Document Type

Thesis

Degree Name

Master of Science (MSc)

Department

Kinesiology and Physical Education

Faculty/School

Faculty of Science

First Advisor

Dr. Stephen Perry

Advisor Role

Supervisor

Abstract

Individuals with Parkinson’s disease (PD) demonstrate impairments in gait and dynamic balance that may be influenced by altered sensory integration during locomotion. Plantar sensory information contributes to dynamic balance control, and footwear modifications may provide a practical means of altering plantar sensory input during challenging locomotor tasks. This study examined the effects of insole texture and midsole hardness on gait, dynamic stability, and lower-limb muscle activity in individuals with PD and neurologically healthy older adults.

Participants completed normal walking (NW) and unexpected gait termination (GT) trials while wearing four footwear conditions combining textured (T) or non-textured (NT) insoles with medium (M) or hard (H) midsoles. Three-dimensional motion capture, force plates, and surface electromyography were used to assess spatiotemporal gait characteristics, center of mass – base of support (COM-BOS) and center of mass – center of pressure (COM-COP) relationships, and lower-limb muscle activity. A mixed-model repeated-measures ANOVA examined the effects of group, task, insole texture, and midsole hardness, with significant effects followed by Tukey-adjusted post-hoc comparisons.

Gait velocity was significantly lower in individuals with PD compared with controls across footwear conditions (p < 0.0001). Step width increased during GT compared with NW (p < 0.0001), while step length decreased during GT (p < 0.0001). During GT, step length was significantly greater in the HNT condition compared with MNT, MT, and HT within the PD group (all p < 0.0001), with a between-group difference observed only in HNT (p < 0.0001). For dynamic stability, maximum and minimum margin of stability (MOS) did not differ between groups or footwear conditions; however, MOS range was greater with the hard midsole (p = 0.0495), with greater MOS range in HNT compared with MNT within the PD group (p =

0.0356). COM–COP measures demonstrated more consistent group differences. Individuals with PD showed lower maximum anterior-posterior (AP) COM–COP distance than controls across all footwear conditions (all p < 0.0001), as well as lower minimum AP COM–COP distance overall, with significant between-group differences in MT (p = 0.003) and HNT (p = 0.0003). Maximum and minimum mediolateral (ML) COM–COP distances were also lower in PD, with significant group × hardness × texture interactions and between-group differences in MT and HNT. Muscle activity differed between groups, with lower tibialis anterior activity but greater medial gastrocnemius and peroneus longus activity in PD. Footwear-related muscle responses were muscle- and condition-specific, with no consistent response across footwear conditions.

Overall, individuals with PD demonstrated a more balance-conservative gait pattern, COM–COP regulation, and lower-limb muscle activity compared with controls during GT, despite similar maximum and minimum MOS. Insole texture and midsole hardness produced selected condition-dependent changes in step placement, MOS range, and muscle activity, but did not consistently improve dynamic stability or reduce differences between groups. These findings suggest that footwear-based manipulation of plantar sensory and mechanical properties can modify specific components of gait termination in PD, however, the effects depend on the combination of footwear characteristics and the biomechanical or neuromuscular outcome examined.

Convocation Year

2027

Convocation Season

Spring

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Available for download on Friday, September 29, 2028

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