Figure - uploaded by Nachiappan Chockalingam
Content may be subject to copyright.
Three toe box shapes, (A) round, (B) square and (C) pointed. All shoes were a slip on flat pump. The volume of each shoe was measured using the indicated shoe width and upper for definition of toe box, highlighted by white arrows. The table indicates the volume (cm3), width and depth (cm) of the toe box for each shoe size tested.

Three toe box shapes, (A) round, (B) square and (C) pointed. All shoes were a slip on flat pump. The volume of each shoe was measured using the indicated shoe width and upper for definition of toe box, highlighted by white arrows. The table indicates the volume (cm3), width and depth (cm) of the toe box for each shoe size tested.

Source publication
Article
Full-text available
Ill-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort. Studies on footwear have primarily examined sports or orthopaedic prescription shoes and little is known about the effects that everyday flat shoes have on the forefoot. The aim of this study was to investigate the effect of toe box shape in...

Contexts in source publication

Context 1
... types of foot- wear were used within this study. The key difference in the 3 footwear styles tested was the shape and dimen- sions of the toe box: square, round and pointed toe (Figure 1). Colour and design were controlled by includ- ing black ballet pumps with an accessory feature on the toe box. ...
Context 2
... thickness and mater- ial were assessed and closely matched, however differences in sole material were present. The volume of each shoe's toe box was measured by calculating the average quantity of fine sand that filled the shoe to a level where the toe box upper finished (Figure 1). ...
Context 3
... volume for each shoe tested varied between style and size ( Figure 1). The round shoe shape had the least volume in the toe box across all sizes and the square toed shoe had the highest volume except in size 5. ...

Similar publications

Preprint
Full-text available
In an attempt to improve their distance-running performance, many athletes race with carbon fiber plates embedded in their shoe soles. Accordingly, we sought to establish whether, and if so how, adding carbon fiber plates to shoes soles reduces athlete aerobic energy expenditure during running (improves running economy). We tested 15 athletes durin...
Article
Full-text available
Background and Study Aim. In the early years when sports footwear became compulsory, the importance of shoe design was not considered in terms of athletes’ health. Since the early years of wrestling shoe use, these gears have been manufactured according to the rules of competition, and modifications have been very limited. In this regard, this stud...
Conference Paper
Full-text available
This paper describes a computer assisted interview for children and vulnerable adults. The system implements a “triadic interview” interaction since it is used as a focus point between the child and the clinician, whose dialogue is mediated by the tool. The tool helps children express their feelings and experiences, by making use of an “emotion pal...
Article
Full-text available
RUNNING BAREFOOT OR IN MINIMALIST FOOTWEAR HAS BECOME A POPULAR TREND. WHETHER THIS TREND IS SUPPORTED BY EVIDENCE OR CONJECTURE HAS YET TO BE DETERMINED. THIS ARTICLE WILL REVIEW THE BIOMECHANICAL DIFFERENCES BETWEEN RUNNING BAREFOOT AND IN SHOES THAT HAVE BEEN IDENTIFIED IN THE LITERATURE. IT WILL ALSO PROVIDE AN EVIDENCE-BASED PREPARATORY EXERCI...
Article
Full-text available
The objective of this study was to analyze the differences in foot measurements of Ecuadorian children according to their geographical location of residence, taking into account climatic differences (1). A total of 1662 children (2) participated in the study. Three groups were established: coast, mountains and amazonia. The type of footwear (3) use...

