***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Age-related loss of foot-sole cutaneous sensation is very common and is associated with impaired balance control . This study investigated the effect of a balance-enhancing insole ( design ed to facilitate foot-sole sensation ) on lateral gait stability and evaluated its effectiveness in daily life . METHODS Forty community-dwelling older adults ( age 65 - 75 ) with moderate loss of foot-sole sensation ( unrelated to neuropathy ) were fitted with the same model of walking shoes . Half of the participants were assigned , at r and om , to wear the shoes with a facilitatory insole for 12 weeks ; the other participants wore a conventional insole . A gait perturbation protocol , simulating uneven terrain , was performed at baseline and after wearing the assigned insoles for 12 weeks . Participants were tested with both types of insoles during each gait-testing session and sent in weekly postcards with information pertaining to insole comfort , hours of wear , and falls . RESULTS The facilitatory insole improved lateral stability during gait , and this benefit did not habituate after 12 weeks of wearing the insole in daily life . Nine participants who wore conventional insoles experienced one or more falls , whereas only five of the facilitatory group fell . Although there were initial reports of mild discomfort in 10 cases , all but one participant tolerated the facilitatory insole , and most indicated that they would like to continue wearing the insole on a long-term basis . CONCLUSIONS A relatively simple change in insole design can help to counter effects of age-related ( non-neuropathic ) decline in foot-sole sensitivity , and is a viable intervention to enhance balance control Foot orthotics ( FO ) may be prescribed for a range of lower limb and foot conditions . Prior studies report use of FO in enhancing postural stability in healthy younger adults , and do not control for footwear type . Currently , interest in the effects of FO on postural stability in older adults has increased . Limited reports exist of the effects on postural stability of FO made of combinations of material s , thicknesses and surface textures . In this study 40 healthy females ( 51.1+/-5.8 years ) recruited into a within subject test-retest r and omised clinical trial were provided with identical footwear and r and omised into four FO conditions ( control , grid , dimple and plain , n=10 for each condition ) . Participants wore the footwear for 4 weeks , a minimum of 6h/day . A Kistler force plate was used to determine postural stability variables ( anterior-posterior displacements and medial-lateral displacements ) for each participant in a static position , with eyes open and eyes closed . Base of support was evaluated using the GAITRite system . Each outcome measure was measured at baseline and 4 weeks . Postural stability variables demonstrated no significant differences between the four FO conditions . No significant differences were observed with base of support between the four conditions . We have demonstrated no detrimental effects on postural stability in older females after 4 weeks . This is regardless of orthotic texture and is independent of footwear . Biomechanical or sensory effects of FO on postural stability are still to be determined . These may be dependent on the geometry and texture of the orthotic OBJECTIVE To identify the effect of vibratory stimuli applied to the plantar region on the balance of women 60 years or older . DESIGN A r and omized controlled trial ( blinded assessor ) . SETTING University research laboratory . PARTICIPANTS All women ( N=30 ; age , ≥60y ) selected had a balance deficit , assessed by using the One-Leg Stance test with eyes open ( EO ) . INTERVENTIONS Participants were r and omly divided into an experimental group , which received vibratory stimuli , and a control group , which received no intervention . MAIN OUTCOME MEASURES Functional reach ( FR ) test and center-of-pressure ( CoP ) sway area ( force platform ) . RESULTS There was a significant difference in the time factor of the experimental group for the FR test and CoP sway area with eyes closed ( EC ) . For the group × time interaction , there was improvement in balance in anterior-posterior ( AP ) CoP sway velocity with EO and EC . There also was improvement in CoP sway area with EC . CONCLUSION Vibratory stimuli applied to the plantar region have beneficial effects on balance in women 60 years or older , with greater effectiveness in anterior displacement , postural control of the AP axis , and the EC condition OBJECTIVE To determine whether shoe characteristics affect balance in older women . DESIGN R and omized order , cross-over , controlled comparison . SETTING A retirement village . PARTICIPANTS Thirty women aged 60 to 89 years ( mean 78.7 SD = 8.5 ) . Twenty-five subjects were hostel residents , and five were living independently in the community . OUTCOME MEASURES Postural sway , maximal balance range , and co-ordinated stability . MAIN RESULTS The subjects underwent assessment s of static balance ( body sway ) and dynamic balance ( maximal balance range and co-ordinated stability ) under four conditions : ( 1 ) barefoot , ( 2 ) in st and ard low-heeled shoes ( walking shoes ) , ( 3 ) in st and ard high-heeled shoes , and ( 4 ) in their own shoes . Manova analysis revealed a significant overall shoe condition effect -- subjects performed best in bare feet or low-heeled shoes and worst in high-heeled shoes . There were no significant differences between subjects with and without foot abnormalities in any of the balance measures or test conditions . CONCLUSION These findings suggest that bare feet and walking shoes maximize balance , whereas high-heeled shoes constitute a needless balance hazard for older women PURPOSE The purpose of this study was to examine the effects of arch supports on balance , functional mobility , and pain in the back and lower extremity joints  among older adults . DESIGN A single-factor within-subjects design was used . METHOD A convenience sample of older adults formed a single group for fitting with arch supports .  Balance , functional mobility , and self-reported pain in the back and lower extremities were measured without the arch supports , immediately after the insertion of the supports in the subjects ' shoes , and after 6 weeks of arch support use . FINDINGS Sixty-seven older adults completed the study . The measures used indicated statistically significant improvements in scores for the Berg Balance Scale [ Berg , K. , Williams-Dauphinee , S. , & Williams , J. I. , ( 1995 ) . The Balance Scale : Reliability assessment for elderly residents and patients with an acute stroke . Sc and inavian Journal of Rehabilitation Medicine , 27 , 27 - 31 ] and functional mobility [ Timed Up and Go test ; Podsiadlo , D. , & Richardson , S. ( 1991 ) . The Timed " Up and Go " : A test of basic functional mobility for frail elderly persons . Journal of the American Geriatrics Society , 39 , 142 - 148 ] as well as reduced back , foot , knee , and hip pain ( p < .05 ) . There was no statistically significant change in ankle pain ( p > .05 ) . IMPLICATION S Knowledge of interventions that enhance health and well-being is essential for nurses . Arch supports may provide improved balance and functional mobility while reducing back and lower extremity joint pains . Further research is needed to support evidence -based practice BACKGROUND AND PURPOSE Footwear is not consistently st and ardized in the administration of the Functional Reach Test ( FRT ) , Timed Up & Go Test ( TUG ) , and 10-Meter Walk Test ( TMW ) . This study was conducted to determine whether footwear affected performance on these tests in older women . SUBJECTS Thirty-five women , aged 65 to 93 years , were recruited from assisted living facilities and retirement communities . METHODS Each subject performed the FRT , TUG , and TMW wearing walking shoes , wearing dress shoes , and barefooted . Because of space constraints at the facilities where the testing was performed , 22 subjects performed the FRT and TUG on a linoleum floor and 13 subjects performed the tests on a firm , low-pile , carpeted floor . All 35 subjects completed the TMW on a firm , low-pile , carpeted floor . One-way repeated- measures analyses of variance ( ANOVAs ) and a Tukey Honestly Significant Difference test were used to compare the outcomes for the 3 footwear conditions , with separate ANOVAs conducted for the different floor surfaces for the FRT and TUG . RESULTS Subjects performed better on the FRT when barefooted or wearing walking shoes compared with when they wore dress shoes , regardless of floor surface . Differences were found among all footwear conditions for the TUG performed on the linoleum floor and for the TMW . For these tests , the women moved fastest in walking shoes , slower barefooted , and slowest wearing dress shoes . CONCLUSION AND DISCUSSION Footwear should be documented and should remain constant from one test occasion to another when the FRT , TUG , and TMW are used in the clinic and in research . Footwear intervention may improve performance of balance and gait tasks in older women BACKGROUND One of the more pervasive effects of aging is loss of cutaneous sensation , which appears to correlate with impaired postural control and increased risk of falling . This study examined the potential for compensating for the destabilizing effects of reduced cutaneous sensitivity by placing a raised edge underneath the perimeter of the plantar foot surface , so as to facilitate sensation from the stability boundaries of the base of support . METHODS The main experiment involved 14 healthy older adults ( aged 65 - 73 ) selected because they were known , from a previous study , to have moderate plantar cutaneous insensitivity . We also report results of an initial experiment involving 7 healthy young adults ( aged 23 - 31 ) . In both experiments , we studied effects of the plantar facilitation on control of rapid stepping reactions evoked by unpredictable postural perturbation , applied via sudden platform movement in forward , backward , and lateral directions . We also studied effects on " feet-in-place " responses evoked by continuous pseudor and om platform motion in mediolateral and anteroposterior directions . Subjects were blindfolded in all tests . RESULTS Plantar facilitation reduced the incidence of " extra " limb movements , beyond the initial step , during forward-step reactions in the older adults . There also appeared to be an improved ability to control feet-in-place reactions : young subjects were better able to recover balance without stepping when falling backward ( given instructions to " try not to step " ) , and both young and older subjects reduced the extent to which the center of foot pressure approached the posterior foot boundary during continuous anteroposterior platform motion . CONCLUSIONS This study provides evidence that mechanical facilitation of sensation from the boundaries of the plantar surface of the foot can improve the efficacy of certain types of stabilizing reactions evoked by unpredictable postural perturbation . The results may be directly transferable to the design of special footwear insoles to reduce instability and risk of falling in older adults OBJECTIVE To test the hypothesis that shoes with thick , soft midsoles , such as modern running shoes , provide better stability in older individuals than those with thin-hard midsoles . In addition , we examined the relation between footwear comfort and stability and stability when barefoot . DESIGN R and omized-order , cross-over , controlled comparison . SETTING Subjects were drawn from an internal medicine practice . PARTICIPANTS A r and om sample of 25 healthy men , minimum age 60 years . Additional selection criteria were absence of disabilities influencing ability to walk and lack of history of frequent falls . MEASUREMENTS Balance failure frequency , which was defined as falls from the beam per 100 meters of beam walking when 10 passes were made down a 9 M long balance beam .  Comfort rating was based on an ordinal scale . RESULTS Contrary to the hypothesis : ( 1 ) midsole softness was associated with poor stability ( F(2,48 ) = 17.9 , P < 0.0001 ) ; ( 2 ) thick midsoles also provided poor stability ( F(1,24 ) = 7.36 , P < 0.01 ) . When barefoot , subjects showed 19 % higher balance failure frequency than with the poorest shoe and 171 % greater than the best shoe ( t = 5.33 , P < 0.0001 ) . Higher comfort was generally found in shoe types associated with higher balance failure frequency . CONCLUSIONS For optimal stability , shoes with thin , hard soles are preferable for older individuals . Health professionals should exercise caution when recommending shoes with thick , yielding midsoles , such as running shoes , to unstable elderly individuals . Older men and women with a history of falls or who are obviously unstable , should avoid barefoot locomotion OBJECTIVES To test the hypotheses that foot position awareness is related positively to stability , positively to shoe sole hardness , and negatively to shoe sole thickness , and that foot position awareness declines with advancing years . SETTING Older subjects were consecutive volunteers from a medical clinic ; younger subjects were volunteers from the community . DESIGN R and omized-order , cross-over , controlled comparison . PARTICIPANTS Older subjects were a r and om sample of 13 healthy men , mean age 72.58 years , SD + /- 4.50 . Younger subjects were a r and om sample of 13 male subjects from the general population , mean age 28.13 years , SD + /- 3.96 . Additional selection criteria were absence of disabilities influencing ability to walk and no history of frequent falls . MEASUREMENTS Balance failure frequency , defined as falls per 100 meters of beam walking ; rearfoot angle in degrees , measured via an optical position measurement system ; perceived maximum supination when walking , in degrees , estimated by subjects using a ratio scale ; foot position error , in degrees , was defined as the rearfoot angle minus perceived maximum supination . RESULTS Foot position error during walking : ( 1 ) increases with advancing years ; footwear conditions absolute mean error for older sample of 15.48 degrees , SE + /- 1.56 degrees , and younger sample 5.44 degrees , SE + 
    Output:
    
Results : The results demonstrated that older people should be advised to wear thin , hard-soled footwear with high collars to reduce the risk of falling .
The findings for insoles demonstrated an increase in balance control via vibratory or magnetic insoles , but textured insoles do not appear to be beneficial for balance improvement .
Conclusion : Foot orthoses improve postural stability via a somatosensory or biomechanical effect .
Use of footwear with the proper features can be an appropriate intervention in order to increase the balance in the older population and reduce falls .
Clinical relevance Loss of balance is an important factor in increasing the risk of falling in older subjects .
Foot orthoses can improve functional measures of stability in older adults .
In this review , results from studies suggest a number of recommendations regarding the optimal footwear for older people to reduce the risk of falling