Parkinson’s disease (PD) is a progressive neurological condition that significantly affects motor function, causing a variety of mobility challenges. The most common symptoms impacting movement include a characteristic shuffling gait, reduced arm swing, and impaired balance, all of which substantially increase the risk of falls. A frequent and particularly dangerous symptom is “freezing of gait,” where a person suddenly feels as if their feet are momentarily glued to the floor. While often overlooked, the right footwear functions as a crucial safety tool that can help mitigate these specific symptoms and improve walking stability.
Essential Shoe Characteristics for Safety
The structural elements of a shoe must counteract the specific gait patterns associated with PD. To reduce the effort needed for walking and combat foot dragging, shoes must be constructed from lightweight materials. Heavy footwear exacerbates slow movement (bradykinesia), increasing fatigue and the likelihood of a trip. A secure fit is needed, particularly around the ankle and heel, to prevent the foot from slipping, which can destabilize the wearer and lead to falls. A firm heel counter, the rigid cup at the back of the shoe, helps keep the foot properly aligned and prevents unwanted wobbling.
The sole’s design is the most specialized consideration, as it must strike a balance between preventing slips and allowing movement during shuffling. The ideal outsole should be thin, firm, and have a wide base that flares slightly outward to maximize ground contact and lateral stability. A low heel, ideally no higher than one inch, further contributes to a stable base by keeping the center of gravity low.
For individuals who experience a shuffling gait or freezing episodes, the friction of the sole is a major factor. Soles that are too “sticky,” such as those made of thick, soft rubber with deep treads, can cause the foot to catch on the floor during the forward swing of the step, immediately triggering a trip or a freezing event. Therefore, it is important to select a sole with moderate, rather than excessive, traction to allow the foot to slide or pivot slightly when needed. This moderate friction helps ensure the shoe does not stick to the ground, which is a common trigger for freezing of gait.
Closure Systems and Ease of Use
Challenges with fine motor skills, such as hand tremors and muscle rigidity, make tying shoelaces a frustrating and sometimes impossible task for many people with PD. The chosen closure system should prioritize independence and ease of use, allowing the shoe to be donned and doffed with minimal dexterity. Traditional laces should be replaced with simpler alternatives to secure the footwear.
Velcro straps are a common and practical alternative, offering a secure fit managed easily with limited hand function. Another option is to convert lace-up shoes into slip-ons using elastic or curly laces; these are tied once to the preferred tension and allow the shoe to function as a fixed-closure style. Some adaptive footwear features wide-opening zippers, often positioned on the side, which create a large entry portal for the foot.
Features like large, easy-to-grasp pull tabs assist in guiding the foot into the shoe without needing to bend over extensively, which is difficult due to postural instability. Hands-free shoes, which allow the foot to slide in without the use of hands or bending, are also a popular solution to maintain dressing independence. The closure system must ensure the shoe is consistently secured properly for safety, while minimizing the physical effort and fine motor control required.
Footwear That Should Be Avoided
Certain types of footwear can actively increase the risk of falling and should be avoided by individuals with PD. Any shoe that lacks a backstrap or heel cup, such as flip-flops, slippers, or clogs, should not be worn. These open-backed styles require the toes to grip the sole to keep the shoe on, interfering with a natural gait and creating a trip hazard.
High heels pose a danger because they shift the body’s center of gravity forward, compromising an impaired sense of balance and stability. Similarly, shoes with excessively thick or soft, cushioned soles interfere with the foot’s ability to sense the ground, which is crucial for maintaining posture. Rocker-bottom soles, which have a rounded profile, are not recommended as they reduce stability.
Shoes with overly aggressive treads or thick, sticky rubber outsoles should be avoided because they increase friction. Finally, shoes that are worn out or ill-fitting are unsafe, as collapsed heel counters or unevenly worn soles compromise stability and alignment. Regularly inspect footwear for signs of wear and tear and replace them promptly to ensure continued safety and support.