Safety precautions for walking in socks should be provided to older adults who adopted a more cautious gait pattern compared with young adults, according to study results.

“Inappropriate footwear has been identified as one of the extrinsic risk factors of falls for older adults,” the researchers wrote. “For the elderly, walking barefoot or in socks is common for reasons of convenience and comfort. Such a common behavior has been found to be related to increased risk of falls and fall-related severe injuries. The purpose of this study was to investigate the differences in gait patterns during walking barefoot and in socks for both young and older adults.”

Walking barefoot vs. in socks

Researchers used a motion analysis system to record and calculate stride characteristics and motion of the body’s center of mass in 21 young and 20 older adults. Participants performed random walking tasks on a smooth floor surface at their preferred speed either barefoot or in commercially available socks.

Compared with walking barefoot, older adults adopted a more cautious gait pattern while walking in socks, including decreased walking speed and shortened stride length, as well as reduced center of mass minimal velocity during the single limb support phase. However, young adults did not demonstrate significant changes in gait, according to study results.

“Cautious gait, characterized by reduced walking speed and stride length, is a common behavior adopted by individuals when facing greater balance threats or physiological constraints. Young adults who perceived increased balance threats, such as walking on slippery floor surface or wearing footwear with poor slip-resistance, adopted cautious gait patterns,” the researchers wrote. “This study found that the stride characteristics of young adults were not affected by wearing socks. Older adults, on the contrary, adopted cautious gait when walking with socks.”

“Safety precautions about walking in socks should be considered to be given to older adults, especially those with balance deficits,” the researchers concluded.

Future studies

According to the researchers, one potential explanation for the difference between the young and older adults is plantar sensitivity, which provides critical sensory feedback for the control of standing and walking. Imbalance and cautious gait can occur from inadequate plantar sensory feedback. Wearing socks could potentially interfere with the detection of plantar surface stimulation. Although inconsequential for individuals with intact plantar sensitivity, other individuals afflicted with reduced plantar sensitivity, such as older adults, may not be able to detect plantar surface stimulation when walking in socks compared with walking barefoot.

“A further reduction in plantar sensory feedback while walking with socks might lead to insufficient afferent inputs for locomotion control for older adults, and possibly as a result, cautious gait needed to be adopted,” the researchers wrote. “Further studies are needed to determine the relationships between plantar sensitivity and the effect of footwear on gait.”

The researchers described some limitations to their study. They did not quantify the friction demands for walking with socks and barefoot. The walking tasks also were conducted on a smooth floor surface and with only one type of sock. Future studies should observe patients walking on carpeted surfaces and in socks with different materials, such as non-slip socks, to see if patients experience similar effects. — by Casey Murphy

For more information:
Tsai Y. Gait Posture. 2013;37:88-92.

Disclosure: The researchers have no relevant financial disclosures.

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