{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:07:10Z","timestamp":1790104030057,"version":"4.0.1"},"reference-count":57,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Rehabil Assist Technol"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate changes in fall frequency and fall-related outcomes following adoption of variable-friction (VF) footwear.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective pre-post observational study used self-reported survey data collected from community-dwelling adults aged 18 years or older who had worn VF footwear for 3 months or longer. Participants were recruited from a convenience sample of 14,570 invited customers who purchased the device through an electronic survey platform. Outcomes included self-reported fall frequency, injurious falls, fall mechanisms, fall-related health care use (including medical visits, urgent care, and hospitalization), and assistive device use, assessed before and during VF footwear use.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 706 participants completed the survey, yielding 705 participants with usable data for analysis (4.8% response rate). Mean monthly participant-reported 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 test,\n P<\/jats:italic>\n <.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% (n=520) reported a reduction, including 80.7% (n=440) reporting zero falls during VF use. Injurious falls decreased by 93.2% (\n P<\/jats:italic>\n <.001). Participants requiring medical attention decreased from 192 (27.2%) to 12 (1.7%; 93.8% reduction;\n P<\/jats:italic>\n <.001), and hospital or urgent care visits decreased from 131 (18.6%) to 10 (1.4%; 92.4% reduction;\n P<\/jats:italic>\n <.001). Trip-related falls decreased from 52.3% to 31.5% of reported mechanisms among participants who reported a fall mechanism in both periods (\n P<\/jats:italic>\n <.001). Assistive device use decreased from 70.8% to 16.6% (\n P<\/jats:italic>\n <.001). Mean annualized insurance-related fall costs decreased from US $5946.2 to US $45.7 per person-year (99.2% reduction) across the full cohort.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n VF footwear use was associated with substantial reductions in self-reported falls, injurious falls, and fall-related health care use. Reductions in trip-related falls are consistent with the proposed biomechanical mechanism of the device. Given the low survey response rate and potential for self-selection bias, these findings should be considered preliminary. Prospective controlled studies are needed to confirm these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/104177","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T21:20:07Z","timestamp":1788211207000},"page":"e104177-e104177","source":"Crossref","is-referenced-by-count":0,"title":["Participant-Reported Reductions in Falls and Fall-Related Injuries Associated With Variable-Friction Footwear: Retrospective Pre-Post Survey Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0776-8732","authenticated-orcid":false,"given":"Sara","family":"Nataletti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8650-766X","authenticated-orcid":false,"given":"Jennifer","family":"Bartloff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2089-6310","authenticated-orcid":false,"given":"Sara","family":"Prokup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4589-8915","authenticated-orcid":false,"given":"Joseph","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6873-2675","authenticated-orcid":false,"given":"Anushka","family":"Larson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5279-4565","authenticated-orcid":false,"given":"Tyler","family":"Susko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9302-6693","authenticated-orcid":false,"given":"Arun","family":"Jayaraman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1177\/1559827615600137","article-title":"The CDC Injury Center\u2019s response to the growing public health problem of falls among older adults","volume":"10","author":"Houry","journal-title":"Am J Lifestyle Med"},{"key":"R2","unstructured":"Older adult falls data. Centers for Disease Control and Prevention (CDC). 2026. URL: https:\/\/www.cdc.gov\/falls\/data-research\/index.html [Accessed 25-03-2026]"},{"key":"R3","unstructured":"Facts about falls. Centers for Disease Control and Prevention (CDC). 