Effect of Total Contact Insoles Intervention on Balance Ability for the Elderly

The study was designed as a two-group randomized controlled trial involving institutionalized older adults residing in a veterans' residential care facility. Eligible participants were aged 65 years or older, were able to walk independently in daily life, had no previous experience using individually fabricated custom-made total contact insoles, were willing to use the assigned insole condition during daily activities, and were able to understand and comply with the study procedures. Participants were randomly assigned to either an intervention group or a control group. Participants in the intervention group received individually customized total contact insoles fabricated according to each participant's foot morphology and arch characteristics. Participants in the control group continued using their usual personal insoles. The assigned insole condition was maintained throughout the 8-week intervention period. Assessments were conducted at baseline, after initial use of the assigned insole condition, at 4 weeks, and at 8 weeks. Static postural control was assessed using force-platform measurements. Functional mobility and trunk movement characteristics were evaluated using an instrumented Timed Up and Go test. Walking performance was assessed during a 10-meter walk test using a wearable gait analysis system. During the 10-meter walk test, plantar pressure was simultaneously recorded using an in-shoe plantar pressure measurement system. Plantar pressure analysis included peak plantar pressure, timing of peak plantar pressure within the gait cycle, pressure-time integral, and contact area. Measurements were evaluated across plantar regions including the heel, midfoot, individual metatarsal regions, toe regions, and the total foot. Plantar pressure analyses were performed using data from the participant's dominant foot.