Walking Footwear Research Articles

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,...

Foot shape and plantar pressure relationships in shod and barefoot populations.

This study presents population-based multivariate regression models for predicting foot plantar pressure from easily measured foot metrics in both shod and barefoot populations for running and walking tasks. Both shod and barefoot models were trained on 50 participants and predicted plantar pressure from anthropometric measurements using a 'leave-one-out' validation with R2 values of 0.72-0.78 across walking and running in both populations. When the model was blindly tested on 16 new data sets, the model performed just as well with R2 values of 0.76-0.79 across both populations. Walking and running peak plantar pressure were predicted with similar levels of accuracy in both populations. It was revealed that forefoot plantar pressure was more sensitive to the hallux-toe distance in barefoot people with shod participants showing little response to this foot characteristic. Lateral forefoot plantar pressure was sensitive to the arch index in both shod and barefoot participants but only for walking. During running, the arch index was not a useful determinant of lateral forefoot pressure. Hence, habitually barefoot people who adopt minimalist footwear should consider additional support in the medial forefoot and walking footwear should include forefoot support stratified by arch index (foot type), but running footwear is challenging due to the variability in strike patterns.

A mechanical protocol to replicate impact in walking footwear

Impact testing is undertaken to quantify the shock absorption characteristics of footwear. The current widely reported mechanical testing method mimics the heel impact in running and therefore applies excessive energy to walking footwear. The purpose of this study was to modify the ASTM protocol F1614 (Procedure A) to better represent walking gait. This was achieved by collecting kinematic and kinetic data while participants walked in four different styles of walking footwear (trainer, oxford shoe, flip-flop and triple-density sandal). The quantified heel-velocity and effective mass at ground-impact were then replicated in a mechanical protocol. The kinematic data identified different impact characteristics in the footwear styles. Significantly faster heel velocity towards the floor was recorded walking in the toe-post sandals (flip-flop and triple-density sandal) compared with other conditions (e.g. flip-flop: 0.36±0.05ms−1 versus trainer: 0.18±0.06ms−1). The mechanical protocol was adapted by altering the mass and drop height specific to the data captured for each shoe (e.g. flip-flop: drop height 7mm, mass 16.2kg). As expected, the adapted mechanical protocol produced significantly lower peak force and accelerometer values than the ASTM protocol (p<.001). The mean difference between the human and adapted protocol was 12.7±17.5% (p<.001) for peak acceleration and 25.2±17.7% (p=.786) for peak force. This paper demonstrates that altered mechanical test protocols can more closely replicate loading on the lower limb in walking. This therefore suggests that testing of material properties of footbeds not only needs to be gait style specific (e.g. running versus walking), but also footwear style specific.

Testing a mechanical protocol to replicate impact in walking footwear

Impact testing is commonly undertaken to quantify the shock absorption characteristics of footwear. The current widely reported mechanical testing method mimics the vertical heel velocity at touchdown and effective mass of the lower limb recorded in running. This therefore results in a greater impact energy than would be expected at touchdown in walking. Despite this mismatch, the methodology is utilised to quantify the shock absorption properties of running and walking footwear alike. The current work modifies the mechanical testing methodology to replicate the kinematics, specifically the vertical heel velocity, identified in walking footwear. Kinematic and kinetic data was collected for 13 subjects walking in four different styles of footwear used for walking (trainer, oxford shoe, flip-flop and triple-density sandal). The kinematic data was utilised to quantify heel velocity at touchdown and accelerometer and force plate data was utilised to estimate the effective mass of the lower limb. When walking in the toe-post style footwear significantly faster vertical heel velocity toward the floor was recorded compared to barefoot and the other footwear styles (Figure ​(Figure11 for example flip-flop: 0.36±0.05m.s-1 compared to trainer: 0.18±0.06m.s-1). The mechanical protocol was adapted by altering the mass and drop height from 10.6-17.3 kg and 2-7 mm, compared to the original protocol of 8.45 kg dropped from 50 mm. As expected, the adapted mechanical protocol produced significantly lower peak force and accelerometer values than the ASTM protocol (p <.001). These values more closely resembled those recorded in walking. The mean difference between the human and modified protocol was 12.7±17.5% (p<.001) for peak acceleration and 25.2±17.7% (p=.786) for peak force values. The timing of peak force and acceleration variables was less representative of the real-life data with larger mean differences. This pilot test has demonstrated that the altered mechanical test protocol can more closely replicate loading on the lower limb in walking. Further research should consider more variables related to the shock absorption properties of footwear. The results also demonstrate that testing of material properties of footbeds not only needs to be gait style specific (e.g. running versus walking), but also footwear style specific due to the differences in heel touch-down velocity in footwear styles. Figure 1 Vertical heel velocity towards the floor in the human testing for the four footwear conditions. Triple-density sandal = SA, flip-flop = FF, shoe = SH and trainer = TR and Barefoot (BF). Error bars denote standard deviation across the 13 subjects tested. ...

