Shoe closure technologies for persons with reduced mobility: a narrative review.
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PURPOSE: Shoe donning and doffing are a daily challenge for older adults and persons with conditions such as diabetes, stroke, arthritis, and Parkinson's disease, yet closure mechanisms have received little attention compared with sole design and slip resistance. This narrative review examines seven shoe closure technologies from the perspectives of mechanical performance and functional accessibility for persons with reduced mobility. METHODS: A narrative review was conducted drawing on peer-reviewed literature, patents, and industry sources identified through Scopus, Web of Science, PubMed, Google Scholar, and patent databases (USPTO, EPO, WIPO). Sources were selected for their relevance to shoe closure mechanism design, footwear-related functional limitations, or adaptive footwear technology. A total of 44 sources were synthesised, spanning mechanical engineering, rehabilitation science, and clinical literature. RESULTS: Seven closure technology categories were examined: traditional lacing, hook-and-loop (Velcro), buckle/strap, elastic/slip-on, magnetic, dial-wire (BOA), and bistable hinge/hands-free. Each was assessed against six performance dimensions: engagement force, holding security, release controllability, durability, cost accessibility, and hands-free operability. Based on the available evidence, no existing technology satisfies all six criteria simultaneously. Recent hands-free designs (Nike GO FlyEase, Kizik) represent meaningful engineering advances but remain priced beyond the reach of most users in low- and middle-income countries (LMICs). CONCLUSION: No existing closure technology simultaneously achieves hands-free operation, adequate holding security, long-term durability, and LMIC cost accessibility. Passive mechanical closures based on geometric interference represent a promising but empirically unvalidated direction. The absence of standardised test protocols for closure performance remains a structural barrier to evidence-based clinical prescription.