Do footwear styles cause falls or increase falls risk in older women? A systematic review

Ms Annette Davis1,2, Dr Cylie Willliams2,3, Professor Terry Haines1,2

1Monash Health, Clayton, Australia, 2Monash University, Frankston, Australia, 3Peninsula Health, Frankston, Australia

Footwear selection is putatively considered to contribute to falls amongst older women. Laboratory studies have confirmed that certain footwear styles (eg. high heels) affect gait parameters in a way that might increase falls risk. However, it is unclear whether wearing these footwear styles in real life actually increases the risk of falling over.  This study review aimed to identify and synthesise available evidence directly investigating the relationship between wearing particular footwear styles and falls.  This review identified n=10 relevant studies.  However, none of these studies provided any direct evidence of the relationship between wearing particular footwear styles and falls.  The most common methodological flaw in these studies was that the exposure time for wearing particular types of footwear was not captured. Clinician recommendations to wear particular styles of footwear are not based on direct evidence from even observational studies, let alone randomised trials, but extrapolations from laboratory studies.