Comparison of Rocker Shoes and Normal Shoes on Reducing the Risk of Falls in the Elderly During the Implementation of an Agility-Based Fall Prevention Protocol

It is possible that using unstable shoes with fall prevention exercise training contributes to better fall-related measures in older adults. We aimed to evaluate the effects of 12-week agility balance training wearing usual (US) or unstable (UnS) shoes on the balance, mobility, strength, and fear of falling in healthy older men. A prospective three arms randomized controlled trial was conducted in a university lab. Fifty-seven male older adults were initially randomized into US, UnS, or a control group, and 53 participants (mean age 67.5±4.1 years) completed the study. Both US and UnS groups received agility balance training wearing usual and unstable shoes, respectively. Group classes were offered three times per week over 12 weeks. The control group did not receive an active intervention. Ankle plantar flexor muscle strength (Calf-Raise Senior test), balance (Fullerton Advanced Balance scale), mobility (Timed Up and Go test), postural stability (force platform), and Fear of falling (Fall Efficacy Scale-International) were measured at baseline, after the 12-week intervention, and one month after the end of the training program. There was a significant improvement in all fall-related measures after the 12-week agility balance training in both UnS (ES= from 1.19 to 2.4) and the US (ES = from 0.63 to 2.5) compared with the control group. The UnS group experienced more mobility gains at the 12-week posttest (p = 0.03) compared with the US group. At follow-up, all gains were maintained in the UnS group (p < 0.05), but the plantar flexor muscle strength (p = 0.3), mobility (p=0.08), and postural sway (p =0.07) scores returned to baseline values in the US group.  At follow-up, significant differences were found between-group for all fall-related measures (p> 0.05) in favor of the UnS group. Agility balance training with and without unstable shoes improved fall-related measures. However, wearing unstable shoes with agility balance training maintains longer-term positive effects on fall-related measures in older men.