Foot Morphological Difference between Habitually Shod and Unshod Runners

Foot shape assessment techniques for orthotic and footwear applications: a methodological literature review

Introduction

Foot shape assessment is important to characterise the complex shape of a foot, which is in turn essential for accurate design of foot orthoses and footwear, as well as quantification of foot deformities (e.g., hallux valgus). Numerous approaches have been described over the past few decades to evaluate foot shape for orthotic and footwear purposes, as well as for investigating how one's habits and personal characteristics influence the foot shape. This paper presents the developments reported in the literature for foot shape assessment.

Method

In particular, we focus on four main dimensions common to any foot assessment: (a) the choice of measurements to collect, (b) how objective these measurement procedures are, (c) how the foot measurements are analyzed, and (d) other common characteristics that can impact foot shape analysis.

Results

For each dimension, we summarize the most commonly used techniques and identify additional considerations that need to be made to achieve a reliable foot shape assessment.

Discussion

We present how different choices along these two dimensions impact the resulting foot assessment, and discuss possible improvements in the field of foot shape assessment.

A four-week minimalist shoe walking intervention influences foot posture and balance in young adults-a randomized controlled trial

INTRODUCTION

Minimalist shoes (MS) are beneficial for foot health. The foot is a part of the posterior chain. It is suggested that interventions on the plantar foot sole also affect the upper segments of the body. This study aimed to investigate the local and remote effects along the posterior chain of four weeks of MS walking in recreationally active young adults.

METHODS

28 healthy participants (15 female, 13 male; 25.3 ± 5.3 years; 70.2 ± 11.9 kg; 175.0 ± 7.8 cm) were randomly assigned to a control- or intervention group. The intervention group undertook a four-week incremental MS walking program, which included 3,000 steps/day in the first week, increasing to 5,000 steps/day for the remaining three weeks. The control group walked in their preferred shoe (no MS). We assessed the following parameters in a laboratory at baseline [M1], after the four-week intervention [M2], and after a four-week wash-out period [M3]: Foot parameters (i.e., Foot Posture Index-6, Arch Rigidity Index), static single-leg stance balance, foot-, ankle-, and posterior chain range of motion, and muscle strength of the posterior chain. We fitted multiple hierarchically built mixed models to the data.

RESULTS

In the MS group, the Foot Posture Index (b = -3.72, t(51) = -6.05, p < .001, [-4.94, 2.51]) and balance (b = -17.96, t(49) = -2.56, p = .01, [-31.54, 4.37]) significantly improved from M1 to M2, but not all other parameters (all p >.05). The improvements remained at M3 (Foot Posture Index: b = -1.71, t(51) = -2.73, p = .009, [-4,94,0.48]; balance: b = -15.97, t(49) = -2.25, p = .03, [-29.72, 2.21]).

DISCUSSION

Walking in MS for four weeks might be advantageous for foot health of recreationally active young adults but no chronic remote effects should be expected.

Methodological and statistical approaches for the assessment of foot shape using three-dimensional foot scanning: a scoping review

OBJECTIVE

The objectives of this study were to: (i) review and provide a narrative synthesis of three-dimensional (3D) foot surface scanning methodological and statistical analysis protocols, and (ii) develop a set of recommendations for standardising the reporting of 3D foot scanning approaches.

METHODS

A systematic search of the SCOPUS, ProQuest, and Web of Science databases were conducted to identify papers reporting 3D foot scanning protocols and analysis techniques. To be included, studies were required to be published in English, have more than ten participants, and involve the use of static 3D surface scans of the foot. Papers were excluded if they reported two-dimensional footprints only, 3D scans that did not include the medial arch, dynamic scans, or derived foot data from a full body scan.

RESULTS

The search yielded 78 relevant studies from 17 different countries. The available evidence showed a large variation in scanning protocols. The subcategories displaying the most variation included scanner specifications (model, type, accuracy, resolution, capture duration), scanning conditions (markers, weightbearing, number of scans), foot measurements and definitions used, and statistical analysis approaches. A 16-item checklist was developed to improve the consistency of reporting of future 3D scanning studies.

CONCLUSION

3D foot scanning methodological and statistical analysis protocol consistency and reporting has been lacking in the literature to date. Improved reporting of the included subcategories could assist in data pooling and facilitate collaboration between researchers. As a result, larger sample sizes and diversification of population groups could be obtained to vastly improve the quantification of foot shape and inform the development of orthotic and footwear interventions and products.

