Falls among older adults are a major public health issue, and footwear has been identified as a modifiable risk factor for falls. However, evidence comparing the effects of specific footwear types on spatiotemporal gait parameters in older adults remains limited. This study aimed to examine the effects of conventional, minimalist, and slipper-type footwear on gait speed, stride length, and cadence in community-dwelling older adults. Web of Science, SPORTDiscus, MEDLINE, CINAHL, and Google Scholar were searched from January to February 2025 for studies comparing spatiotemporal gait parameters between barefoot walking and at least one footwear type (conventional, minimalist, or slipper-type) in community-dwelling adults aged 65 or older. Random- and mixed-effects meta-analysis models were used to estimate pooled effect sizes and examine footwear type and gender as potential moderators of gait outcomes. Eight studies (n = 223 participants) were included. All footwear conditions, regardless of type, resulted in significantly faster gait speeds (g = 0.491, 95% CI [0.346, 0.635]; 7.52% increase) and longer stride lengths (g = 0.699, 95% CI [0.456, 0.941]; 6.16% increase) compared to barefoot walking, with no significant effect on cadence. Conventional footwear showed the largest estimated effects on gait speed (g = 0.574, 95% CI [0.390, 0.757]; 9.22% increase) and stride length (g = 0.817, 95% CI [0.479, 1.155]; 8.09% increase), though footwear type was not a statistically significant moderator across any outcome. These findings suggest that wearing footwear, particularly conventional supportive shoes, may enhance gait speed and stride length in older adults compared to walking barefoot, supporting footwear selection as an accessible and modifiable strategy for optimising mobility.
Although boots are commonly used for many occupational and daily activities, their effects on joint mechanics and injury risk are not well understood. This study aimed to evaluate the influence of boots on lower limb joint contact forces during walking. To achieve this, experimental markers and ground reaction force data were collected from 20 healthy individuals during walking in boots and casual footwear. Musculoskeletal modelling was used to compute the three-dimensional lower limb joint contact forces, as well as the total contribution of muscles to joint compressive load. The continuous and discrete results were compared between the conditions using statistical parametric mapping and paired t-test, respectively. Walking in boots significantly increased hip joint compressive forces during mid-stance (p = 0.002, d = 0.85) and push-off (p = 0.03, d = 0.44) phases, as well as the knee joint compressive forces during the push-off phase (p = 0.007, d = 0.53), while it reduced the ankle compressive force during the mid-stance phase (p = 0.016, d = 0.75). The intersegmental compressive impulse was greater significantly in the hip (p = 0.003, d = 0.48), knee (p = 0.003, d = 0.52), and ankle (p = 0.007, d = 0.46) joints. The contributions to joint compressive impulse were significantly greater for the hip abductors (p < 0.001, d = 0.99), iliopsoas (p = 0.001, d = 0.47), and hamstrings (p < 0.001, d = 0.94) in the boot condition. Overall, hip and knee compressive impulses were increased by 10.5% and 7%, respectively, whereas ankle compressive impulse was decreased by 1.5% when walking in boots compared with casual footwear. Our findings suggest that walking in boots is associated with compensatory mechanisms at the hip and knee joints in response to the potential ankle restrictions imposed by boots. This might have implications for joint health, injury prevention and footwear design.
Given the established effects of advanced footwear technology shoes (AFTs) on lower limb kinematics and muscle activation in running, similar effects may be expected in race walking. This pilot study aimed to examine the effect of AFTs on lower limb muscle activation using proton transverse relaxation time (T2)-weighted magnetic resonance (MR) imaging following near-maximal effort race walking, and investigate lower limb kinematics, compared with traditional shoes (TRADs). Six elite race walkers performed a 10-min race walk on the treadmill at 100% of their season-best 10-km pace (average speed: 14.8 km/h) at four separate visits, wearing either TRADs or AFTs. Sagittal joint kinematics were determined using a high-speed camera at 240 fps during the last 2-min of the race walk. For each visit, the T2-weighted MR images of either the shank or thigh were obtained in randomised order before and immediately after exercise, and the T2 values were calculated from the images. Two-way analysis of variance showed a significant Shoes & times; Time interaction in the soleus (p < 0.05, eta(2): 0.351), lateral gastrocnemius (p < 0.05, eta(2): 0.216), medial gastrocnemius (p < 0.05, eta(2): 0.179), and the biceps femoris (p < 0.05, eta(2): 0.349). The T2 values were significantly lower in these muscles when wearing AFTs compared with TRADs after race walking. In contrast, lower limb kinematics remained unchanged between AFTs and TRADs during race walking. These findings suggest that AFTs may reduce the exercise-induced metabolic response in the activated posterior lower limb muscles without affecting kinematics during near-maximal effort race walking.
