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What Physical Therapists Should Look for in Shoes for Stroke Patients

Posted by:

Johannes Sauer

Updated at: October 10, 2025

Table of Contents

  1. What Physical Therapists Should Look for in Shoes for Stroke Patients

  2. Why Standard Shoes Often Don’t Work

  3. Key Features Physical Therapists Should Look For

  4. Practical Examples from Clinical Settings

  5. How the Right Footwear Supports Gait Retraining

  6. Tips for Recommending Shoes to Patients

  7. Cadense Shoes for Patients in Stroke Recovery

What Physical Therapists Should Look for in Shoes for Stroke Patients

For stroke survivors, walking again can be one of the most challenging yet rewarding parts of recovery. As a physical therapist, you know how much gait mechanics, balance, and proprioception influence overall mobility. But one piece of the rehabilitation puzzle that’s often overlooked is footwear.

The right shoes for stroke patients can make gait training more effective, reduce fatigue, and help patients feel safer and more confident in each step. Meanwhile, the wrong footwear can compromise alignment, increase instability, or limit progress in therapy sessions.

That’s why it’s worth taking a closer look at what makes certain shoes truly supportive for patients recovering from a stroke.

Why Standard Shoes Often Don’t Work

After a stroke, many patients experience weakness, muscle spasticity, or partial paralysis — especially in the lower limbs. These changes affect how the foot interacts with the ground. Common gait issues such as drop foot, uneven weight distribution, and reduced dorsiflexion make it harder to walk safely in standard shoes.

Off-the-shelf footwear often has:

  • Narrow openings that make them difficult to put on with limited hand strength.
  • Thin soles that provide little cushioning or shock absorption.
  • Laces that require dexterity some patients no longer have.
  • Flat insoles that don’t accommodate orthotics or AFOs (ankle-foot orthoses).

These factors not only make daily use harder but can also discourage independence — something most patients and therapists are working hard to rebuild.

Key Features Physical Therapists Should Look For

1. Wide-Opening, Easy-Access Designs

Many stroke patients deal with one-sided weakness or limited coordination. Shoes that open wide and use zippers or hook-and-loop closures (like Velcro) make it easier for patients to put them on without assistance.

Adaptive shoes designed for stroke recovery often allow the upper to open completely, so the foot slides in effortlessly — reducing frustration and encouraging independence.

2. Stable, Non-Slip Outsoles

Balance is one of the biggest concerns in post-stroke mobility. Shoes with a firm, wide base and slip-resistant soles help patients feel grounded and reduce the risk of slips and trips during therapy or at home. Look for soles with enough flexibility to allow natural motion without being overly soft or unstable.

3. Support for Weak Ankles and Drop Foot

Many stroke survivors experience weakness or stiffness in the ankle joint, increasing the risk of foot drag or improper heel strike. A shoe that supports dorsiflexion and provides structured ankle stability can make gait training smoother and safer.

Therapists may also recommend shoes that are AFO-compatible — providing enough space and flexibility to fit braces without compromising comfort.

4. Lightweight and Cushioned Construction

Patients working to regain walking endurance tire easily. Lightweight shoes with responsive cushioning help reduce fatigue and joint strain. This can extend the length of therapy sessions and improve overall gait quality.

5. Adjustable Fit and Custom Insoles

Every patient’s needs differ. Some deal with swelling, orthotics, or asymmetrical foot sizes post-stroke. Shoes with removable insoles and adjustable straps allow for personalized support — which is essential for long-term use beyond the clinic.

6. Flexible Yet Structured Upper

Shoes that combine flexibility in the forefoot with stability in the midfoot help promote natural movement while maintaining control. Breathable materials also prevent overheating during extended wear or exercise sessions.

What Physical Therapists Should Look for in Shoes for Stroke Patients - Cadense Adaptive Shoes for Physical Therapy Patients in Stroke Recovery

Oct 10, 2025

Practical Examples from Clinical Settings

Physical therapists who specialize in neurorehabilitation often see how much difference the right footwear can make. For example:

  • A 62-year-old patient with mild left-side weakness improved stride length and confidence after switching to adaptive shoes with slip-resistant soles and a wide heel base.
  • A 55-year-old stroke survivor using an AFO found it easier to walk on uneven surfaces after switching to shoes with an extra-depth toe box and removable insoles
  • A patient in home-based therapy was able to put shoes on independently for the first time in months after trying an adaptive pair with side-zip openings.

In all of these cases, the goal wasn’t just walking — it was restoring confidence, independence, and daily function.

How the Right Footwear Supports Gait Retraining

When physical therapists choose shoes that align with a patient’s rehab plan, gait improvement tends to accelerate. The benefits include:

  • Enhanced proprioceptive feedback: Stable soles and proper cushioning help patients sense their foot position more accurately.
  • Improved weight transfer: Proper midfoot and heel support encourage balanced loading.
  • Reduced compensatory movement: Supportive shoes help prevent patients from developing awkward gait patterns.
  • Greater participation: Comfortable shoes increase motivation to walk more frequently, even outside of therapy sessions.

This makes footwear not just an accessory but an active part of therapy outcomes.

Tips for Recommending Shoes to Patients

When advising stroke survivors or their caregivers on footwear, consider these practical tips:

  1. Involve the patient: Let them test different pairs in a safe environment to evaluate comfort and ease of use.

  2. Check brace compatibility: Always confirm that the shoe accommodates any AFOs or orthotics.

  3. Observe gait with and without the shoe: Subtle differences in stride or balance can reveal which features make the most difference.

4. Encourage gradual adaptation: Patients may need time to adjust to new support levels or materials.

Cadense Shoes for Patients in Stroke Recovery

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Posted by: Johannes Sauer

Johannes is the CEO and Co-Founder of Cadense and passionate about helping people with walking difficulties. He was immediately drawn to the mission of the company because his cousin lost his lower leg in a tragic motorcycle accident a few years ago and is experiencing walking difficulties ever since. Johannes brings over a decade of experience in working for consumer product companies to Cadense. He holds an MBA from the University of Graz in Austria. Johannes lives with his family in Santa Barbara, CA.

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Medical Disclaimer: This website is not intended for the purpose of providing medical advice. This website’s information, content, and material are for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Cadense Inc. may not be held liable for any damages whether incidental, ordinary or consequential. Cadense does not make any guarantee of any particular end result. Cadense makes no claims or guarantees of payment/reimbursement by any insurance companies. Cadense adaptive shoes are intended to provide greater mobility to those with walking difficulties.

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