Neutral Shoe Research Articles

The suppression of lower leg electromyography when walking in textured foot orthoses.

Previous research exploring the effects of tactile feedback in standing balance protocols may have generated results that misrepresent the modulatory capabilities of cutaneous afference on generating motor output responses. The neurosensory mechanism of textured foot orthoses to maximize the activation of cutaneous mechanoreceptors is through repetitive foot sole skin indentation. Thus, the purpose of this experimental protocol was to investigate muscular activity amplitude changes during the stance phase of gait, specifically when walking on level ground and when stepping onto a raised wedge, and while wearing textured foot orthoses compared to orthoses without texture. Twenty-one healthy young adults were fit to a standardized neutral running shoe and completed five level and wedged walking trials wearing both orthoses. Kinematic, kinetic and electromyography (EMG) data were recorded from eight lower limb muscles. The results of this study revealed EMG suppression of lower leg musculature during stance when walking in textured foot orthoses,and this was most pronounced when lower leg musculature is typically most active. The addition of texture in foot orthoses design, spanning the entire length of the foot sole, appears to be a clear mechanism to modulate neurosensory feedback with intent to suppress EMG of shank musculature during gait.

Quantifying coordinative patterns in steady‐state running: The impact of footwear and foot strike on joint coupling variability

AbstractIn this study, we aimed to compare and contrast the intralimb coordinative patterns of habitual forefoot strikers (FFS) and rearfoot strikers (RFS) during steady‐state running across three different shoe types: minimalist, neutral and cushioned shoes. To describe these coordinative patterns, we implemented the concept of the ‘preferred movement path’ which represents the movement path that runners naturally select in response to their physical capacity and external environment. We quantified cycle‐to‐cycle consistency (ACC) and within‐trial variance in coordination patterns (SoV) using joint angle data from the ankle and knee for ankle‐knee coupling and from the knee and hip for knee‐hip coupling. Additionally, we calculated the measure of shape difference in joint coupling as the sum of squared distances (SSD) between/within conditions and groups. The percentage of runners who displayed shape differences below certain SSD thresholds was also evaluated. Our findings revealed no significant group or shoe type effect on any of the variability measures (ACC: p = 0.460 for ankle‐knee and p = 0.832 for knee‐hip; SoV: p = 0.345 for ankle‐knee and p = 0.755 for knee‐hip). However, there was a significant (p < 0.001) shape difference observed between the most extreme shoe conditions. Despite this, when runners switched shoes, 70%–90% of them maintained their original coordinative pattern across both joint couplings, indicating a strong adherence to their preferred movement path. This suggests that while shoe type can influence the shape of the coordinative pattern, the inherent movement tendencies of the runners remain largely consistent.

A Comparative Analysis of Bionic and Neutral Shoes: Impact on Lower Limb Kinematics and Kinetics during Varied-Speed Running

The running biomechanics of running shoes have been extensively investigated. However, there is limited knowledge about the use of bionic shoes compared to neutral shoes, along with the velocities involved in their use. The aim of this study was to examine the biomechanical alterations associated with various running velocities of bionic shoes. By removing different thicknesses of the forefoot section, bionic shoes created a more natural shape—close to that of a human foot. The study included 16 heel strike runners running at 10 km/h, 12 km/h and 14 km/h in bionic shoes and neutral shoes, respectively. A two-way ANOVA and SPM1d were employed for examining kinematic and kinetic differences. Regarding the results for the shoes, increased ROM was observed for the bionic shoes for the hip (p < 0.001) and ankle joints (p < 0.001). Ankle positive work (p < 0.001) and negative work (p = 0.042) also showed significant differences. Regarding the velocity results, hip ROM (p < 0.001) increased and peak knee angular velocity (p = 0.018) increased, while knee ROM (p = 0.023) decreased. The interaction effects only existed in hip (p = 0.031) and ankle (p = 0.008) ROM. The results of this study suggested that the impact of running propulsion in the bionic shoes was minimal. However, with increased velocities, the bionic shoes demonstrated the ability to absorb more force, created a more stable training environment, and contributed to injury prevention for the hip and ankle joints.

