Accessible Summary:

Purpose: The relation between balance and impact was suggested in reports indicating gymnasts land with greater impact when landing on soft mats compared to hard surfaces.  This suggested a relation between balance and impact.  The was the first report in this series which examined the effect of footwear on balance.

Synopsis: In this report dynamic balance was measured in an older cohort.  Balance was found to be positively related to sole hardness and negatively related to sole thickness.  Balance when barefoot was worse than any shoe condition.

Significance: This required was needed because data indicated that footwear in common use by older people presented a public health hazard.  This was the first published report indicating that footwear associated with elevated impact also impair balance.  It was the first report indicating that thick materials of low hardness significantly impair balance in older people.  It also was the first report indicating that when normally shod older people commence barefoot activity, balance is dismal, probably due to rigid feet, used to the interior of shoes to accommodate to flat surfaces.  This report was the first to suggest that the sense of comfort in well fitting footwear was the result low amplitude an uniform load distribution across the plantar surface.