The evaluation of walking footwear on postural stability in healthy older adults: An exploratory study

BackgroundIt has been proposed that walking footwear enhances postural stability in healthy older adults. The aim of the study is to evaluate differences between two different types of athletic footwear in relation to postural stability in healthy older adults. MethodsA convenience sample of 21 healthy older adults with mean (SD) of 74 (5) years was recruited. Postural stability was measured using a force plate for anterior–posterior (AP) and mediolateral (ML) centre of pressure excursion for 30s with eyes closed and open using two different types of athletic footwear. Each participant performed three repetitions of bipedal standing. Two-way analysis of variance tested the interaction effect of the footwear and eye conditions on anterior–posterior (AP) and mediolateral (ML) postural sway. FindingsThere was no significant footwear–eye condition interaction for anterior-posterior(AP) postural sway but there were significant main effects for both the footwear and eye conditions (P<0.05). The significant main effects for the footwear conditions occurred between barefeet and the two shoe conditions, but not between the two shoe conditions. For mediolateral (ML) postural sway there was no significant interaction effect and no main effects for the footwear and eye conditions (P>0.05). InterpretationThe results suggest that older adults demonstrate an initial destabilisation effect which could possibly be of benefit to functional ability but the long-term effects of ability of athletic footwear to enhance postural stability requires further investigation.

Randomized trial of custom orthoses and footwear on foot pain and plantar pressure in diabetic peripheral arterial disease

Custom-made foot orthoses reduce plantar pressure, ulceration and amputation in patients with diabetes mellitus. There is limited evidence of their effect on foot pain. In a randomized, single-blind, sham-controlled trial, the efficacy of custom orthoses on foot pain and plantar pressure in diabetic patients with peripheral arterial disease was investigated. Sixty-one participants were randomly assigned to either custom foot orthoses (n = 30) or sham insoles (n = 31). Both groups also received standardized walking footwear. Outcomes included foot pain and function, mean pressure, toe-brachial index, average daily steps, disability, comfort, quality of life, adherence and adverse events. A multivariate predictive model was constructed to explore factors contributing to pain relief during the trial. At 8 weeks, 95% of participants provided follow-up data, adherence was high and there were few adverse events. Foot pain and function scores significantly improved at 8 weeks with both custom orthoses and the sham, but there was no significant difference between groups. Custom orthoses reduced pressure significantly more than the sham. There were no significant differences between groups for toe-brachial index, daily steps, disability, comfort or quality of life. Regression modelling identified inappropriate pre-trial footwear as the strongest predictor of foot pain relief during the trial. Custom foot orthoses significantly reduced plantar pressure compared with the sham, but there were no significant differences between groups for pain or function. The high-quality walking footwear provided to both groups may explain this finding. Footwear should have greater emphasis as the clinical intervention.