Comparison of lower extremity kinematics and ground reaction forces between adolescents who run in motion control shoes with adolescents who run in neutral shoes

Differences in running biomechanics have been reported in adult long-distance runners when running in motion control or neutral shoes. The influence of growth and coordination refinement during puberty limits the generalisability of adult research to adolescents and it is unknown if biomechanics differ between adolescent who run in different types of shoes. The purpose of our study was to compare lower extremity kinematics and ground reaction forces between adolescents running in motion control or neutral shoes. We matched 18 adolescent long-distance runners who ran in motion control shoes with 18 adolescent long-distance runners who ran in neutral shoes according to running speed, sex, and physical maturation. We collected three-dimensional kinematic and ground reaction force data during overground running and performed statistical parametric mapping to compare joint angle and ground reaction force waveforms between the motion control and neutral shoe groups. We found no significant differences for hip, knee, or ankle joint angles (average differences <2°) or ground reaction forces (average differences <0.05 N/kg) between runners who ran in motion control or neutral shoes. Lower extremity kinematics and ground reaction forces were similar between adolescents who ran in motion control or neutral shoes.

Effective and clinically relevant optimisation of cushioning stiffness to maximise the offloading capacity of diabetic footwear

IntroductionOptimising the cushioning stiffness of diabetic footwear/orthoses can significantly enhance their offloading capacity. This study explores whether optimum cushioning stiffness can be predicted using simple demographic and anthropometric parameters. MethodsSixty-nine adults with diabetes and loss of protective sensation in their feet were recruited for this cross-sectional observational study. In-shoe plantar pressure was measured using Pedar® for a neutral diabetic shoe (baseline) and after adding cushioning footbeds of varying stiffness. The cushioning stiffness that achieved maximum offloading was identified for each participant. The link between optimum cushioning stiffness and plantar loading or demographic/anthropometric parameters was assessed using multinomial regression. ResultsPeople with higher baseline plantar loading required stiffer cushioning materials for maximum offloading. Using sex, age, weight, height, and shoe-size as covariates correctly predicted the cushioning stiffness that minimised peak pressure across the entire foot, or specifically in the metatarsal heads, midfoot and heel regions in 70%, 72%, 83% and 66% of participants respectively. ConclusionsIncreased plantar loading is associated with the need for stiffer cushioning materials for maximum offloading. Patient-specific optimum cushioning stiffness can be predicted using five simple demographic/anthropometric parameters. These results open the way for methods to optimise cushioning stiffness as part of clinical practice.

Dorsiflexion shoes affect joint-level landing mechanics related to lower extremity injury risk in females

ABSTRACT Athletic shoes that induce dorsiflexion in standing can improve jump height compared to traditional athletic shoes that induce plantarflexion, but it is unknown if dorsiflexion shoes (DF) also affect landing biomechanics associated with lower extremity injury risk. Thus, the purpose of this study was to investigate if DF adversely affect landing mechanics related to patellofemoral pain and anterior cruciate ligament injury risk compared to neutral (NT) and plantarflexion (PF) shoes. Sixteen females (21.65 ± 4.7 years, 63.69 ± 14.3 kg, 1.60 ± 0.05 m) performed three maximum vertical countermovement jumps in DF (−1.5°), NT (0°) and PF (8°) shoes as 3D kinetics and kinematics were recorded. One-way repeated-measures ANOVAs revealed peak vertical ground reaction force, knee abduction moment and total energy absorption were similar between conditions. At the knee, peak flexion and joint displacement were lower in DF and NT, while relative energy absorption was greater in PF (all p < .01). Conversely, relative ankle energy absorption was greater in DF and NT compared to PF (p < .01). Both DF and NT induce landing patterns that may increase strain on passive structures in the knee, emphasising the need for landing mechanics to be considered when testing footwear as gains in performance could come at the cost of injury risk.

Effect of motion control versus neutral walking footwear on pain associated with lateral tibiofemoral joint osteoarthritis: a comparative effectiveness randomised clinical trial

ObjectivesTo determine if motion control walking shoes are superior to neutral walking shoes in reducing knee pain on walking in people with lateral knee osteoarthritis (OA).DesignParticipant-blinded and assessor-blinded, comparative effectiveness,...

