This study popped up last week and I thought it had some interesting implications.
Altering gait by way of stimulation of the plantar surface of the foot: the immediate effect of wearing textured insoles in older fallers
Conclusions - Stimulating the plantar surface of the foot by way of wearing this type of textured insole causes an immediate effect - in this case a slower, more cautious gait in older fallers. Further work is required to determine how textured insoles can be used to improve gait in older fallers.
The whole study is there for you to look through.
Anyway, what this made me think of was the value of being barefoot. So much information comes from the feet, from the sole. While shod, all that information is blunted. Barefoot there is so much more stimulation and data that can be processed by the brain to feed into the proprioceptive system.
Textured insoles are just a "stepping stone" to being barefoot. If they can help to prevent falls, maybe being barefoot....on rough rich surfaces...could do even more
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I discussed this idea with Dr. Michael Merzenich, the neuroscientist featured in The Brain That Changes Itself. He's of the belief that old people fall because the 'brain map' of the foot has "de-differentiated" and doesn't see the foot as 5 flexible toes and a sole, but of a big, inflexible paddle. He agrees that they need to get barefoot to re-differentiate the brain map and regain the ability to get the necessary sensory information for balancing.
Similarly, I talked to Dr. Kirk Erikson, whose long-term study of old people showed that those who walked retained more gray matter as they aged. I proposed that if they walked barefoot they would have retained even more! He thought I was probably right, but didn't have the funding for another 9-year study ;-)
It's an interesting topic, but there needs to be much more research completed. It's all well and good to have the theories, but without a robust evidence-base all we have are theories.
This particular study is not randomized, and from what I can tell there is no blinding of subjects or assessors. The findings are promising, but of seemingly poor methodological quality.
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Old folk walking around in bare feet would not be allowed in mum's care home. "They'd catch a chill" would be one reason. Old folk have to be kept at a sufficiently high temperature that they're asleep most of the time during the day.
"They'd slip and fall" would be another reason. "They'd get an infection in their feet" would probably be another.
I read a bunch of research on this a while back. Seniors are *more* likely to fall while barefoot than while wearing shoes - I think the thinking is their proprioceptiveness weakens with age (no idea if this also happens with barefooters - I would hope not but you never know). Training with a wobble board can help with balance. I think they need the extra feedback from the sides of their shoes for balance, since the sensory input from the soles is weaker.
Funny enough my grandmother fell down the stairs and told me that she doesn't have these problems when barefoot, but only with running shoes (never mind why not walk around barefoot in your own house...)
I bought her some shoes with very thin soles - some old Speedo water shoes, I think - and problem solved.
good pre-paleo-popularity book I read on this was Phil Maffetone's "fix your feet".
Maffetone was ahead of his time as usual....
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