Measurement and reporting of footwear characteristics in running biomechanics: A systematic search and narrative synthesis of contemporary research methods

This review aimed to synthesise the methods for assessing and reporting footwear characteristics among studies evaluating the effect of footwear on running biomechanics. Electronic searches of Scopus®, EBSCO, PubMed®, ScienceDirect®, and Web of Science® were performed to identify original research articles of the effect of running footwear on running biomechanics published from 1^st January 2015 to 7^th October 2020. Risk of bias among included studies was not assessed. Results were presented via narrative synthesis. Eligible studies compared the effect of two or more footwear conditions in adult runners on a biomechanical parameter. Eighty-seven articles were included and data from 242 individual footwear were extracted. Predominantly, studies reported footwear taxonomy (i.e., classification) and manufacturer information, however omitted detail regarding the technical specifications of running footwear and did not use validated footwear reporting tools. There is inconsistency among contemporary studies in the methods by which footwear characteristics are assessed and reported. These findings point towards a need for consensus regarding the reporting of these characteristics within biomechanical studies to facilitate the conduct of systematic reviews and meta-analyses pertaining to the effect of running footwear on running biomechanics.

Toward improved understanding of foot shape, foot posture, and foot biomechanics during running: A narrative review

The current narrative review has explored known associations between foot shape, foot posture, and foot conditions during running. The artificial intelligence was found to be a useful metric of foot posture but was less useful in developing and obese individuals. Care should be taken when using the foot posture index to associate pronation with injury risk, and the Achilles tendon and longitudinal arch angles are required to elucidate the risk. The statistical shape modeling (SSM) may derive learnt information from population-based inference and fill in missing data from personalized information. Bone shapes and tissue morphology have been associated with pathology, gender, age, and height and may develop rapid population-specific foot classifiers. Based on this review, future studies are suggested for 1) tracking the internal multi-segmental foot motion and mapping the biplanar 2D motion to 3D shape motion using the SSM; 2) implementing multivariate machine learning or convolutional neural network to address nonlinear correlations in foot mechanics with shape or posture; 3) standardizing wearable data for rapid prediction of instant mechanics, load accumulation, injury risks and adaptation in foot tissue and bones, and correlation with shapes; 4) analyzing dynamic shape and posture via marker-less and real-time techniques under real-life scenarios for precise evaluation of clinical foot conditions and performance-fit footwear development.

Analysis of hallux valgus angles automatically extracted from 3D foot scans taken in North America, Europe, and Asia

The forefoot is the foot part most affected by ill-fitting shoes. Footwear fitting considers the measurements of length, width, and arch length. Toe shape has not yet been used in sizing feet and fitting shoes. This study aims to investigate the variation in toe shape, as measured by the hallux valgus angle. An automatic and reproducible hallux valgus angle measuring method using 3D foot scans with no palpation markers is proposed and applied to about half a million samples collected across North America, Europe, and Asia. The measuring method is robust and can detect the medial contour along the proximal phalanx even in extreme cases. The hallux valgus angle has a normal distribution with long tails on both sides in the general population. Large dispersions of HVA values were observed for both genders and in all three geographical regions. Practitioner summary: The hallux valgus angle has a broad distribution in the general population. Females have larger hallux valgus angles than males, and people from Asia have larger hallux valgus angles than people from North America and Europe. Shoe toe boxes should be designed to fit the actual shapes of shoppers' toes. The proposed method for measuring HVA opens a new opportunity to study the causal relationship between shoe wearing habits and HVA on a large scale.

How barefoot and conventional shoes affect the foot and gait characteristics in toddlers

Objectives

Barefoot shoes have recently become a popular alternative to conventional shoes among the parents of pre-school children. As the long-term effect of habitual shoe-wearing on the foot is still unclear, the aim of this study was to compare the arch index, dynamic foot anthropometry and gait parameters in toddlers who had been habitually wearing barefoot shoes or conventional shoes since their first steps.

Methods

30 toddlers– 15 habitually wearing barefoot shoes (BF group) and 15 habitually wearing conventional shoes (N-BF group)–participated in this study. Each child was measured twice during the study. The first data collection session occurred within one month after the first five consecutive unsupported steps were performed by the toddler. The second data collection session occurred seven months after this event. At each data collection session, the toddler was instructed to walk barefooted at its natural speed over an Emed^® platform (Novel GmbH, Germany). The Emed ^® software generated data regarding the arch index, dynamic foot anthropometry, foot progression angle, contact area, contact time, peak pressure and maximum force. The Wilcoxon signed-rank test was used to compare the differences between the 1^st and 2^nd data collections. The Mann-Whitney U test was used to compare the differences between the BF and N-BF groups.

