Cadense Falls Research Featured in The American Journal of Managed Care

The American Journal of Managed Care (AJMC) recently published two articles examining Cadense falls research and the role footwear may play in addressing trip-related falls and walking challenges.

The first, “Variable-Friction Footwear Tied to Fewer Falls in MS, Survey Finds,” reports on findings from the recently published retrospective survey of Cadense users. AJMC followed the article with an in-depth interview with Nathan Estrada, DPT, Vice President of Clinical Affairs at Cadense, titled “Rethinking Fall Prevention Footwear for MS: Nathan Estrada, DPT.”

Together, the articles explore an often-overlooked part of the conversation around falls: what happens when the foot unexpectedly makes contact with the ground during a step — and whether footwear can be designed differently to respond to that moment.

One of the central themes of Nathan’s conversation with AJMC was that clinicians should consider how someone walks, rather than focusing solely on their diagnosis, when evaluating footwear and mobility needs.

People living with multiple sclerosis, peripheral neuropathy, stroke, Parkinson disease, age-related mobility changes and other conditions may experience challenges such as reduced foot clearance, shuffling, foot drag or repeated toe contact. But two people with the same diagnosis can have very different walking mechanics and mobility needs.

As Nathan told AJMC:

“You don’t have to have a Parkinson’s shoe. You don’t have to have an MS shoe.”

Instead, he suggests looking for the mechanics that may contribute to a trip. One simple question clinicians can ask is whether a patient frequently hears themselves scuffing their feet while walking.

That shift in perspective is central to the thinking behind Cadense.

AJMC’s coverage examined a study published in JMIR Rehabilitation and Assistive Technologies involving customers who had worn Cadense Original variable-friction footwear for at least three months.

Researchers surveyed 705 Cadense users, with a mean age of 59.5 years. More than half of respondents reported living with multiple sclerosis, while other reported conditions included peripheral neuropathy, stroke, spinal cord injury and Parkinson disease.

Among survey respondents:

Mean monthly participant-reported falls were 87.1% lower during Cadense use, decreasing from 2.4 falls per month before use to 0.3 during use.

Additionally, 84.4% of respondents reported experiencing zero falls during the period they used Cadense, compared with 22.7% reporting zero falls during the period before use.

Among participants who reported fall mechanisms during both periods, AJMC also highlighted that a smaller proportion of falls was attributed to tripping during Cadense use.

These findings are encouraging, but understanding the limitations of the research is equally important.

The study was a retrospective, self-reported customer survey with no concurrent control group and a 4.8% response rate. The results demonstrate an association and do not establish that Cadense caused the reported reductions in falls.

Nathan described the findings to AJMC as “an early signal; it’s not definitive proof of effectiveness.”

That distinction is important as Cadense continues to invest in further research.

Traditional footwear is generally designed to create traction between the shoe and the ground.

Cadense approaches the problem differently through its patented Glide & Grip Technology.

Low-friction elements in the sole are designed to allow the foot to continue moving forward during light contact with the ground. As the wearer puts weight down, those elements retract and allow the higher-friction outsole to engage.

In simple terms: glide during light contact, grip when weight is applied.

The goal is not to replace rehabilitation, strengthening, bracing, assistive devices or other interventions. Instead, Cadense is designed to be another tool that can accompany someone throughout everyday life.

As Nathan explained in his AJMC interview, fall prevention is best approached from multiple directions.

“It’s not intended to replace rehab, strengthening, or bracing; the best approach to fall prevention is multimodal.”

Physical therapy sessions eventually end. Home modifications can address hazards within the home. Footwear, however, travels with a person throughout their day.

The retrospective survey represents an early step in understanding the potential role of variable-friction footwear.

The next step is prospective research.

As Nathan discussed with AJMC, a prospective controlled study is underway to objectively compare outcomes with variable-friction and conventional footwear.

Cadense is also involved in a prospective actuarial study in a Medicaid population examining footwear from a population-health perspective.

Future research can also help answer an important clinical question: Which walking patterns are most likely to benefit from this type of footwear?

Rather than requiring a specific diagnosis, Nathan sees an opportunity to help clinicians identify observable mechanics — such as low foot clearance, repeated toe contact or scuffing — that may indicate when responsive footwear is worth considering.

This work builds on the research and development behind Cadense’s patented Glide & Grip Technology, which began with research at MIT and was further developed at UC Santa Barbara.

Physical therapists, occupational therapists, physicians and other professionals interested in learning more about Cadense can join the Cadense Coaches Program.

The free program gives professionals access to Cadense clinical resources and education, including educational materials for patients and staff, clinical information about the technology, and opportunities to experience and demonstrate Cadense footwear when appropriate.

Start enrollment in the Cadense Coaches Program →

If you or someone you care for experiences challenges such as foot drag, toe catching or shuffling, footwear may be one part of the broader conversation about mobility.

Cadense adaptive footwear is designed to respond differently when the foot makes light contact with the ground during a step, while returning to familiar traction as weight is applied.

Many Cadense customers report feeling more confident and comfortable while walking, but individual experiences vary. A physical therapist, physician or other health care professional can also help you consider footwear alongside rehabilitation, strengthening, bracing, an AFO or other elements of your existing care plan.

Shop Cadense Adaptive Footwear →

We’re grateful to The American Journal of Managed Care for taking a closer look at this research and for giving Nathan the opportunity to share his clinical perspective on footwear, walking mechanics and the future of fall-related research.

Read AJMC’s full coverage:

“Variable-Friction Footwear Tied to Fewer Falls in MS, Survey Finds”

“Rethinking Fall Prevention Footwear for MS: Nathan Estrada, DPT”

You can also read the full study in JMIR Rehabilitation and Assistive Technologies.

Research disclosure: The Cadense study discussed above was a retrospective, self-reported customer survey with no concurrent control group and a 4.8% response rate. Associations observed in the study do not establish causation.