Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type





Exercise Science

First Advisor

Dr. Carl G. Mattacola

Second Advisor

Robert Shapiro


An increase in postural sway is one of the risk factors that have been linked to an increased incidence of falls in the older adult population. Researchers have shown that peripheral sensation is crucial in maintaining a static posture for adults of all ages. It has been reported that older adults have decreased tactile sensation of the plantar surface of their feet. and when the sensory feedback was increased older adults had improved postural control. It was hypothesized that facilitation of the sole of the foot with the use of a semirigid foot orthotic would result in improved postural stability in older adults.

Twenty-seven volunteers (19 females, 8 males, mean age: 87 ± 5 yrs) were recruited as subjects from a retirement community. All subjects were supplied with the SmartStep™ Stabilization System. There were a total of 5 Test Days for each subject. The first 2 Test Days were performed while the subjects wore their own shoes, while the last 3 Test Days were performed while the subjects wore the SmartStep™. Test Days 1 and 2 were performed 48 hours apart. Test Day 3 occurred 2 to 4 weeks after Test 2. Test Days 4 and 5 occurred 4-weeks after the prior Test Day. During the 8-weeks between Test Days 3 and 5, subjects were asked to wear the SmartStep™ as their daily shoe.

Clinical measures of balance, force plate measurements, sensation testing, and confidence and activity scales were collected on all subjects throughout the eight week test period. Statistical significance was found for 3 of the clinical measures. The Timed “Up & Go” improved from 17.25 to 15.47 sec. The Functional Reach and Lateral Reach Tests demonstrated a decline in scores during the eight weeks. There was only 1 statistically significant finding for the force plate measures. The center of pressure displacement in the anteriorposterior direction was increased from 4.6 to 5.3 cm. No significant differences where reported for any other dependent variable. The results did not indicate statistically that the in-shoe orthotic enhanced postural stability in this group of subjects. However, there were indications that there was a subset of the current population that benefited from the intervention and this needs to be investigated further.

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Kinesiology Commons