Journal of Aging and Physical Activity · Nov 6, 2026
Effects of Different Insole Types on Balance and Fall-Risk–Related Outcomes in Older Adults: A Systematic Review and Bayesian Network Meta-Analysis
By Qian Y, Sun D, Hu C et al.
Background : Falls are a leading cause of injury and disability in older adults, and insoles are widely used to improve balance in older adults, but their comparative effectiveness across types, exposure durations, and task domains remains unclear. Methods : A systematic review and Bayesian network meta-analysis of randomized controlled trials was conducted. PubMed, Web of Science, Embase, and the Cochrane Library were searched until December 20, 2025. Interventions were classified into seven nodes. Outcomes were synthesized in four strata: long-term and acute dynamic stability and acute static postural control (eyes open/closed). Random-effects consistency models were applied. Results : Thirteen studies were included. In the long-term dynamic network, orthotic insoles showed the largest point estimate versus control for Timed Up and Go test (mean difference: −3.51 s, 95% credible interval [CrI] −8.10 to 1.14). In acute static postural control, orthotic insoles had the highest surface under the cumulative ranking curve value under eyes-open conditions (standardized mean difference: −0.51, 95% CrI −1.70 to 0.68), whereas soft and hard insoles ranked highest under eyes-closed conditions, with similarly wide CrIs (soft insoles: standardized mean difference: −0.85, 95% CrI −3.26 to 1.57). Most CrIs crossed the null. Conclusions : Insole effects on balance-related outcomes appear context-dependent, varying by task domain, visual condition, and exposure duration. However, current evidence is imprecise, and most comparative estimates remain compatible with both benefit and no effect. Larger, long-term randomized trials with clinically meaningful outcomes are needed. Significance : These findings may help guide hypothesis generation for individualized insole selection, but they should not be interpreted as definitive evidence of fall-prevention efficacy.