Results

The results of this study show a higher plantar arch and a smaller foot progression angle in the BF group. The forefoot width in both the BF and N-BF groups remained proportional to the foot length after seven months of independent walking.

Conclusions

These findings may encourage parents and caregivers to introduce barefoot shoes or create a habitual barefoot time for their child.

Influence of Shod and Barefoot Running on the In Vivo Kinematics of the First Metatarsophalangeal Joint

The biomechanics of the first metatarsophalangeal joint (MTPJ) is affected by different shoe conditions. In the biomechanical research field, traditional skin marker motion capture cannot easily acquire the in vivo joint kinematics of the first MTPJ in shoes. Thus, the present study aims to investigate the differences of the first MTPJ's six-degree-of-freedom (6DOF) kinematics between shod and barefoot running by using a high-speed dual fluoroscopic imaging system (DFIS). In total, 15 healthy male runners were recruited. Computed tomography scans were taken from each participant's right foot for the construction of 3D models and local coordinate systems. Radiographic images were acquired at 100 Hz while the participants ran at a speed of 3 m/s ± 5% in shod and barefoot conditions along an elevated runway, and 6DOF kinematics of the first MTPJ were calculated by 3D-2D registration. Paired sample t-tests were used to compare the kinematic characteristics of the first MTPJ 6DOF kinematics during the stance phase between shod and barefoot conditions. Compared with barefoot, wearing shoes showed significant changes (p < 0.05): 1) the first MTPJ moved less inferior at 50% but moved less superior at 90 and 100% of the stance phase; 2) the peak medial, posterior, and superior translation of the first MTPJ significantly decreased in the shod condition; 3) the extension angle of the first MTPJ was larger at 30-60% but smaller at 90 and 100% of the stance phase; 4) the maximum extension angle and flexion/extension range of motion of the first MTPJ were reduced; and 5) the minimum extension and adduction angle of the first MTPJ was increased in the shod condition. On the basis of the high-speed DFIS, the aforementioned results indicated that wearing shoes limited the first MTPJ flexion and extension movement and increased the adduction angle, suggesting that shoes may affect the propulsion of the first MTPJ and increase the risk of hallux valgus.

Non-South East Asians have a better running economy and different anthropometrics and biomechanics than South East Asians

Running biomechanics and ethnicity can influence running economy (RE), which is a critical factor of running performance. Our aim was to compare RE of South East Asian (SEA) and non-South East Asian (non-SEA) runners at several endurance running speeds (10-14 km/h) matched for on-road racing performance and sex. Secondly, we explored anthropometric characteristics and relationships between RE and anthropometric and biomechanical variables. SEA were 6% less economical (p = 0.04) than non-SEA. SEA were lighter and shorter than non-SEA, and had lower body mass indexes and leg lengths (p ≤ 0.01). In terms of biomechanics, a higher prevalence of forefoot strikers in SEA than non-SEA was seen at each speed tested (p ≤ 0.04). Furthermore, SEA had a significantly higher step frequency (p = 0.02), shorter contact time (p = 0.04), smaller footstrike angle (p < 0.001), and less knee extension at toe-off (p = 0.03) than non-SEA. Amongst these variables, only mass was positively correlated to RE for both SEA (12 km/h) and non-SEA (all speeds); step frequency, negatively correlated to RE for both SEA (10 km/h) and non-SEA (12 km/h); and contact time, positively correlated to RE for SEA (12 km/h). Despite the observed anthropometric and biomechanical differences between cohorts, these data were limited in underpinning the observed RE differences at a group level. This exploratory study provides preliminary indications of potential differences between SEA and non-SEA runners warranting further consideration. Altogether, these findings suggest caution when generalizing from non-SEA running studies to SEA runners.

Are habitually barefoot children compelled to wear ill-fitting school shoes? A cross-sectional study

Background

Research shows that ill-fitting shoes can negatively impact the development of the pediatric foot, in a very direct manner. The primary aim of the study was to determine if the dimensions of available prescribed school shoes fit the foot dimensions of habitually barefoot South African children and adolescents.