Insight into the hierarchical control governing leg stiffness during the stance phase of running

Leg stiffness plays a key role in the storage and release of elastic energy during stance. However, the extent to which a runner is able to reuse stored energy remains a limiting factor in determining their running effectiveness. In this study, ten habitual rearfoot strikers and ten habitual forefoot strikers were asked to run on a treadmill in three footwear conditions: traditional, neutral, and minimal running shoes. We examined the effect of habitual foot strike pattern and footwear on leg stiffness control within three task-relevant phases of stance (i.e. touch-down, loading, unloading). Control was quantified using stride-to-stride leg stiffness time-series and the coefficient of variability and detrended fluctuation analysis (DFA). The results are interpreted within a theoretical framework that blends dynamic systems theory and optimal feedback control. Results indicate that leg stiffness control is tightly regulated by an active control process during the loading period of stance. In contrast, the touch-down and unloading phases are driven mostly by passive allometric control mechanisms. The effect of footwear on leg stiffness control was inconclusive due to inconsistent trends across three shoe types. However, stiffness control was affected by landing technique. Habitual rearfoot strike runners have reduced DFA values during the touch-down and unloading phases. These sub-phases are associated with an allometric control process and suggests that rearfoot strike runners express a reduction in system complexity for leg stiffness control and hence, a less adaptable system.

Differences in Peak Impact Accelerations Among Foot Strike Patterns in Recreational Runners.

IntroductionRunning-related injuries (RRIs) occur from a combination of training load errors and aberrant biomechanics. Impact loading, measured by peak acceleration, is an important measure of running biomechanics that is related to RRI. Foot strike patterns may moderate the magnitude of impact load in runners. The effect of foot strike pattern on peak acceleration has been measured using tibia-mounted inertial measurement units (IMUs), but not commercially available insole-embedded IMUs. The aim of this study was to compare the peak acceleration signal associated with rearfoot (RFS), midfoot (MFS), and forefoot (FFS) strike patterns when measured with an insole-embedded IMU.Materials and MethodsHealthy runners ran on a treadmill for 1 min at three different speeds with their habitual foot strike pattern. An insole-embedded IMU was placed inside standardized neutral cushioned shoes to measure the peak resultant, vertical, and anteroposterior accelerations at impact. The Foot strike pattern was determined by two experienced observers and evaluated using high-speed video. Linear effect mixed-effect models were used to quantify the relationship between foot strike pattern and peak resultant, vertical, and anteroposterior acceleration.ResultsA total of 81% of the 187 participants exhibited an RFS pattern. An RFS pattern was associated with a higher peak resultant (0.29 SDs; p = 0.029) and vertical (1.19 SD; p < 0.001) acceleration when compared with an FFS running pattern, when controlling for speed and limb, respectively. However, an MFS was associated with the highest peak accelerations in the resultant direction (0.91 SD vs. FFS; p = 0.002 and 0.17 SD vs. RFS; p = 0.091). An FFS pattern was associated with the lowest peak accelerations in both the resultant and vertical directions. An RFS was also associated with a significantly greater peak acceleration in the anteroposterior direction (0.28 SD; p = 0.033) than an FFS pattern, while there was no difference between MFS and FFS patterns.ConclusionOur findings indicate that runners should be grouped by RFS, MFS, and FFS when comparing peak acceleration, rather than the common practice of grouping MFS and FFS together as non-RFS runners. Future studies should aim to determine the risk of RRI associated with peak accelerations from an insole-embedded IMU to understand whether the small observed differences in this study are clinically meaningful.

Assessment of a New Lateral Cushioned Casting Orthosis: Effects on Peroneus Longus Muscle Electromyographic Activity During Running