Previous studies have demonstrated that asymptomatic and symptomatic pronated feet (AP and SP) differ not only in gait kinematics but also in foot muscle morphology, indicating a potential link between kinematic alterations and muscular adaptations. However, it remains unclear whether such adaptations extend to neuromuscular control strategies and muscle-tendon unit (MTU) behaviour in individuals with AP and SP. Whether or not the AP and SP differ in neuromuscular control characteristics of intrinsic and extrinsic foot muscles and their MTU behaviour during running? A total of 59 participants were recruited,19 with asymptomatic neutral feet (AN), 18 with AP and 22 with SP. Surface EMG data of six foot muscles were collected during running for calculating muscle synergy and co-activation. OpenSim was used to estimate changes in MTU length and velocity based on motion capture data. One-way ANOVA and statistical parametric mapping were used to assess differences among groups. The SP showed higher tVAF1 (total variance accounted for by one synergy) than the AP. Muscle synergy number and weightings were comparable across groups. Both AP and SP had higher co-activation of abductor hallucis-peroneus longus than the AN. Moreover, the AN and AP showed similar MTU dynamic behaviour, while the SP had different MTU length and velocity of extrinsic foot muscles during swing phase. Differences in neuromuscular control characteristics and MTU dynamic behaviour were noticed among groups. The SP showed less motor control complexity, higher muscle co-activation, and more shortening in ankle plantarflexors, indicating a less efficient control strategy. In contrast, the AN and AP functioned similarly in the MTU behaviour during running.
While trail running has seen the growing use of advanced footwear technologies (AFT), most scientific investigations have evaluated shoes in laboratory settings under non-fatigued conditions. This study compared the effect of two footwear foams on running economy and affective responses before and after a prolonged trail run, as well as their impact on performance. Fourteen trained male trail runners completed two sessions with shoes allocated in a randomized and counterbalanced order. The two shoes tested differed in their foam proprieties with the AFT foam being softer, more compliant and resilient than the traditional foam. Each session involved a 90-minute trail run performed at a clamped rate of perceived exertion of 14/20. Running economy, affective valence and arousal were assessed pre- and post-prolonged run. Performance was assessed as the distance completed during the task. No differences in running economy or affective responses were observed between the two footwear conditions before and after the prolonged run. No difference independent of timing were identified for affective valence and running economy, although a tendency for higher pleasure was reported with the AFT foam (p = 0.088). Similarly, no differences in distance covered were found between shoes conditions. However, exploratory analysis revelated an interaction effect between speed and footwear across time, with better speed preservation from the first to the last loop with the AFT foam. The prolonged trail run induced significant physiological (increased VO2, HR, RER) and affective (lower valence, increased arousal) changes, reflecting fatigue-induced shifts in metabolic and affective states. While the shoes did not induce changes in running economy in a field setting, they may offer benefits in terms of running experience and fatigue preservation.
The acute ergogenic effects of advanced footwear technology (AFT) have been previously documented, though the potential for habituation to further improve these performance benefits is a recent area of interest. The purpose of this study was to investigate the impact of previous AFT experience on acute metabolic benefits from AFT as a measure of habituation to AFT. A retrospective cross-sectional analysis was conducted, examining the pre-test metabolic data from 25 collegiate and competitive club cross-country runners (male: n = 15; female: n = 10) who went on to participate in a training intervention. Participants completed four 5-minute trials at a self-selected submaximal speed, in a randomised ABBA order, in the Nike ZoomX Vaporfly Next% 3 (VP) and Nike Zoom Rival Waffle 5 (FL) to assess running economy (RE) and energetic cost (EC). Shoe specific RE and EC values were used to calculate AFT% benefit as the percent improvement in VP relative to FL. Runners were categorised as having previous AFT experience or not having prior AFT experience, via self-report questionnaire. Independent samples t-tests were used to compare AFT% benefit between groups. Runners with previous AFT experience (n = 16) had a significantly larger AFT% benefit (RE: 3.91 +/- 2.17%; EC: 4.20 +/- 2.30%) compared to runners who had not used AFT previously (RE: 2.00 +/- 1.78%; EC: 2.47 +/- 1.97%) (RE: p = 0.017; EC: p = 0.039). Habituation to AFT, measured by increased AFT% benefit, was observed among runners who had previously used AFT in this study. Therefore, AFT use prior to competition may provide performance benefits.
