Footwear Alters Gait And Predicts Falls: Two-minute Walk Test Insights In Over-50 Adults

Falls in older adults pose significant health risks and economic burdens, with gait analysis playing a crucial role in fall risk assessment. However, the impact of everyday footwear on gait kinematics in this population and the sensitivity of gait parameters to footwear effects during standardized tests remain unclear. PURPOSE: To investigate the effects of footwear on gait kinematics during the Two-Minute Walk Test (2MWT), examine correlations with footwear features, and evaluate footwear characteristics as predictors of faller/non-faller status in adults over 50 years old, assessing the impact on walking performance. METHODS: 34 participants (age: 59 ± 6 years; height: 158.9 ± 5.8 cm; mass: 64.4 ± 8.1 kg) completed two randomized trials of the 2MWT: barefoot and wearing their primary sports footwear. Kinematic data were collected using six inertial sensors, measuring temporal and spatial parameters. Footwear specifications and fall history for the past three months were documented. Statistical analyses included paired t-tests comparing footwear and barefoot conditions, Pearson correlations between footwear features and 2MWT kinematics, and binomial logistic regression predicting faller/non-faller status using footwear features as predictors. RESULTS: There were significant differences between barefoot and footwear conditions in 25 gait parameters during the 2MWT (p < .05). Higher shoe mass correlated with lower cadence (r = -0.35, p = .041), longer gait cycle duration (r = 0.36, p = .035), and reduced midswing elevation (r = -0.42, p = .012). Larger heel width correlated with faster gait speed (r = 0.34, p = .046) and greater toe-off angle (r = 0.41, p = .016). Larger toebox width is correlated with faster gait speed (r = 0.47, p = .004). Logistic regression found that the shoe features moderate predicted fall risk (Nagelkerke R2 = 0.32, p = .041). However, shoe mass (OR = 0.98, p = .065), heel width (OR = 1.01, p = .902), and toebox width (OR = 1.21, p = .055) independently showed no statistically significant effect on fall status. CONCLUSIONS: Footwear characteristics relate to gait parameters in adults over 50 during the 2MWT. These findings highlight the relationship between footwear characteristics and walking performance in older adults, suggesting important considerations for fall risk assessment protocols.