Study designs of evaluations included in the review
Randomised controlled trials, case series and observational, cross-sectional, case-control and cohort studies were eligible for inclusion in the review.
Specific interventions included in the review
Studies of any type of shoe or AFA were eligible for inclusion. Most of the interventions included in the review involved shoes with soles of varying thickness and hardness. Other interventions included a senior sport shoe with heel elevation; new orthopaedic footwear combined with an individual training programme; the application of flexible tubing to the plantar surface boundaries of the feet; and vibrating gel-based insoles.
Participants included in the review
Studies had to include either older adults (60 years and older) or individuals with a PNSD (not specifically defined). Only one of the included studies assessed individuals with a PNSD; this study included patients aged 12 to 44 years with hereditary motor and sensory neuropathy. The remaining studies included patients with a mean age ranging from 69 to 73 years (where reported); three of these studies also included groups of younger individuals. Three studies included only older men and one study
included only older women.
Outcomes assessed in the review
Eligible studies had to include a measure of balance or falls. The included studies assessed: velocity and displacements of the centre of pressure under varying conditions; stepping reactions; whole body postural sway; balance failure (number of falls from a beam per 100 metres); rear foot angle; and perceived maximal supination. The majority of the included studies examined immediate effects, but the follow-up in two studies ranged from 5 weeks to 4 months.
How were decisions on the relevance of primary studies made?
One reviewer read and assessed titles and abstracts. Two reviewers then independently assessed the full papers and any disagreements were resolved through discussion or intervention by a third reviewer.