Background:Classical medial wedge (CMW) orthoses have been prescribed to treat overpronation foot pathologies in runners. The effects of a novel supination orthosis (NSO) on the surface electromyography (EMG) activity of the peroneus longus (PL) muscle during a complete cycle of running have yet to be tested.Purpose/Hypothesis:The purpose of this study was to compare the EMG activity of the PL in participants wearing CMW orthoses and NSOs versus neutral running shoes (NRS) during a full cycle of running gait. It was hypothesized that the PL muscle activity would be lower for the NSO compared with CMW or NRS.Study Design:Controlled laboratory study.Methods:Included were 31 healthy recreational runners of both sexes (14 male and 17 female; mean age, 38.58 ± 4.02 years) with a neutral Foot Posture Index and standard rearfoot-strike pattern. Participants ran on a treadmill at 9 km/h while wearing NSO (3-, 6-, and 9-mm thicknesses), CMW (3-, 6-, and 9-mm thicknesses), and NRS, for a total of 7 different conditions randomly selected, while the EMG signal activity of the PL was recorded for 30 seconds. Each trial was recorded 3 times, and the intraclass correlation coefficient (ICC) to test reliability of the measurements was calculated. The Wilcoxon pair to pair nonparametric test with Bonferroni correction was performed to analyze differences among the conditions.Results:The reliability of all assessments was almost perfect (ICC, >0.81). For both the CMW and NSO, regardless of thickness, the PL activity was statistically significantly lower compared with the NRS (P < .05 for all). For all CMW thicknesses, the PL activity was lower compared with the respective NSO thicknesses, with the 3-mm thickness having the largest difference (CMW3mm, 18.63 ± 4.64 vs NSO3mm, 20.78 ± 4.99 mV; P < .001).Conclusion:Both CMW and NSO produced reduced EMG activity of the PL muscle; therefore, they can be prescribed to treat overpronation pathologies without associated PL strain concerns. In addition, the NSO saved the enhancement material placed on the medial-rear side of CMW, making it easier to wear sports shoes.Clinical Relevance:Knowing the safety of CMW and NSO will aid in understanding treatments for overpronation pathologies.

Ground Reaction Force Differences between Bionic Shoes and Neutral Running Shoes in Recreational Male Runners before and after a 5 km Run.

Running-related injuries are common among runners. Recent studies in footwear have shown that designs of shoes can potentially affect sports performance and risk of injury. Bionic shoes combine the functions of barefoot running and foot protection and incorporate traditional unstable structures based on bionic science. The purpose of this study was to investigate ground reaction force (GRF) differences for a 5 km run and how bionic shoes affect GRFs. Sixteen male recreational runners volunteered to participate in this study and finished two 5 km running sessions (a neutral shoe session and a bionic shoe session). Two-way repeated-measures ANOVAs were performed to determine the differences in GRFs. In the analysis of the footwear conditions of runners, bionic shoes showed significant decreases in vertical impulse, peak propulsive force, propulsive impulse, and contact time, while the braking impulse and vertical instantaneous loading rate (VILR) increased significantly compared to the neutral shoes. Main effects for a 5 km run were also observed at vertical GRFs and anterior–posterior GRFs. The increases of peak vertical impact force, vertical average loading rate (VALR), VILR, peak braking force and braking impulse were observed in post-5 km running trials and a reduction in peak propulsive force and propulsive impulse. The interaction effects existed in VILR and contact time. The results suggest that bionic shoes may benefit runners with decreasing injury risk during running. The findings of the present study may help to understand the effects of footwear design during prolonged running, thereby providing valuable information for reducing the risk of running injuries.

The Effect of Footwear, Running Speed, and Location on the Validity of Two Commercially Available Inertial Measurement Units During Running.

Introduction: Most running-related injuries are believed to be caused by abrupt changes in training load, compounded by biomechanical movement patterns. Wearable technology has made it possible for runners to quantify biomechanical loads (e.g., peak positive acceleration; PPA) using commercially available inertial measurement units (IMUs). However, few devices have established criterion validity. The aim of this study was to assess the validity of two commercially available IMUs during running. Secondary aims were to determine the effect of footwear, running speed, and IMU location on PPA.Materials and Methods: Healthy runners underwent a biomechanical running analysis on an instrumented treadmill. Participants ran at their preferred speed in three footwear conditions (neutral, minimalist, and maximalist), and at three speeds (preferred, +10%, −10%) in the neutral running shoes. Four IMUs were affixed at the distal tibia (IMeasureU-Tibia), shoelaces (RunScribe and IMeasureU-Shoe), and insole (Plantiga) of the right shoe. Pearson correlations were calculated for average vertical loading rate (AVLR) and PPA at each IMU location.Results: The AVLR had a high positive association with PPA (IMeasureU-Tibia) in the neutral and maximalist (r = 0.70–0.72; p ≤ 0.001) shoes and in all running speed conditions (r = 0.71–0.83; p ≤ 0.001), but low positive association in the minimalist (r = 0.47; p < 0.05) footwear condition. Conversely, the relationship between AVLR and PPA (Plantiga) was high in the minimalist (r = 0.75; p ≤ 0.001) condition and moderate in the neutral (r = 0.50; p < 0.05) and maximalist (r = 0.57; p < 0.01) footwear. The RunScribe metrics demonstrated low to moderate positive associations (r = 0.40–0.62; p < 0.05) with AVLR across most footwear and speed conditions.Discussion: Our findings indicate that the commercially available Plantiga IMU is comparable to a tibia-mounted IMU when acting as a surrogate for AVLR. However, these results vary between different levels of footwear and running speeds. The shoe-mounted RunScribe IMU exhibited slightly lower positive associations with AVLR. In general, the relationship with AVLR improved for the RunScribe sensor at slower speeds and improved for the Plantiga and tibia-mounted IMeasureU sensors at faster speeds.