Methods

A cross-sectional observational study was conducted where static standing foot measurements of children and adolescents from urban and rural schools were obtained with a mobile caliper. The maximum heel-toe-length and foot width with an added 10 mm toe- and width fit allowance to each participant, were compared to the corresponding school shoe length and shoe width available in retail. A mixed model ANOVA was used to compare foot dimensions between gender, age and side.

Results

Six hundred and ninety-eight school children (N = 698) (431 girls; 267 boys; average age 10.86 years, SD = 2.55) were participants. A total of seventy-seven (N = 77) black coloured prescribed school shoes currently available in retail ranging from different styles and brands were measured. Results show that, comparing the shoe length and maximum heel-toe-length of participants, as well as taking 10 mm toe allowance into account, fifty-nine percent (59%) of children wore shoes that were not the correct length. With regards to the shoe width and the added 10 mm of width fit allowance, ninety-eight percent (98%) of the shoes worn by participants were too narrow for their feet.

Conclusions

Results confirmed that school shoes currently available in retail, are not suited for the habitually barefoot population studied. It is recommended that the shoe manufacturing industry should consider the shoe width of school shoes for children and adolescents in habitually barefoot populations to avoid the long-term negative effect of ill-fitting shoes on the pediatric foot.

Automatic Classification of Barefoot and Shod Populations Based on the Foot Metrics and Plantar Pressure Patterns

The human being’s locomotion under the barefoot condition enables normal foot function and lower limb biomechanical performance from a biological evolution perspective. No study has demonstrated the specific differences between habitually barefoot and shod cohorts based on foot morphology and dynamic plantar pressure during walking and running. The present study aimed to assess and classify foot metrics and dynamic plantar pressure patterns of barefoot and shod people via machine learning algorithms. One hundred and forty-six age-matched barefoot (n = 78) and shod (n = 68) participants were recruited for this study. Gaussian Naïve Bayes were selected to identify foot morphology differences between unshod and shod cohorts. The support vector machine (SVM) classifiers based on the principal component analysis (PCA) feature extraction and recursive feature elimination (RFE) feature selection methods were utilized to separate and classify the barefoot and shod populations via walking and running plantar pressure parameters. Peak pressure in the M1-M5 regions during running was significantly higher for the shod participants, increasing 34.8, 37.3, 29.2, 31.7, and 40.1%, respectively. The test accuracy of the Gaussian Naïve Bayes model achieved an accuracy of 93%. The mean 10-fold cross-validation scores were 0.98 and 0.96 for the RFE- and PCA-based SVM models, and both feature extract-based and feature select-based SVM models achieved an accuracy of 95%. The foot shape, especially the forefoot region, was shown to be a valuable classifier of shod and unshod groups. Dynamic pressure patterns during running contribute most to the identification of the two cohorts, especially the forefoot region.

Understanding Foot Loading and Balance Behavior of Children with Motor Sensory Processing Disorder

Sensory processing disorder (SPD) could influence the neuromuscular response and adjustment to external sensory discrimination and lead to disruptions in daily locomotion. The objective of the current study was to compare plantar loadings and foot balance during walking, running and turning activities in SPD children in order to reveal the behavioral strategy of movement and balance control. Six SPD children and six age-match healthy controls participated in the test using a FootScan plantar pressure plate. The time-varying parameters of forces, center of pressure and foot balance index were analyzed using an open-source one-dimensional Statistical Parametric Mapping (SPM1d) package. No difference was found in foot balance and plantar loadings during walking, while limited supination–pronation motion was observed in the SPD children during running and turning. The plantar forces were mainly located in the midfoot region while less toe activity was found as well. Findings should be noted that SPD children had limited supination–pronation movement for shock attenuation in the foot complex and reduced ankle pronation to assist push-off and toe gripping movements. Understanding the behavior of plantar loading strategy and balance control during walking, running and turning activities may provide clinical implications for the rehabilitation and training of daily tasks.

Human footprints provide snapshot of last interglacial ecology in the Arabian interior

The nature of human dispersals out of Africa has remained elusive because of the poor resolution of paleoecological data in direct association with remains of the earliest non-African people. Here, we report hominin and non-hominin mammalian tracks from an ancient lake deposit in the Arabian Peninsula, dated within the last interglacial. The findings, it is argued, likely represent the oldest securely dated evidence for Homo sapiens in Arabia. The paleoecological evidence indicates a well-watered semi-arid grassland setting during human movements into the Nefud Desert of Saudi Arabia. We conclude that visitation to the lake was transient, likely serving as a place to drink and to forage, and that late Pleistocene human and mammalian migrations and landscape use patterns in Arabia were inexorably linked.