2026. URL: https:\/\/www.cdc.gov\/falls\/data-research\/facts-stats\/index.html [Accessed 25-03-2026]"},{"issue":"2","key":"R4","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.pmr.2009.12.003","article-title":"Falls, aging, and disability","volume":"21","author":"Finlayson","journal-title":"Phys Med Rehabil Clin N Am"},{"issue":"5-6","key":"R5","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1177\/08982643221132450","article-title":"Hip fracture-related emergency department visits, hospitalizations and deaths by mechanism of injury among adults aged 65 and older, United States 2019","volume":"35","author":"Moreland","journal-title":"J Aging Health"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s43465-019-00037-x","article-title":"Falls in older adults are serious","volume":"54","author":"Vaishya","journal-title":"Indian J Orthop"},{"key":"R7","unstructured":"Falls. World Health Organization. URL: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/falls [Accessed 25-03-2026]"},{"issue":"3","key":"R8","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.jsr.2008.05.002","article-title":"Self-reported falls and fall-related injuries among persons aged>or=65 years--United States, 2006","volume":"39","author":"Stevens","journal-title":"J Safety Res"},{"issue":"4","key":"R9","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1136\/ip-2023-045023","article-title":"Healthcare spending for non-fatal falls among older adults, USA","volume":"30","author":"Haddad","journal-title":"Inj Prev"},{"issue":"4","key":"R10","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1111\/jgs.15304","article-title":"Medical costs of fatal and nonfatal falls in older adults","volume":"66","author":"Florence","journal-title":"J Am Geriatr Soc"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S197857","article-title":"A systematic review on the influence of fear of falling on quality of life in older people: is there a role for falls?","volume":"14","author":"Schoene","journal-title":"Clin Interv Aging"},{"issue":"4","key":"R12","doi-asserted-by":"publisher","first-page":"379","DOI":"10.5770\/cgj.24.521","article-title":"Fear of falling in older adults: a scoping review of recent literature","volume":"24","author":"MacKay","journal-title":"Can Geriatr J"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1093\/ageing\/afm169","article-title":"Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons","volume":"37","author":"Scheffer","journal-title":"Age Ageing"},{"issue":"4","key":"R14","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1046\/j.1442-2018.2002.00123.x","article-title":"The relationship between fear of falling, activities of daily living and quality of life among elderly individuals","volume":"4","author":"Suzuki","journal-title":"Nurs Health Sci"},{"issue":"3","key":"R15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0194967","article-title":"Fear of falling in community-dwelling older adults: a cause of falls, a consequence, or both?","volume":"13","author":"Laved\u00e1n","journal-title":"PLoS One"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaf089","article-title":"Does concern about falling predict future falls in older adults? A systematic review and meta-analysis","volume":"54","author":"Ellmers","journal-title":"Age Ageing"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.gaitpost.2014.09.006","article-title":"How fear of falling can increase fall-risk in older adults: applying psychological theory to practical observations","volume":"41","author":"Young","journal-title":"Gait Posture"},{"issue":"3","key":"R18","doi-asserted-by":"publisher","first-page":"115","DOI":"10.5277\/ABB-00475-2015-02","article-title":"Postural stability in women in the eighth and ninth decades of life","volume":"18","author":"Puszcza\u0142owska-Lizis","journal-title":"Acta Bioeng Biomech"},{"issue":"3","key":"R19","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1007\/s00415-009-5332-y","article-title":"Neurological gait abnormalities and risk of falls in older adults","volume":"257","author":"Verghese","journal-title":"J Neurol"},{"issue":"11","key":"R20","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003367","article-title":"The impact of neurological disorders on the risk for falls in the community dwelling elderly: a case-controlled study","volume":"3","author":"Homann","journal-title":"BMJ Open"},{"issue":"3","key":"R21","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.apmr.2014.09.034","article-title":"Falls among adults aging with disability","volume":"96","author":"Matsuda","journal-title":"Arch Phys Med Rehabil"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","DOI":"10.1177\/20552173251329825","article-title":"Assessing fall risk in multiple sclerosis using patient-reported outcomes and wearable gait metrics","volume":"11","author":"Banks","journal-title":"Mult Scler J Exp Transl Clin"},{"issue":"11","key":"R23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0028021","article-title":"Mobility, balance and falls in persons with multiple sclerosis","volume":"6","author":"Sosnoff","journal-title":"PLoS One"},{"issue":"6","key":"R24","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1016\/j.apmr.2007.10.043","article-title":"Injurious falls among