It remains unknown if shoes with increased longitudinal bending stiffness (LBS) can affect jump performance during stationary countermovement jumps with and without the use of arms, and whether a different amount of footwear LBS is optimal for each jump type. In this study, ten healthy male participants performed maximal countermovement jumps with and without free arm movement in four LBS conditions, accomplished by adding carbon fibre plates of varying thickness underneath the insole. Compared to the very stiff LBS condition, significant decreases in metatarsophalangeal (MTP) joint range of motion (p = 0.043, d = 0.80) and negative work (p = 0.017, d = 0.68) were observed in the control condition. A significant increase was also found for MTP joint positive work (p < 0.001, d = 1.18) in the very stiff LBS compared to the control condition; however, no change in maximum jump height was observed (p = 0.755, d = 0.03). Torsional spring energy at the MTP joint significantly increased in the very stiff LBS compared to the control condition (p = 0.017, d = 0.66). An interaction between jump type and footwear LBS was not observed (p = 0.630, eta(2)(p) = 0.061); however, jumping with free arm movement redistributed positive work from the ankle and hip to the knee. The observed differences in joint biomechanics did not propagate to changes in maximal jump height, potentially due to the athletes not being able to properly translate energetic savings into jump performance. These findings suggest that performing stationary jumps in increased LBS footwear redistributes lower limb work but does not necessarily lead to changes in jump performance, regardless of arm movement.
The past decade has seen a proliferation of Advanced Footwear Technologies (AFT) that have been shown to significantly influence the metabolic cost of running. Highly resilient midsoles are just one characteristic defining AFT, although energy return in athletic footwear has been researched for decades. A theoretical framework is provided to support the claim that energy return from AFT (while perhaps 'small' in magnitude) still likely has a non-negligible influence on running economy. A necessary variable to this framework is an estimate of the energy return from benchtop testing. Energy return is not a material property but rather is a function of the testing demands imposed; thus, the test method (e.g. gravity-driven, displacement-controlled compression, and force-controlled compression) will dictate the interpretation of the test's results. The framework also considers gross efficiency - the ability of the human body in converting metabolic energy expenditure to meaningful external work output. Gross efficiency varies by activity, with cycling reaching values as high as 25%. While not an established metric, running mechanical power can be predicted from running metabolic power with an estimate of gross efficiency. Based on this calculation, the increase in energy return afforded by AFT may have a roughly comparable influence on running economy (similar to 1%-2%) to several other well-researched design attributes. This only becomes evident when considering energy return per step relative to mechanical running power rather than metabolic running power. As the quantification of energy return is a function of the demands imposed upon a specimen, the concept of experimentally controlling for energy return should be called into question.
Advanced footwear technology (AFT) includes a tall stack of compliant, resilient, low-density foam. Despite the unclear effect of stack height on running economy, advanced footwear commonly approaches the World Athletics 40 mm limit. Additionally, compliant and resilient foams may improve running economy by up to 2%, but studies isolating compliance and resilience are few. The goal of this study was therefore to examine the independent effects of altering these three principal determinates of footwear energy return on running economy, biomechanics, and perception. Twelve experienced male runners ran at a self-selected steady-state speed in four weight-matched footwear in randomised, mirrored order: a control AFT and experimental footwear with reduced compliance, resilience, or midsole stack height. Compared to the control AFT, reducing midsole compliance, which increased compression stiffness by 24.2%, significantly worsened running economy by 1.3%. This energetic change was accompanied by reduced stride length, vertical leg stiffness, peak vertical ground reaction force, peak propulsive force, vertical impulse, and peak knee extension, and greater duty factor and braking impulse. It was also perceived as more rigid, noticeable, firm, and high impact and less enjoyable and less comfortable. Reducing resilience by 11.4% or stack height by 10 mm both resulted in numerous biomechanical changes accompanied by non-significant changes in running economy. Reduced stack height also resulted in numerous perceptual differences, while reduced resilience did not. This study demonstrates that midsole compliance is a key determinant of running economy, biomechanics, and perception in AFT, while reductions in midsole resilience or stack height produce more limited effects.