Locomotion Variations of Arch Index and Interlimb Symmetry in Shod and Barefoot Populations

The purpose of this study was to investigate the variations of arch index from static standing to dynamic walking and running; furthermore, the interlimb symmetry was checked in the two populations. A total of eighty male participants were recruited for this study, with forty habitually barefoot and forty habitually shod males, respectively. Arch index (AI) was calculated following the previously established “gold standard” measurement via contact areas recorded from EMED. Repeated measure analysis of variance (ANOVA) was employed to compare the difference between static and dynamic walking and running arch index. Paired-samples t-test and symmetry index (SI) were used to investigate the symmetry of the left foot arch index and right foot arch index. It was found that the dynamic arch index was significantly higher than the static arch index in barefoot and shod males, showing an increase from static weight-bearing standing to dynamic walking and running. However, interlimb (right-left) symmetry in the foot arch index was observed in the two populations. Dynamic changes of the arch index may provide implications that need to be considered while designing shoe lasts or insoles. Knowledge of the healthy arch index range reported from this study could also be used as a standard baseline to probe into foot and arch disorders.

Effect of additional body weight on arch index and dynamic plantar pressure distribution during walking and gait termination

The medial longitudinal arch is considered as an essential feature which distinguishes humans from other primates. The longitudinal arch plays a supporting and buffering role in human daily physical activities. However, bad movement patterns could lead to deformation of arch morphology, resulting in foot injuries. The authors aimed to investigate any alterations in static and dynamic arch index following different weight bearings. A further aim was to analyze any changes in plantar pressure distribution characteristics on gait during walking and stopping, Twelve males were required to complete foot morphology scans and three types of gait tests with 0%, 10%, 20% and 30% of additional body weight. The dynamic gait tests included walking, planned and unplanned gait termination. Foot morphology details and plantar pressure data were collected from subjects using the Easy-Foot-Scan and Footscan pressure platform. No significant differences were observed in static arch index when adding low levels of additional body weight (10%). There were no significant changes observed in dynamic arch index when loads were added in the range of 20% to 30%, except in unplanned gait termination. Significant maximal pressure increases were observed in the rearfoot during walking and in both the forefoot and rearfoot during planned gait termination. In addition, significant maximum pressure increases were shown in the lateral forefoot and midfoot during unplanned gait termination when weight was increased. Findings from the study indicated that excessive weight bearing could lead to a collapse of the arch structure and, therefore, increases in plantar loading. This may result in foot injuries, especially during unplanned gait termination.

Association of Arch Stiffness with Plantar Impulse Distribution during Walking, Running, and Gait Termination

The purpose of this study was to determine relationships between arch stiffness and relative regional impulse during walking, running, and stopping. A total of 61 asymptomatic male subjects volunteered to participate in the study. All were classified by calculating the arch stiffness index using 3-dimensional foot morphological scanning. Plantar pressure distribution data were collected from participants using a Footscan pressure platform during gait tests that included walking, running, and gait termination. The stiff arches group (n = 19) and flexible arches group (n = 17) were included in the following data analysis. The results suggested that subjects with stiffer arches had a larger and smaller percentage of plantar impulse in the forefoot and rearfoot, respectively, than subjects with more flexible arches during walking and running. However, during gait termination, which included planned and unplanned gait stopping, the plantar impulse distribution pattern was found to be reversed. The current findings demonstrate that the distributional changes of plantar loading follow unidirectional transfer between the forefoot and the rearfoot on the plantar longitudinal axis. Moreover, the patterns of impulse distribution are also different based on different gait task mechanisms.