Prolonged Running Using Bionic Footwear Influences Lower Limb Biomechanics.

The running biomechanics of unstable shoes have been well investigated, however, little is known about how traditional neutral shoes in combination with unstable design elements and scientifically (bionic) designed shoes influence prolonged running biomechanics. The purpose of this study was to investigate biomechanical changes for a typical 5 km run and how footwear technology may affect outcomes. Sixteen healthy male recreational heel strike runners participated in this study, and completed two prolonged running sessions (neutral shoe session and bionic shoe session), with 7 to 10 days interval between sessions. A two-way repeated-measures analysis of variance (ANOVA, shoe × time) was conducted to determine any differences in joint biomechanics. Main effects for shoe type were observed at the ankle, knee and hip joints during the stance phase. In particular, decreased range of motion (ROM) was observed using the bionic shoes for all three joints, and the joint moments also had significant changes except for the frontal plane of the hip. Main effects for time were also observed at the ankle, knee and hip joints. The ROM of the sagittal plane in the knee and hip decreased post-5 km running. The reduction of ankle dorsiflexion, hip flexion, hip adduction and hip internal rotation angles were observed post-5 km running, as well as the increase of ankle eversion and external rotation, knee adduction and internal rotation angles. The kinetics also exhibited significant differences between pre-5 km running and post-5 km running. The interaction effects only existed in the ROM of the hip sagittal plane, hip adduction angle and hip internal rotation angle. The results suggested that bionic shoes could be beneficial for strengthening muscle control, enhancing postural stability and proprioceptive ability. Footwear personalization could be a solution that benefits runners, reduces injury risk and improves running performance.

The influence of design variations in footwear medial-lateral support on the running biomechanics of older female runners

Reports of greater incidence of knee pain and injury in older female runners compared with their younger counterparts may be associated with differences in lower limb biomechanics that influence knee joint loading. The aim of this study was to investigate footwear interventions aimed at influencing lower limb biomechanics in older female runners (&gt;45 years). Strategies for reducing peak rearfoot eversion and the external knee adductor moment were investigated, since both measures have been associated with knee joint injury. Twenty female runners (mean age 50.7 ± 5.6 years) performed 10 running trials in four footwear conditions: neutral running shoe (Control); neutral shoe with 4° medial heel wedge insole (Medial Wedge); neutral shoe with 4° lateral heel wedge insole (Lateral Wedge); and neutral shoe with combined insole with 5° lateral wedge and medial arch support (Combined Insole). Peak rearfoot eversion and knee external adductor moment were compared for the four conditions using RMANOVA and post-hoc Tukey tests ( p &lt; 0.05). Compared with the Control, peak rearfoot eversion was lower for the Combined Insole condition, with this value being lower than for all other insole conditions ( p &lt; 0.05). Compared with the Control, the peak knee external adductor moment was lower for the Lateral Wedge and the Combined Insole conditions ( p &lt; 0.05). These results support the use of a combined insole with lateral wedge and medial arch support for the reduction of peak rearfoot eversion and peak knee external adductor moment, variables that have been associated with increased risk of knee injury. If aiming to reduce knee external adductor moment alone, then the lateral wedge technology employed in this study provides an effective method for older female runners.

Motion-Control Shoes Reduce the Risk of Pronation-Related Pathologies in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial.