middle aged and older adults with multiple sclerosis","volume":"89","author":"Peterson","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1001\/jama.2024.4166","article-title":"Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force","volume":"332","author":"Guirguis-Blake","journal-title":"JAMA"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1209319","article-title":"Effectiveness of exercise interventions on fall prevention in ambulatory community-dwelling older adults: a systematic review with narrative synthesis","volume":"11","author":"Sadaqa","journal-title":"Front Public Health"},{"issue":"6","key":"R27","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1016\/j.gerinurse.2021.06.001","article-title":"Physical exercise and fall prevention: a systematic review and meta-analysis of experimental studies included in Cochrane reviews","volume":"42","author":"Caristia","journal-title":"Geriatr Nurs"},{"issue":"4","key":"R28","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1249\/JES.0000000000000023","article-title":"Exercise-based fall prevention: can you be a bit more specific?","volume":"42","author":"Grabiner","journal-title":"Exerc Sport Sci Rev"},{"issue":"3","key":"R29","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1177\/0269215513501092","article-title":"Home-based exercise program and fall-risk reduction in older adults with multiple sclerosis: phase 1 randomized controlled trial","volume":"28","author":"Sosnoff","journal-title":"Clin Rehabil"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2022.1015394","article-title":"Perturbation-based balance training: principles, mechanisms and implementation in clinical practice","volume":"4","author":"McCrum","journal-title":"Front Sports Act Living"},{"issue":"7","key":"R31","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1123\/jpah.2012-0258","article-title":"Predicting adherence of adults to a 12-month exercise intervention","volume":"11","author":"Cadmus-Bertram","journal-title":"J Phys Act Health"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1177\/2333721418823604","article-title":"Adherence to exercise programs in older adults: informative report","volume":"5","author":"Rivera-Torres","journal-title":"Gerontol Geriatr Med"},{"issue":"2","key":"R33","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.archger.2013.10.010","article-title":"Twelve month follow up of a falls prevention program in older adults from diverse populations in Australia: a qualitative study","volume":"58","author":"Haas","journal-title":"Arch Gerontol Geriatr"},{"issue":"1-2","key":"R34","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3121\/cmr.2013.1171","article-title":"Barriers to and facilitators of physical activity program use among older adults","volume":"12","author":"Bethancourt","journal-title":"Clin Med Res"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1177\/30495334251358528","article-title":"Effectiveness of shoes with non-slip insole on balance, fear of falling, and fall prevention among older women: a parallel RCT","volume":"11","author":"Norouzi","journal-title":"Sage Open Aging"},{"issue":"2","key":"R36","doi-asserted-by":"publisher","first-page":"121","DOI":"10.4235\/agmr.23.0167","article-title":"Enhancing footwear safety for fall prevention in older adults: a comprehensive review of design features","volume":"28","author":"Kim","journal-title":"Ann Geriatr Med Res"},{"key":"R37","unstructured":"Feet and footwear for older adults. Centers for Disease Control and Prevention (CDC); 2024. URL: https:\/\/www.cdc.gov\/steadi\/media\/pdfs\/2024\/08\/STEADI_Feet_Footwear_Guide_O.pdf [Accessed 04-09-2026]"},{"issue":"10","key":"R38","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19106267","article-title":"Relationships between the perception of footwear comfort and the fear of falls in people at the early period of old age","volume":"19","author":"Puszczalowska-Lizis","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"R39","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-25116-2","article-title":"The rocker-soled shoes change the kinematics and muscle contractions of the lower extremity during various functional movement","volume":"12","author":"Chen","journal-title":"Sci Rep"},{"issue":"1","key":"R40","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2016-000170","article-title":"Do rocker-sole shoes influence postural stability in chronic low back pain? A randomised trial","volume":"2","author":"MacRae","journal-title":"BMJ Open Sport Exerc Med"},{"issue":"5","key":"R41","doi-asserted-by":"publisher","DOI":"10.1186\/2197-1714-1-5","article-title":"Circumstances and outcomes of falls among high risk community-dwelling older adults","volume":"1","author":"Stevens","journal-title":"Inj