To what extent does not wearing shoes affect the local dynamic stability of the gait? Effect size and intra-session repeatability

Abstract

Local dynamic stability (LDS) quantifies how a system responds to small perturbations. Several experimental and clinical findings have highlighted the association between gait LDS and fall risk. Walking without shoes is known to slightly modify gait parameters. Barefoot walking (BW) may cause unusual sensory feedback to individuals accustomed to shod walking (SW), and this may impact on LDS. The objective of this study was therefore to compare the LDS of SW and BW in healthy individuals and to analyze the intrasession repeatability. Forty participants traversed a 70 m indoor corridor wearing normal shoes in one trial and walking barefoot in a second trial. Trunk accelerations were recorded with a 3D-accelerometer attached to the lower back. The LDS was computed using the finite-time maximal Lyapunov exponent method. Absolute agreement between the forward and backward paths was estimated with the intraclass correlation coefficient (ICC). BW did not significantly modify the LDS as compared to SW (average standardized effect size: +0.12). The intrasession repeatability was high in SW (ICC: 0.73-0.79) and slightly higher in BW (ICC: 0.82-0.88). Therefore, it seems that BW can be used to evaluate LDS without introducing bias as compared to SW, and with a sufficient reliability.