To investigate whether motion-control shoes reduce the risk of pronation-related injuries in recreational runners. Secondary analysis of a randomized controlled trial of the effect of shoes on running injuries. Three hundred seventy-two recreational runners were randomized to receive either standard neutral or motion-control shoes and were followed up for 6 months regarding running activity and injury. Running injuries that occurred during this period were registered and classified as pronation-related injuries (Achilles tendinopathy, plantar fasciopathy, exercise-related lower-leg pain, and anterior knee pain) or other running-related injuries. With the use of competing risk analysis, the relationship between pronation-related and other running-related injuries and shoe type was evaluated by estimating the cause-specific hazard, controlling for other possible confounders like age, sex, body mass index, previous injury, and sport participation pattern. Twenty-five runners sustained pronation-related running injuries and 68 runners sustained other running-related injuries. Runners wearing the motion-control shoes had a lower risk of pronation-related running injuries compared with runners who wore standard neutral shoes (hazard ratio = 0.41; 95% confidence interval: 0.17, 0.98). There was no effect of shoe type (hazard ratio = 0.68; 95% confidence interval: 0.41, 1.10) on the risk of other running-related injuries. Motion-control shoes may reduce the risk of pronation-related running injuries, but did not influence the risk of other running-related injuries. J Orthop Sports Phys Ther 2021;51(3):135-143. Epub 11 Dec 2020. doi:10.2519/jospt.2021.9710.

The Influence of Prolonged Running and Footwear on Lower Extremity Joint Stiffness.

The purpose of this study was to compare leg, sagittal plane knee and ankle, and frontal plane ankle stiffness over the course of a prolonged treadmill run in neutral and stability footwear. Thirteen male habitual rearfoot runners completed two biomechanical testing sessions in which they ran for 21 min at their preferred running speed in a neutral shoe, then changed either into the same neutral shoe or a stability shoe and ran a further 21 min on a force-instrumented treadmill. Three-dimensional kinematics and kinetics were recorded at the beginning and end of each 21-min interval. No differences were observed in leg stiffness between footwear conditions throughout the run (P > 0.05). Knee stiffness increased during the first 21 min (P = 0.009), whereas ankle stiffness reduced at minute 21 (P = 0.004) and minute 44 (P = 0.006). These changes were modulated by an increase in ankle joint compliance and knee joint moments. No differences were observed between footwear conditions for leg and sagittal plane lower extremity joint stiffness (P > 0.05). During the second half of the run, frontal plane ankle stiffness increased in the stability shoe but decreased in the neutral shoe (P = 0.019), attributed to reduced eversion range of motion caused by the added medial post. These results suggest that over the course of a prolonged treadmill run, shock attenuation strategies change, which may affect the knee joint.

Review of Terms and Definitions Used in Descriptions of Running Shoes.

Objective: Our study aim is to identify and describe the definitions used for different types of running shoes. In addition, we highlight the existence of gaps in these concepts and propose possible new approaches. Methods: This review was undertaken in line with the guidelines proposed by Green et al., based on a literature search (until December 2019) of the PubMed, Web of Science, Scopus, SPORTDiscus and Google Scholar databases. A total of 23 papers met the inclusion criteria applied to identify the definition of running shoes. Results: Although there is a certain consensus on the characteristics of minimalist footwear, it is also described by other terms, such as barefoot-style or barefoot-simulating. Diverse terms are also used to describe other types of footwear, and in these cases, there is little or no consensus regarding their characteristics. Conclusions: The terms barefoot-simulated footwear, barefoot-style footwear, lightweight shoes and full minimalist shoes are all used to describe minimalist footwear. The expressions partial minimalist, uncushioned minimalist and transition shoes are used to describe footwear with non-consensual characteristics. Finally, labels such as shod shoes, standard cushioned running shoes, modern shoes, neutral protective running shoes, conventional, standardised, stability style or motion control shoes span a large group of footwear styles presenting different properties.

