Plantar sensation associates with gait instability in older adults.
Jason R Franz, Andrew D Shelton, Kota Z Takahashi and 1 others
PMID 39849593WHAT IT FOUND
Older adults with poorer plantar sensation showed greater gait instability during normal walking and when pulled sideways.
No link was found for slip-like or visual disturbances. This suggests foot sensation matters most for lateral balance, but does not prove treating it prevents falls.
Key findings
01Higher plantar sensation thresholds (worse sensation) correlated with larger margins of stability during habitual walking.
02Worse plantar sensation correlated with greater instability (larger changes in angular momentum and decreased stability margins) in response to lateral waist-pull perturbations.
03No significant correlations were found between plantar sensation and instability in response to optical flow or treadmill-induced slip perturbations.
STILL TO COME
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What it does not show
Small sample size (28 participants) limits generalizability. The study measured laboratory-based gait instability metrics, not actual fall rates, so clinical significance for fall prevention is speculative. Perturbation magnitudes were smaller than those that typically cause falls in the real world. No medication review was conducted, so the influence of medications on balance or sensation is unknown. The cross-sectional nature of the data cannot prove that poor sensation causes instability or that improving sensation will improve balance.
Declared interests
The study was funded by the National Institutes of Health. No other conflicts of interest were reported.
The easy way to misread this
Do not interpret the association between poor plantar sensation and gait instability as proof that treating sensation (e.g., with insoles) will prevent falls. The study measured biomechanical instability in a lab, not actual falls, and found no link between sensation and instability during slip-like perturbations.