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  1. Roman de Mettelinge, Tine PT, PhD
  2. Calders, Patrick PhD
  3. Danneels, Evy PT
  4. Geeroms, Sofie PT
  5. Du Four, Celine PT
  6. Cambier, Dirk PT, PhD


Background and Purpose: Although shoe type may influence gait performance and is considered to be an extrinsic fall risk factor, little or no attention is paid to it when conducting research in this field. Therefore, this study aimed to assess the effect of various types of footwear under single- and dual-task conditions on spatiotemporal gait characteristics in older women.


Methods: Fifty-seven community-dwelling women (68.0 +/- 4.6 years) were enrolled in this study. Spatiotemporal gait analysis using the GAITRite walkway was performed under 4 footwear conditions (barefoot, slippers, high heels, and standard shoes) and 3 task conditions (single-task, motor dual-task, and cognitive dual-task). Two-factor repeated-measures analysis of variance was conducted. Primary outcomes were velocity, cadence, stride time, stride length, and stride length variability.


Results: Irrespective of task condition, walking barefoot resulted in a significantly slower gait pattern with decreased cadence and stride length and increased stride time and stride length variability compared with walking with the standard shoe. These significant gait alterations were also observed when adding a cognitive task to normal walking. The effects of footwear were most obvious during the cognitive dual-task condition and for the spatiotemporal parameters velocity and stride length.


Conclusions: Footwear matters when analyzing gait in older women. It should be described in greater detail by gait researchers. Footwear should also be considered by clinicians in light of the study findings and its effects on gait. Older women are strongly discouraged to walk barefoot because barefoot walking adversely affects gait patterns. A well-fitting standard shoe with laces, a low and wide heel, firm heel collar and a grooved, moderately hard sole is recommended in research, rehabilitation, and daily use.