Multi-Segmental Motion in Foot during Counter-Movement Jump with Toe Manipulation

Human toes are crucial for vertical jumping performance. The purpose of this study is to investigate the acute effect of hallux abduction manipulation on foot inter-segment kinematic alterations and plantar loading redistribution during the countermovement jump (CMJ). Thirteen participants were recruited to join in this experiment, for the collection of the foot inter-segment kinematics and plantar pressure data. During the take-off phase, the contact area presented a significant increase while the pressure-time integral decreased in the second metatarsal (M2), whilst the third metatarsal (M3) and fourth metatarsal (M4) decreased significantly in pressure-time integral with Toe-Manipulation (TM). During the landing phase, maximum force and peak pressure were smaller in the big toe (BT) after hallux abduction manipulation. HXFFA (hallux-forefoot angle) showed a greater pronation after manipulation in the frontal plane (0%–26% and 50%–100%) with p = 0.002 and p < 0.001. In the transverse plane, the smaller adductions were found during 62%–82% in take-off and 62%–91% in landing (p = 0.003 and p < 0.001). There was a redistributed plantar loading during the landing phase from the medial to lateral forefoot. However, a reduced hallux range of motion in the TM session was exhibited, compared to Non-Toe-Manipulation (NTM).

Morphology-Related Foot Function Analysis: Implications for Jumping and Running

Barefoot and shod running has received increased attention in recent years, however, the influence of morphology-related foot function has not been explored. This study aimed to investigate morphology-related jumping and running biomechanical functions in habitually barefoot and shod males. A total of 90 barefoot males (Indians) and 130 shod males (Chinese), with significant forefoot and toe morphology differences, participated in a vertical jump and running test to enable the collection of kinematic and kinetic data. The difference of pressure distribution in the hallux and forefoot was shown while jumping and running. The unrestricted forefoot and toes of the barefoot group presented flexible movement and leverage functions to expand the forefoot loading area during performance of the two tasks. Findings related to morphology functions, especially in the forefoot and toe may provide useful information for footwear design.

The effect of running on foot muscles and bones: A systematic review

Despite the widespread evidence of running as a health-preserving exercise, little is known concerning its effect on the foot musculature and bones. While running may influence anatomical foot adaptation, it remains unclear to what extent these adaptations occur. The aim of this paper is to provide a systematic review of the studies that investigated the effects of running and the adaptations that occur in foot muscles and bones. The search was performed following the PRISMA guidelines. Relevant keywords were used for the search through PubMed/MEDLINE, Scopus and SPORTDiscus. The methodological quality of intervention studies was assessed using the Downs and Black checklist. For cross-sectional studies, the Newcastle-Ottawa scale was used. Sixteen studies were found meeting the inclusion criteria. In general, the included studies were deemed to be of moderate methodological quality. Although results of relevant literature are limited and somewhat contradictory, the outcome suggests that running may increase foot muscle volume, muscle cross-sectional area and bone density, but this seems to depend on training volume and experience. Future studies conducted in this area should aim for a standard way of reporting foot muscle/bone characteristics. Also, herein, suggestions for future research are provided.

Minimalist shoes running intervention can alter the plantar loading distribution and deformation of hallux valgus: A pilot study

BACKGROUND

Hallux valgus (HV) is one common deformity of the human foot. Metatarsal pain, gait deviation and foot function disorder may occur when HV is severe.

RESEARCH QUESTION

It was hypothesized that a 12-week minimalist shoes running intervention among mild and moderate hallux valgus males may alter foot morphology and plantar pressure distribution during walking and running.

METHODS

The foot morphology and plantar pressure data, in this study, were collected from eleven participants using the Easy-Foot-Scan (EFS) and Novel EMED force plate.

RESULTS

Compared to pre-intervention sessions, the hallux abductus angle and forefoot width decreased significantly with increased metatarsal waist girth in the post-intervention session. The peak pressure, maximum force and force time integral in the first metatarsal reduced significantly due to the distribution of plantar pressure to the central foot regions.

SIGNIFICANCE

The findings suggest that minimalist shoes may deform forefoot morphology and neutralize loading concentration for mild and moderate hallux valgus.

Long-Term Effects of Habitual Barefoot Running and Walking: A Systematic Review

INTRODUCTION

Barefoot locomotion is widely believed to be beneficial for motor development and biomechanics but are implied to be responsible for foot pathologies and running-related injuries. Although most of available studies focused on acute effects of barefoot running and walking little is known regarding the effects of long-term barefoot versus shod locomotion. The purpose of this study was to systematically review the literature to evaluate current evidence of habitual barefoot (HB) versus habitual shod locomotion on foot anthropometrics, biomechanics, motor performance, and pathologies.

METHODS

Four electronic databases were searched using terms related to habitually barefoot locomotion. Relevant studies were identified based on title, abstract, and full text, and a forward (citation tracking) and backward (references) search was performed. Risk of bias was assessed, data pooling, and meta-analysis (random effects model) performed and finally levels of evidence determined.

