JMIR Publications

ABSTRACT

Background:

Falls represent a critical public health burden in older adults and individuals with neurological disabilities, but evidence for passive footwear-based fall prevention strategies remains limited.

Objective:

To evaluate changes in fall frequency and fall-related outcomes following adoption of variable-friction (VF) footwear in individuals at elevated risk of falling.

Methods:

This retrospective pre-post observational study used self-reported survey data collected from community-dwelling adults aged ≥18 years (N=705) who had worn VF footwear for ≥3 months and self-reported elevated fall risk. Participants were recruited from a convenience sample of customers who purchased the device through an electronic survey platform. Outcomes included self-reported fall frequency, injurious falls, fall mechanisms, fall-related health care utilization (including medical visits, urgent care, and hospitalization) and assistive device use, assessed before and during VF footwear use.

Results:

Mean monthly falls decreased from 2.4 (SD 4.3) before VF use to 0.3 (SD 1.9) during VF use (87.1% reduction; Wilcoxon signed-rank, P < .001). The proportion reporting zero falls increased from 22.7% to 84.4%. Among participants with at least 1 fall before VF use (n = 545), 95.4% reported a reduction, including 80.7% reporting zero falls during VF use. Injurious falls decreased by 94.4% (P < .001). Participants requiring medical attention decreased from 192 (27.2%) to 12 (1.7%; 93.8% reduction; P < .001), and hospital or urgent care visits decreased from 131 (18.6%) to 10 (1.4%; 92.4% reduction; P < .001). Trip-related falls decreased from 67.7% to 30.7% of reported mechanisms. Assistive device use decreased from 70.8% to 16.6% (P < .001). Total insurance costs decreased from $4,193,104 to $34,798 (99.2% reduction) across participants reporting costs.

Conclusions:

VF footwear use was associated with substantial reductions in self-reported falls, injurious falls, and fall-related healthcare utilization in a high fall-risk population. Reductions in trip-related falls are consistent with the proposed biomechanical mechanism of the device. Prospective controlled studies are needed to confirm these findings.