INTRODUCTION
Many falls experienced by older people result from age-related deterioration of the balance and neuromuscular systems [1]. Most falls occur during motor tasks [2],
and footwear has been identified as an environmental risk factor for both indoor and outdoor falls [3–4]. By altering somatosensory feedback to the foot and ankle and modifying frictional conditions at the shoe-sole/floor interface, footwear influences postural stability and the subsequent risk of slips, trips, and falls. While the primary
role of a shoe is to protect the foot and facilitate propulsion [5], fashion has strongly influenced the design of footwear throughout the ages, compromising the natural
functioning of the foot [5–6]. As a result, little is known about what constitutes safe footwear for older people undertaking activities in and around the home [7]. Because footwear appears to be an easily modifiable risk factor for falls, identifying the specific shoe features that might facilitate or impair balance in older people is imperative
for the design of targeted fall prevention interventions and provision of evidence-based recommendations. In this systematic review, we initially describe the
types of footwear commonly worn by older people. We then highlight studies in which footwear has been recognized as a risk factor for falls. Finally, we review the evidence pertaining to the effects of specific footwear characteristics on balance and related factors in older people.