Effects of footwear comfort perception on the neuromuscular control of balance.

The purpose of this research was to determine the effects of footwear comfort perception on the gain of the gastrocnemius H-reflex response during single leg balance tasks. Subjects performed single leg balance tasks while wearing aerobic sneakers with two different pairs of shoe insoles that were subjectively rated for comfort using a reliable 150 mm visual analog scale. The primary outcome was the consistency of decreasing the gain of the gastrocnemius H-reflex with increasing balance task complexity as a function of footwear comfort perception. Among the asymptomatic subjects (n = 11), H-reflex gain significantly decreased by 19% and 10% from balancing on a stable surface to an unstable surface for the shoe-brand and replacement insoles, respectively (p < .05). Among the subjects with musculoskeletal disorders (n = 13), H-reflex gain significantly decreased by 10% from balancing on a stable surface to an unstable surface when wearing custom-molded foot orthotics, but H-reflex gain significantly increased by 27% from balancing on a stable surface to an unstable surface when wearing replacement insoles (p < .05). Decreases in footwear comfort perception may negatively impact the attenuation of gastrocnemius H-reflex gain that contributes to the neuromuscular control of challenging balance tasks.