GAIPOS-2377; No of Pages 7 Effect of textured foot orthotics on static and dynamic postural stability in middle-aged females Marjorie L. Wilson a, * , Keith Rome a,1 , David Hodgson a,2 , Peter Ball b,2 a School of Health & Social Care, Centuria Building, University of Teesside, Middlesbrough TS1 3BA, UK b Durham School of Podiatric Medicine, New College Durham, Durham, UK Received 20 January 2006; received in revised form 16 November 2006; accepted 27 December 2006 Abstract Foot orthotics (FO) may be prescribed for a range of lower limb and foot conditions. Prior studies report use of FO in enhancing postural stability in healthy younger adults, and do not control for footwear type. Currently, interest in the effects of FO on postural stability in older adults has increased. Limited reports exist of the effects on postural stability of FO made of combinations of materials, thicknesses and surface textures. In this study 40 healthy females (51.1 Æ 5.8 years) recruited into a within subject test–retest randomised clinical trial were provided with identical footwear and randomised into four FO conditions (control, grid, dimple and plain, n = 10 for each condition). Participants wore the footwear for 4 weeks, a minimum of 6 h/day. A Kistler force plate was used to determine postural stability variables (anterior–posterior displacements and medial–lateral displacements) for each participant in a static position, with eyes open and eyes closed. Base of support was evaluated using the GAITRite1 system. Each outcome measure was measured at baseline and 4 weeks. Postural stability variables demonstrated no significant differences between the four FO conditions. No significant differences were observed with base of support between the four conditions. We have demonstrated no detrimental effects on postural stability in older females after 4 weeks. This is regardless of orthotic texture and is independent of footwear. Biomechanical or sensory effects of FO on postural stability are still to be determined. These may be dependent on the geometry and texture of the orthotic. # 2007 Elsevier B.V. All rights reserved. Keywords: Textured foot orthoses; Older adults; Postural stability 1. Introduction When walking, the foot is the first point of contact between the body and the external environment, providing sensory information to the central nervous system for stability and locomotion. Postural stability and balance are dependent on the position of the centre of mass of the body and its displacement within the base of support [1]. External disturbance of balance in the anterior–posterior direction is corrected by a synergy of muscle activations known as the hip–ankle strategy [1]. Medial–lateral disturbances in quiet standing make use of hip muscle activation to maintain postural control [1]. The main- tenance of postural stability is also dependent on a range of somatosensory inputs. Tactile sensitivity within the foot has a strong influence on maintenance of postural stability, as evidenced when this sensory input is lost in diabetic neuropathy [2,3]. Vision has a definitive role in postural control [2,4]. Trials of postural control of older subjects who have visual field temporarily removed demonstrate a worse performance of the task than under full vision conditions [4]. A reduction in somatic sensation and vestibular function have been strongly linked to postural instability, to the extent of adversely impacting on balance and contributing to falls in the elderly [4]. The link between postural stability and falls is well documented with postural instability deficits being significant pre- dictors of falls in older adults [5,6]. www.elsevier.com/locate/gaitpost Gait & Posture xxx (2007) xxx–xxx * Corresponding author. Tel.: +44 1642 384529. E-mail addresses: M.Wilson@tees.ac.uk (M.L. Wilson), K.Rome@tees.ac.uk (K. Rome), David.Hodgson@tees.ac.uk (D. Hodgson). 1 Tel.: +44 1642 382754. 2 Tel.: +44 1642 384100. 0966-6362/$ – see front matter # 2007 Elsevier B.V. All rights reserved. doi:10.1016/j.gaitpost.2006.12.006 Please cite this article in press as: Wilson ML, et al., Effect of textured foot orthotics on static and dynamic postural stability in middle- aged females, Gait Posture (2007), doi:10.1016/j.gaitpost.2006.12.006