The effects of habitual footwear in gait outcomes in people with Parkinson's disease

Background: Gait is impaired in individuals with Parkinson's disease (PD). Although the effect of habitual footwear on gait spatiotemporal parameters has already been established in neurologically healthy individuals, its effects on people with PD is unknown. Research question: This study aimed to investigate the impact of habitual footwear on the step spatiotemporal parameters in people with PD. Methods: Sixteen individuals with PD (G-PD) and 15 neurologically healthy individuals (G-HC) were assessed. Participants walked on an 8 m long pressure sensitive walkway at their preferred speed with and without their habitual footwear (3 trials per condition). Footwear included flip-flops, shoes, sneakers and sandals. The average, variability and asymmetry for step length, width, duration, and velocity and the percentage time in the swing and stance phases were calculated. Results: The results showed in both groups a reduced percentage time in the swing phase and an increased step width, duration and length with footwear (F(1,29) > 5.64; p < 0.02). Additionally, habitual footwear increased step width variability in G-PD and G-HC (F(1,29) =3.97; p = 0.06). Interestingly, only G-HC showed a higher step length asymmetry in the footwear condition than in the barefoot condition (p = 0.02). Finally, only when habitual footwear was used, G-HC showed a higher step velocity asymmetry than G-PD (p =0.04). Significance: These results indicate a negative influence of footwear on gait spatiotemporal parameters in both groups. Furthermore, footwear induced differences between groups. These findings indicate that footwear use is an influencing factor in studies comparing people with PD and healthy elderly. Further data are needed before definitive recommendations are made.