title: Effectiveness of a heel cup with an arch support insole on the standing balance of the elderly.
abstract: BACKGROUND
  The use of insoles may enhance postural stability and prevent falls. The aim of this study was to design a new insole and to explore the effectiveness of the insole on the standing balance of the healthy elderly.
  
  
  METHODS
  The study was conducted at a community hospital. Patients older than 65 years at an outpatient clinic without abnormal gait patterns, lower limb deformities, or foot pain were enrolled. The participants were assigned to good- and poor-stability groups on the basis of the stability index (SI), using the Biodex® Balance System. A heel cup with an arch support insole was provided. Participants wore the insole for 8 weeks for a minimum of 4 hours/day. A static balance test for SI was performed at the initial meeting and 8 weeks after the assigned insoles were worn for each participant.
  
  
  RESULTS
  Five participants (10.0%) of 50 total did not finish the study. There were 25 patients in the good-stability group and 20 in the poor-stability group. The SI, before and after intervention, was significantly different for all 45 participants (3.244±0.688 versus 3.064±0.671; P<0.001). The differences in SI before and after the intervention both in the good-stability group (2.764±0.546 versus 2.592±0.538) and the poor-stability group (3.845±0.188 versus 3.655±0.128) were statistically significant (P<0.001). No statistically significant difference on changes of SI were seen between the two groups.
  
  
  CONCLUSIONS
  The results suggest a heel cup with arch support insole is effective in enhancing the standing balance of the elderly. This may be of benefit in preventing falls.
authors.affiliation: Department of Rehabilitation, Mackay Memorial Hospital, Hsinchu, Taiwan.
authors.forename: Tzu-Hsuan
authors.initials: TH
authors.lastname: Chen
authors.affiliation: Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan ; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Chou
authors.affiliation: Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Mei-Wun
authors.initials: MW
authors.lastname: Tsai
authors.affiliation: Department of Rehabilitation, Yangming Branch, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Ming-Jor
authors.initials: MJ
authors.lastname: Lo
authors.affiliation: Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan ; Department of Rehabilitation, Yangming Branch, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Mu-Jung
authors.initials: MJ
authors.lastname: Kao
mesh_terms: D000367:Age Factors; D000368:Aged; D061826:Foot Orthoses; D006365:Heel; D006801:Humans; D008684:Metatarsus; D004856:Postural Balance
keywords: elderly; heel cup; insole; stability; standing balance