RESULTS

Fifteen studies with 8399 participants were included. Limited evidence was found for a reduced ankle dorsiflexion at footstrike (pooled effect size, -3.47; 95% confidence interval [CI], -5.18 to -1.76) and a lower pedobarographically measured hallux angle (-1.16; 95% CI, -1.64 to -0.68). HB populations had wider (0.55; 95% CI, 0.06-1.05) but no shorter (-0.22; 95% CI, -0.51 to 0.08) feet compared with habitual shod populations. No differences in relative injury rates were found, with limited evidence for a different body part distribution of musculoskeletal injuries and more foot pathologies and less foot deformities and defects in HB runners.

CONCLUSIONS

Only limited or very limited evidence is found for long-term effects of HB locomotion regarding biomechanics or health-related outcomes. Moreover, no evidence exists for motor performance. Future research should include prospective study designs.

Growing-up (habitually) barefoot influences the development of foot and arch morphology in children and adolescents

The development of the human foot is crucial for motor learning in children and adolescents as it ensures the basic requirements for bipedal locomotion and stable standing. Although there is an ongoing debate of the advantages and disadvantages of early and permanent footwear use, the influence of regular barefootness on foot characteristics in different stages of child development has not been extensively evaluated. A multicenter epidemiological study was conducted to compare the foot morphology between habitually barefoot children and adolescents (N = 810) to age-, sex- and ethnicity-matched counterparts that are used to wearing shoes. While controlling for confounders, we found that habitual footwear use has significant effects on foot-related outcomes in all age groups, such as a reduction in foot arch and hallux angles. The results indicate an impact of habitual footwear use on the development of the feet of children and adolescents. Therefore, growing up barefoot or shod may play an important role for childhood foot development, implying long-term consequences for motor learning and health later in life.

Dynamic loading and kinematics analysis of vertical jump based on different forefoot morphology

Purpose

This study examined differences in ankle motion and plantar pressure between habitually barefoot male (HBM) and habitually shod male (HSM) during vertical jump.

Methods

Eighteen habitually barefoot males and twenty habitually shod males volunteered to join the test. Distance between hallux and second toe was measured with Easy-Foot-Scan. Plantar pressure and ankle kinematics were measured with EMED force platform and Vicon motion analysis system respectively. T test was taken to analyse the significant differences using Stata 12.0 software.

Results

The distance between hallux and other toes in HBM was greater than it in HSM. HBM showed larger plantar loading under hallux and medial forefoot, while HSM showed lager plantar loading under medial and central forefoot. HBM had smaller ankle plantarflexion, eversion and external rotation than HSM.

Conclusion

Findings of this study provide basic information for further studies on different hallux/toe function in motion control between habitually shod and barefoot populations.

The effects of being habitually barefoot on foot mechanics and motor performance in children and adolescents aged 6-18 years: study protocol for a multicenter cross-sectional study (Barefoot LIFE project)

Background

Barefoot locomotion has evoked an increasing scientific interest with a controversial debate about benefits and limitations of barefoot and simulated barefoot walking and running. While most current knowledge comes from cross sectional laboratory studies, the evolutionary perspective suggests the importance of investigating the long-term effects. Observing habitually barefoot populations could fill the current gap of missing high quality longitudinal studies. Therefore, the study described in this design paper aims to investigate the effects of being habitually barefoot on foot mechanics and motor performance of children and adolescents.

Methods

This study has a cross-sectional, binational design and is part of the “Barefoot Locomotion for Individual Foot- and health Enhancement (Barefoot LIFE)” project. Two large cohorts (n_(total) = 520) of healthy children and adolescents between 6 and 18 years of age will be included respectively in Germany and South Africa. A barefoot questionnaire will be used to determine habitually barefoot individuals. The testing will be school-based and include foot mechanical (static arch height index, dynamic arch index, foot pliability) and motor performance (coordination, speed, leg power) outcomes. Gender, BMI and level of physical activity will be considered for confounding.

Discussion

The strength of this study is the comparison of two large cohorts with different footwear habits to determine long-term effects of being habitually barefoot on foot mechanics and motor performance.

Electronic supplementary material

The online version of this article (doi:10.1186/s13047-016-0166-1) contains supplementary material, which is available to authorized users.