Individual responses to different running shoes may offer a means of functionally grouping runners. Thus, the aim of this exploratory study was to explore whether changes in rearfoot eversion between running shoes with different motion control properties could be used to functionally group male runners and to explore the characteristics of each functional group. Fifty male participants ran at the same self-selected velocity, along a 20 m runway in standardised motion control and neutral/cushioned running shoes. Rearfoot motion was recorded using a 10-camera motion capture system. Functional groups were identified based upon changes in peak rearfoot eversion between footwear conditions. Positive responders displayed a reduction of >= 3 degrees, negative responders an increase of >= 3 degrees and non-responders changes within +/- 3 degrees when running in the motion control shoe. Eighteen participants were classified as positive, seven negative and 25 non-responders to the motion control running shoe. Exploration of participant characteristics, running velocity and rearfoot kinematics revealed that peak eversion in the neutral/cushioned running shoe and the change in peak eversion and eversion excursion between footwear conditions were significantly (p <= 0.021) different between responder groups. Positive responders displayed the greatest peak eversion in the neutral/cushioned running shoe and the largest reduction in both peak eversion and eversion excursion when running in the motion control shoe. In contrast, negative responders displayed the lowest peak eversion in the neutral/cushioned running shoe and smallest changes in eversion excursion in the motion control shoe. These findings highlight the feasibility of functionally grouping runners based upon their response to motion control running shoes and suggest that the magnitude of peak eversion influences responses to motion control running shoes.
Carbon fibre insoles (CFIs) may be a highly suitable option to augment ankle moment and improve walking performance in older adults. However, some footwear modifications have been implicated as possible contributors in detrimentally altering knee joint loading. Therefore, the purpose of the study was to determine the magnitude of differences in model-predicted knee joint loading in healthy older adults walking with three footwear conditions (i.e. standard walking shoes with and without 1.6-mm and 3.2-mm CFIs). Participants (n = 14) completed three, 2-minute walking trials (i.e. no insole, 1.6-mm CFIs, and 3.2-mm CFIs) on a dual-belt instrumented treadmill at self-selected overground walking speed. Marker trajectories and ground reaction forces were extracted from a single step occurring at the midpoint of the trial and used as inputs to a computational cost-optimisation algorithm (i.e. Concurrent Optimisation of Muscle Activation and Kinematics) to estimate medial and lateral tibiofemoral joint contact force magnitudes. A repeated-measures, functional linear model assessed within-subject differences in knee joint contact force profiles across conditions. Compared to standardised footwear alone, neither the 1.6-mm CFIs nor 3.2-mm CFIs significantly altered knee joint contact forces in the medial compartment of the tibiofemoral joint. Greater lateral compartment tibiofemoral joint contact force magnitudes were identified only for the 3.2-mm CFIs compared to the 1.6-mm CFIs in a small portion of late stance (81%-91% stance phase; maximum between-condition difference: +0.23 kN; d = 1.53). Altered knee joint forces may not be a substantial contraindication for older adults who seek to use CFIs to enhance walking performance.
Runners may select shoes based on marketing recommendations rather than scientific evidence. It remains unknown if education on the latest research can influence subjective appreciation of footwear and selection. Our aims were to identify how an evidence-based educational video influences how runners select shoes, and perceive shoe comfort, satisfaction, and performance over three months compared with a control video. Fifty-six uninjured runners looking for a new pair of running shoes completed this randomised controlled trial. Prior to purchasing new shoes for road running in speciality stores, runners were assigned to watch an educational video on (1) the latest research about the association between running shoes and injuries (intervention) or (2) the evolution of running demographics (control). Runners completed surveys about their newly purchased shoes in reference to their previous shoes at three time points: before first use, one-month post-purchase, and three-months post-purchase. Perceived shoe comfort, satisfaction, and performance were assessed using 100 mm visual analogue scales. Comfort and satisfaction were not significantly different between groups at any time points. The average perceived performance of new shoes (75.6 mm) was significantly greater than previous shoes (67.6 mm) before first use, but ratings returned to previous-shoe levels one month later in both groups. The intervention group reported the educational video influencing their purchase (55.4 mm) more so than the control group (21.8 mm). However, participants from both groups chose the same brand and model as previously worn over half of the time. The evidence-based educational video did not appear to influence overall perceived shoe comfort, satisfaction, or performance or shoe selection habits. Runners in both groups often chose similar shoes to the ones they previously used.
