Immediate effects of wearing textured versus smooth insoles on standing balance and spatiotemporal gait patterns when walking over even and uneven surfaces in people with multiple sclerosis

Abstract

Purpose

To investigate the immediate effects of wearing novel sensory-stimulating textured insoles on balance and gait in 41 people with multiple sclerosis (pwMS).

Materials and methods

Assessments of balance (firm/foam surface; eyes open/closed) and walking (when negotiating even/uneven surfaces) were performed wearing textured insoles, smooth insoles, shoes only, and barefoot. Outcome measures were centre of pressure (CoP) movement during standing (elliptical area, sway path velocity) and spatiotemporal gait patterns (stride/step width, stride time, double-limb support time, stride length, velocity).

Results

Wearing textured insoles led to reductions in CoP velocity measures when standing on foam with eyes open and closed when compared to barefoot (p values ≤0.02). Textured insoles did not appear to be consistently superior to smooth insoles or shoes only for improving gait. Relative to the insole/shoe conditions, walking barefoot led to poorer gait performance for the even and uneven surface tasks (p values ≤0.03).

Conclusions

For pwMS, stimulating the foot with “texture” appears to provide enhanced sensory input with the capacity to improve CoP movement control during standing; offering a potential new treatment option for balance rehabilitation. Further research is needed to identify which individuals may benefit most from textured insoles.

Implications for rehabilitation

• Textured shoe insoles, designed to stimulate plantar mechanoreceptors, are a novel approach to improve standing balance and walking patterns in people with multiple sclerosis (pwMS).

• Wearing textured insoles for the first time can lead to improvements in centre of pressure movement control when standing on an unstable compliant supporting surface.

• Textured insoles offer a potential new treatment technique for balance rehabilitation in pwMS who show early signs of diminished foot sensation.

Keywords:

• Balance
• gait
• orthotic devices
• multiple sclerosis
• cutaneous sensation

Acknowledgements

The authors would like to acknowledge Sarah Robins and Jessica Thompson for their contribution to completing the laboratory assessments. The authors would also like to thank Nampech Wuthapanich and Jessica Thompson for their assistance with data processing. In particular, the authors would like to acknowledge Multiple Sclerosis Queensland for their involvement with participant recruitment.

Disclosure statement

The authors declare that there is no conflict of interest.

Additional information

Funding

This work was supported by a Multiple Sclerosis Research Australia Project Grant (13-006).