We focus on comfort, stability, footwear tolerance and walking confidence, always according to the individual case.
In older adults, small changes in support, footwear or sensation can affect walking tolerance. The priority is often to improve comfort, stability and confidence without imposing treatment that is difficult to use.
At MEDIPIE we assess gait, functional balance, footwear, skin, mobility, previous orthoses and realistic goals. Treatment should be progressive and reviewable.
How gait, support and function are integrated in the biomechanical assessment
When appropriate, an orthosis or adaptation may help unload sensitive areas, improve support or increase footwear tolerance. It needs to be comfortable, stable and easy to use.
If neurological, vascular, diabetes-related or other medical factors are relevant, they are considered and the case is guided cautiously.
Walking stability may be influenced by strength, gait, sensation, vision, vestibular function, blood pressure, medication, previous health conditions, environment and footwear. The foot is a relevant part of assessment, but an orthosis does not replace a comprehensive assessment when several factors are present.
Repeated falls, fainting, new-onset dizziness, sudden weakness, new neurological changes or rapid deterioration in gait require medical assessment. When strength or balance deficits predominate, physiotherapy or other resources may need to be involved.
The podiatry contribution focuses on the foot, pressure areas, footwear, orthosis and tolerance, integrating them into a wider plan when needed.
NICE guidance from 2025 on falls assessment and prevention includes foot condition and footwear within a comprehensive assessment alongside gait, balance, mobility, strength, vision, medication, health conditions and other factors. It also recommends that interventions are tailored to each person's identified risks and that exercise programmes address components such as balance, coordination, strength and power when appropriate.
MEDIPIE therefore does not present a foot orthosis as a stand-alone fall-prevention treatment. Our contribution is limited to the podiatry component—foot condition, pressure, footwear, support and tolerance—and we coordinate or refer when broader management is needed.
Source: NICE. Falls: assessment and prevention in older people and in people 50 and over at higher risk. NG249, 2025. View NICE recommendations.
When well indicated, it may help make support feel more stable or comfortable and improve load distribution. Its effect on balance and walking safety depends on many factors and should be checked individually through use and follow-up.
No. Falls are multifactorial and a foot orthosis cannot be considered a stand-alone fall-prevention intervention. Strength, gait, balance, sensation, vision, medication, health conditions, environment and footwear may all matter. An orthosis may form part of care only when there is a specific podiatry objective.
See which footwear, previous devices, reports and information about falls or unsteadiness are useful to bring.
We can guide you before the appointment about useful footwear, previous orthoses, reports and the main problems you have noticed.
Clinical content reviewed by Juan Bautista Calero Márquez, podiatrist registered no. 115 in the Region of Murcia.