Footwear companies modify midsole stack height in running shoes, often aiming to either enhance performance or reduce the risk of injuries, such as patellofemoral pain. Despite changes in midsole characteristics, the incidence of running-related injuries remains high. Limited research has investigated the effects of minimal, traditional, and maximal footwear in the same study. Therefore, the purpose of this study was to compare patellofemoral kinetics and ankle, knee, and hip joint work between minimal, traditional, and maximal footwear during running. It was hypothesised that minimal shoes would reduce patellofemoral joint stress and knee negative work but increase ankle negative work compared to traditional and maximal shoes. Twenty-seven healthy runners completed five trials in each footwear condition, while an 8-camera motion capture system and two embedded force plates collected three-dimensional kinematic and kinetic data of the hip, knee, and ankle. Peak quadriceps force, patellofemoral joint reaction force, patellofemoral joint stress, and positive, negative, and net joint work were compared between footwear conditions using repeated measures ANOVAs (alpha = 0.05). Peak quadriceps force, patellofemoral joint reaction force and patellofemoral joint stress were significantly lower in the minimal shoe compared to the maximal and traditional shoes. Negative ankle work was significantly higher in the minimal shoe and significantly lower in the maximal shoe compared to the traditional shoe, while net ankle work was significantly lower in the minimal shoe compared to the maximal and traditional shoes. Negative knee work, positive knee work, and net knee work were significantly lower in the minimal shoe compared to the other two shoes. These findings suggest that midsole stack height can influence patellofemoral kinetics as well as joint work at the ankle and knee.
Existing evaluation for footwear comfort relies on subjective self-reported measures like questionnaires, while objective neurophysiological real-time indicators have not been established yet. Even though functional near-infrared spectroscopy (fNIRS) signals on the prefrontal cortex have been investigated during locomotion tasks, there is limited research on the effects of footwear comfort levels on brain response using fNIRS. This study aims to investigate the effect of two varying footwear comfort conditions (manipulated by shoe size) on prefrontal cortex activation while walking, and to determine whether it is possible to distinguish between more comfortable and less comfortable footwear through prefrontal cortex fNIRS measurements. Twenty-seven participants walked at a set speed of 5 km/h while wearing less and more comfortable footwear to elicit differences in their perceived comfort level. Their prefrontal cortex real-time activation was recorded by a 15-channel fNIRS device. Signals from 23 participants were analyzed, because four participants failed to distinguish the comfort differences between the two shoes. Statistical analyses were performed on averaged oxy-Hb and deoxy-Hb concentration changes of subdivided walking task phases to compare the two footwear comfort conditions. For the more comfortable condition, data showed significantly enhanced hemodynamic responses, reflected by increased oxy-Hb levels and/or decreased deoxy-Hb levels in channels 2, 3, 11, 12 and 14, which are located in the left and right dorsal prefrontal cortex (dlPFC) and the left frontopolar prefrontal cortex (FPC). In conclusion, comfort level of footwear may influence prefrontal cortex activation, as observed through fNIRS measurements. The present study implies the possibility to distinguish more (or less) comfortable footwear through prefrontal cortex hemodynamic analysis, which may provide a novel method for footwear comfort evaluation.
Slips and falls are a major cause of workplace injuries, often exacerbated by worn shoe outsoles. Tread wear leads to increased under-shoe fluid pressures and increased slip risk. Frustrated total internal reflection (FTIR) technology offers a cost-effective approach for assessing the slip risk for worn shoes. However, current FTIR-based image analysis methods are not fully automated, and existing fluid pressure models have not been applied to the complex geometries that form on actual worn shoes. This study aimed to advance the use of FTIR for assessing shoe slip risk by: (1) assessing the accuracy of a U-Net network (a convolution neural network) in automatically identifying contact regions from FTIR images, and (2) investigating the association between model-predicted fluid pressures of the identified worn regions and slip outcome, coefficient of friction (COF) and experimentally measured peak fluid pressures. Fifty-five participants wearing worn slip-resistant shoes completed walking trials, including unexpected exposure to a slippery surface. Experimental peak fluid pressures were recorded using an array of fluid pressure sensors embedded in the floor and slip outcome was determined from heel kinematics. The COF was measured with a mechanical slip testing device. The shoes from the participants were scanned with a FTIR device. The U-Net was able to predict contact regions that overlapped with the ground truth contact regions by 80%. Higher predicted peak fluid pressures were associated with higher experimentally measured peak fluid pressures (R2 = 0.22), lower COF values (R2 = 0.50), and increased slip risk (p = 0.007). In conclusion, this study demonstrates the feasibility of using FTIR technology combined with convolutional neural networks and hydrodynamic modelling to automate the evaluation of slip risk due to the shoe's worn condition.
