A comparative study of balance wearing shoes or barefoot in adults

Abstract

Background: Worldwide, poor balance is linked with falls and risks of injuries. There is a vast amount of information on balance and interventions, however there is a limited amount of information discussing and investigating the differences brought about by comparing using footwear to barefoot. Research question: Does balance in adults improve whilst barefoot as compared to when using shoes? Study design: A systematic literature review using the PICO approach on balance wearing shoes or barefoot in adults. Methods: A search strategy based on the key elements of the PICO framework was executed using keywords from the research question across advanced search engines in the PubMed and Cochrane databases. The PICO elements were; adults, barefoot, wearing shoes and improvement in balance. After searching using the PICO elements certain limiters were applied in order to help reduce the amount of hits and only obtain the most relevant evidence. The study, cautiously with the inclusion and exclusion criteria formulated were used to select certain papers which were then critically appraised using the CASP tools for both RCTs and Systematic Reviews. Results: A total of 7 articles were selected from the past 10 years comprised of 6 RCTs and 1 Systematic Review. Conclusion: Three studies found that wearing shoes showed more improvement in balance while another one study showed that both interventions lead to improvements in balance. One study showed that barefoot lead to improvements in balance while another study found that barefoot shoes lead to improvements in balance. There is insufficient translatable, available evidence to support that one intervention is better than the other in balance. It is recommended to carry out future research on larger populations and also different populations involving the elderly, injured/diseased. These may produce different results. The systematic review found that habitual shoe users responded acutely to walking barefoot while habitual barefoot walkers responded to better balance distribution when studied.