have extensive foot osteoarthritis particularly at the metatarsal-phalangeal joints - far greater than normally unshod groups presumably due to footwear use. This osteoarthritis in the normally shod elderly appears to cause a more rigid foot that is unable to conform to a flat surface when barefoot. With both attenuated plantar sensory feedback and with a foot that poorly accommodates to a flat surface, stability in the normally shod elderly is poorer when barefoot than when shod. Presumably their feet have been permanently deformed by the footwear they have worn. The normally shod elderly should attempt to adapt to barefoot mobility with caution because of falls risk.
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