Falls in the elderly are attributed to many factors, one of them being unsafe footwear. Lord and associates conducted a randomized, crossover controlled trial to determine if sole hardness and shoe collar height have any effect on stability and balance in older women.

Balance assessments were made while the subjects were barefoot and while wearing four different types of shoes: soft-soled “bowls” shoes (shoes with a continuous sole used in lawn bowls); hard-soled bowls shoes; Doc Martins shoes with a standard (6.5 cm) collar height; and Doc Martins with a high (15 cm) collar. The balance assessments were of body sway (found to be a good discriminator between those who fall and those who do not), maximal balance range (where each woman was asked to lean forward and back, from the ankles, as far as possible), and ability to adjust balance. The study included 42 women.

Study results showed that the high-collar shoe was associated with better balance than the low-collar shoe or the barefoot state. There was no significant difference between the soft-and the hard-soled shoes in terms of their effect on balance.

The authors conclude that high-collar (so-called “high-top”) shoes are associated with better balance than low-collar shoes. The hardness or softness of the sole does not seem to affect balance in older women.