Date of Award


Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)


Physical Therapy

First Advisor

Meridee Danks


Postural Balance; Safety; Shoes


A growing number of healthcare professionals have been choosing to wear an open-back shoe rather than a traditional closed-back shoe in the workplace. Healthcare professionals incorporate dynamic balance and quick reactions during direct patient interaction. The purpose of the study was to determine if dynamic balance would be affected in healthcare professionals when wearing open-back shoes versus closed-back shoes.

Thirty-two healthcare professionals or students of healthcare professions (28 females and 4 males) were recruited for this study. Subjects ranged in age from 20 to 62 years (mean age 28.2 years), with the majority being physical therapists or physical therapy students. Subjects were required to use their own shoes during testing to ensure familiarity.

A shoe questionnaire was given to each participant prior to testing. The majority of participants felt their open-back shoes provided adequate support and did not affect their balance while walking. However, when given options to select activities that may be limited while wearing open-back shoes, the following were most commonly selected: walking speed, step length and transfers.

Three tests were conducted in both open- and closed-back shoes to assess whether dynamic balance was affected between the two types of footwear. The tests included the Forward Lunge Test (FLT) using the NeuroCom® Balance Master (NBM~, Functional Reach Test (FRT), and Single Leg Hop (SLH)-Forward and Backward. Type of footwear and testing order were randomly selected by each individual. Three trials were conducted for each test and an average was calculated.

Results indicated a better test performance in the closed-back shoes. A significant difference in dynamic balance was found between the open- and closed-back shoes in the following areas: FLT-Distance (right, p = .022; left, p = .048 respectively), FRT (p = .005), and SLH-Forward and Backward (p = .000, p = .001 respectively). The results of this study indicate that dynamic balance may be affected by open-back shoes worn by a healthcare professional.

This is significant to healthcare professionals who are responsible for the safety of their patients. Although there is little evidence in literature about the safety of open-back shoes, the results of this study indicates that patient and professionals' safety may be compromised with open-back shoes. Further research is needed to determine if there should be specific policies and procedures regarding open-back footwear worn in healthcare facilities to ensure maximal safety for the patient and the healthcare employee.