Footwear for osteoarthritis of the lateral knee: protocol for the FOLK randomised controlled trial

BackgroundStructural features of lateral tibiofemoral (TF) joint osteoarthritis (OA) occur in up to half of all people with knee OA, and co-existing lateral TF OA is associated with worse knee pain in people with mixed compartmental knee OA. Clinical guidelines for management of knee OA advocate advice about appropriate footwear, yet there is no research evaluating which types of footwear are best for managing pain associated with lateral TF OA. Biomechanical evidence suggests that “motion-control” footwear, which possess midsoles that are stiffer medially compared to laterally, may shift load away from the lateral compartment of the knee and thus may reduce knee pain associated with lateral TF OA. The primary aim of this study is to compare the effects of motion-control shoes to neutral shoes on knee pain in people with predominantly lateral TF OA.MethodsThis will be an assessor- and participant-blinded, two-arm, comparative effectiveness randomized controlled trial (RCT) conducted in Melbourne, Australia. We will recruit a minimum of 92 people with painful lateral TF OA from the community. Participants will be randomly allocated to receive either motion-control shoes or neutral shoes and will be instructed to wear their allocated shoes for a minimum of 6 h per day for 6 months. The primary outcome is change in self-reported knee pain on walking, measured using a numerical rating scale, assessed at baseline and 6 months. Secondary outcomes include other measures of knee pain, physical function, quality of life, participant-perceived change in pain and function, and physical activity levels.DiscussionThis study will compare the efficacy of motion-control shoes to neutral shoes for people with painful lateral TF OA. Findings will be the first to provide evidence of the effects of footwear on knee pain in this important subgroup of people with knee OA and allow clinicians to provide accurate advice about the most appropriate footwear for managing pain associated with lateral TF OA.Trial registrationThis trial has been prospectively registered by the Australian New Zealand Clinical Trials Registry on 15/11/2018 (reference: ACTRN12618001864213).

A time-series based framework for exploring the unknown effects of shoe comfort-induced biomechanical adaptations

Footwear Science struggles at identifying the unknown effects of footwear interventions on the biomechanics of running. Those struggles may partly be explained by methodological and statistical issues, such as using discrete parameters to reduce the dimensionality of time series data or testing against unspecific null hypotheses. This paper evaluates a method to address some of these deficits by applying a time series-based machine learning approach (k-nearest neighbour classification (kNN), Euclidean distance). As an example, we used a data set containing a largely unknown footwear effect: The relationship between subjective comfort and the rollover movement during running. For this purpose, we collected kinematic data and subjective ratings from 22 runners running two times each in both their most comfortable and uncomfortable shoe selected from a pool of different neutral running shoes. The kNN algorithm performed highly accurately in distinguishing between the kinematics of different shoes. We also found that larger differences in subjective comfort perception between two shoes were associated with higher classification rates. The kNN method, however, does not allow for conclusions to be drawn about the causality or quality of the observed changes within the kinematic trajectories. Accordingly, we see the main scope of the presented method primarily in exploring complex data sets in cases where no meaningful hypothesis about the presumed biomechanical effects can be derived a priori. The subsequently acquired knowledge may be used to design larger-scale studies in which these findings can be investigated more systematically by means of more specific hypotheses and better estimates of sample sizes, respectively.

Joint coordination when running in minimalist, neutral, and ultra-cushioning shoes

ABSTRACTUltra-cushioning (ULTRA) shoes are new to the running shoe market. Several studies have evaluated kinematics and kinetics while running in ULTRA shoes, however it remains unknown how such shoes influence joint coordination. Therefore, the purpose of this study was to evaluate lower extremity coordination and coordination variability when running in minimalist (MIN), traditional (NEUT) and ULTRA shoes. Fifteen runners ran for ten minutes in each shoe type. Coordination patterns and coordination variability were assessed for rearfoot-tibia, rearfoot-knee, and tibia-knee couplings using a modified vector coding method during early, mid, and late stance periods. During late stance ULTRA shoes resulted in more antiphase coordination than MIN (p =.036) or NEUT (p =.047) shoes and less in-phase coordination than MIN (p =.048) or NEUT (p =.013) shoes. During late stance there was also more proximal phase rearfoot-knee coordination in ULTRA shoes than in either MIN (p =.039) or NEUT (p =.005) shoes and less in-phase coordination in ULTRA shoes than in NEUT shoes (p =.006). There were no differences in coordination variability between shoes during any phase. The differences in coordination may have implications for tissue loading and injury development when running in ULTRA shoes..