Epidemiol"},{"issue":"6","key":"R42","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1093\/ageing\/17.6.365","article-title":"Falls by elderly people at home: prevalence and associated factors","volume":"17","author":"Blake","journal-title":"Age Ageing"},{"issue":"1","key":"R43","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1177\/1539449214561764","article-title":"Tailored calendar journals to ascertain falls among older adults","volume":"35","author":"Stark","journal-title":"OTJR (Thorofare N J)"},{"issue":"12","key":"R44","doi-asserted-by":"publisher","first-page":"2190","DOI":"10.1111\/j.1532-5415.2005.00509.x","article-title":"Monitoring falls in cohort studies of community-dwelling older people: effect of the recall interval","volume":"53","author":"Ganz","journal-title":"J Am Geriatr Soc"},{"key":"R45","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.612663","article-title":"Comparison of retrospective and prospective falls reporting among community-dwelling older people: findings from two cohort studies","volume":"9","author":"Romli","journal-title":"Front Public Health"},{"issue":"4","key":"R46","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1191\/0269215506cr947oa","article-title":"Validation of self-reported fall events in intervention studies","volume":"20","author":"Mackenzie","journal-title":"Clin Rehabil"},{"issue":"1","key":"R47","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012424.pub2","article-title":"Exercise for preventing falls in older people living in the community","volume":"1","author":"Sherrington","journal-title":"Cochrane Database Syst Rev"},{"issue":"9","key":"R48","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007146.pub3","article-title":"Interventions for preventing falls in older people living in the community","volume":"2012","author":"Gillespie","journal-title":"Cochrane Database Syst Rev"},{"issue":"7","key":"R49","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012221.pub2","article-title":"Multifactorial and multiple component interventions for preventing falls in older people living in the community","volume":"7","author":"Hopewell","journal-title":"Cochrane Database Syst Rev"},{"key":"R50","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2017.07.011","article-title":"The circumstances, orientations, and impact locations of falls in community-dwelling older women","volume":"73","author":"Crenshaw","journal-title":"Arch Gerontol Geriatr"},{"issue":"7","key":"R51","doi-asserted-by":"publisher","first-page":"M428","DOI":"10.1093\/gerona\/56.7.m428","article-title":"Mechanisms leading to a fall from an induced trip in healthy older adults","volume":"56","author":"Pavol","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"6","key":"R52","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/j.annemergmed.2020.07.025","article-title":"Can an emergency department-initiated intervention prevent subsequent falls and health care use in older adults? A randomized controlled trial","volume":"76","author":"Goldberg","journal-title":"Ann Emerg Med"},{"issue":"1","key":"R53","doi-asserted-by":"publisher","DOI":"10.1186\/s40814-019-0491-9","article-title":"GAPcare: the Geriatric Acute and Post-acute Fall Prevention Intervention-a pilot investigation of an emergency department-based fall prevention program for community-dwelling older adults","volume":"5","author":"Goldberg","journal-title":"Pilot Feasibility Stud"},{"issue":"1","key":"R54","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2022.5125","article-title":"Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program","volume":"4","author":"Dykes","journal-title":"JAMA Health Forum"},{"issue":"8","key":"R55","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1046\/j.1532-5415.2002.50352.x","article-title":"Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention","volume":"50","author":"Friedman","journal-title":"J Am Geriatr Soc"},{"issue":"6","key":"R56","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1093\/geronb\/53b.6.p384","article-title":"A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults","volume":"53","author":"Tennstedt","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.12385","article-title":"Perception of footwear comfort and its relationship with the foot structure among youngest-old women and men","volume":"9","author":"Puszczalowska-Lizis","journal-title":"PeerJ"}],"container-title":["JMIR Rehabilitation and Assistive Technologies"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:53:14Z","timestamp":1790103194000},"score":1,"resource":{"primary":{"URL":"https:\/\/rehab.jmir.org\/2026\/1\/e104177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":57,"URL":"https:\/\/doi.org\/10.2196\/104177","relation":{},"ISSN":["2369-2529"],"issn-type":[{"value":"2369-2529","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"v13i1e104177"}}