Citations

... As jogging often lasts longer than running, it also may produce some overuse injuries, such as plantar fasciitis, metatarsal stress fracture, and Achilles tendinitis [19]. Regrettably, only a few researchers studied jogging just for optimizing footwear [19,20] or describing mechanics of lower extremities and lumbar spine [21,22]. While jogging styles have not yet been compared for optimizing foot strike patterns until now. ...
Article
Full-text available
Background and Aim. In order to reduce foot and ankle injuries induced by jogging, two-foot strike patterns, rearfoot strike (RFS), and forefoot strike (FFS), were adopted and compared. First, RFS jogging and FFS jogging were experimentally studied, so as to acquire kinematic and kinetic data, including foot strike angle, knee flexion angle, and ground reaction force (GRF). Then, a 3D finite element model of foot–ankle complex was reconstructed from the scanned 2D-stacked images. Biomechanical characteristics, including plantar pressure, stress of metatarsals, midfoot bone, calcaneus and cartilage, and tensile force of plantar fascia and ligaments, were obtained. The results showed that RFS jogging and FFS jogging had a similar change trend and a close peak value of GRF. Since possessing more momentum in the push stage and less momentum in the brake stage, FFS jogging could be in favor of a higher jogging speed. However, FFS jogging produced larger metatarsal stress in the 5th metatarsal and much larger tensile force of plantar fascia, which might cause metatarsal fracture and heel pain. While RFS jogging produced larger plantar pressure in the hindfoot area, larger calcaneus stress, and much larger tarsal navicular stress, which might cause heel tissue injury, calcaneus damage, and stress fracture of naviculocuneiform joint. In addition, talocrural and talocalcaneal joint cartilage could bear jogging loads, as the peak contact pressure were both small in RFS jogging and FFS jogging. Therefore, jogging with rearfoot or FFS pattern should be chosen according to the health condition of foot–ankle parts.
... In some cases, footwear assessment can be subjective and focus purely on the style rather than the suitability of the footwear [5]. Body image plays an important role in footwear choice [11] and should be included in the evaluation of footwear along with establishing a partnership between clinician and patient [12]. However, developing a reliable clinical record of footwear utilised by a patient remains challenging due to the complexity of previous tools and their relevance to clinical practice. ...
... Having catalogues to demonstrate suitable footwear was disregarded at the final round of consensus as there was disagreement around the interpretation of an individual's style preference (Theme 2.1). This component of footwear advice and choice is however thought to play a role in habits of selection and image should be discussed when discussing footwear [11]. The raters were able to identify footwear style with a high level of reliability observed. ...
Article
Full-text available
Footwear has been documented as a significant factor in the aetiology of foot pain in the general population. Assessing footwear in a clinical setting continues to be practitioner specific and there is limited guidance to direct advice. Health professionals must have access to clinically appropriate and reliable footwear assessment tools to educate patients on healthier footwear choices. The primary aim of this study was to critique what elements should be in a footwear assessment tool with a secondary aim of testing the agreed tool for validity. A combined Nominal Group Technique and then a Delphi technique from purposively sampled experts of foot health professions were employed to critique elements of footwear assessment. The agreed tool was then tested by practising podiatrists on 5 different shoes to assess the validity and reliability of the measures. Twelve test evaluation criteria were identified receiving significant ratings to form the final footwear assessment tool consisting of five footwear themes. Application of the tool in a clinical setting validated the themes of footwear characteristics, footwear structure, motion control and wear patterns. However, the assessment of footwear fit was not reliable. The footwear tool was refined based on the collective consensus achieved from the rounds creating a more clinically appropriate tool. The validity of this tool was assessed as high in some of the themes but for those that were lower, a training need was identified.
... Females in the shod group have significantly larger HVA than males (Barnicot and Hardy 1955;Kouchi 1998). Shoe toe box shape (Branthwaite, Chockalingam, and Greenhalgh 2013), opened-toed vs. closed-toed shoes (Martin-Casado et al. 2021), and shoe fitting (McRitchie, Branthwaite, and Chockalingam 2018) are essential factors influencing the increase of HVA. Women wearing shoes with a narrow toe box between the ages of 20 and 39 are more likely to undergo hallux valgus in later life (Menz et al. 2016). ...
Article
Full-text available
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.
... However, recent studies indicate that no genetic inheritance exists as such but that shared environmental factors determine the development of a HV [7]. Some authors suggest that the use of constrictive footwear produces pressure on the medial aspect of the hallux and can lead to both reactive bone formations at that level (exostosis of DP), and valgus deviations of the first toe [3,[8][9][10][11][12][13][14][15]. ...
Article
Full-text available
Purpose A question still remains as to whether constrictive toe-box shoes (TBS) cause disability only due to pain on pressure points or if they can cause permanent changes in the hallux anatomy. The aim of this study is to compare the hallux morphology in 3 groups classified according to their use of constrictive or open TBS. Methods 424 patients were classified into 3 groups: group A used open TBS daily; group B used constrictive TBS daily; group C used both open and constrictive TBS. Hallux’s angles, presence of exostoses and shape of the distal phalanx (DP) were analyzed on dorsoplantar weight-bearing radiographs and compared amongst groups. Results The intermetatarsal (IMA), metatarsophalangeal (MTPA), DASA, PASA, interphalangeal (IPA), obliquity (AP1), asymmetry (AP2) and joint deviation (JDA) angles for group A were 10°, 8°, 5°, 4°, 9°, 3°, 5°, 3°; for group B were 9°, 19°, 5°, 6°, 12°, 2°, 8°, 2°; and for group C were 10°, 10°, 4°, 4°, 12°, 3°, 8°, 1°. Only the differences in the MTPA, IPA and AP2 were statistically significant (p < 0.05). The prevalence of exostoses on the tibial side of the DP was 22, 36, and 29% in groups A, B and C, respectively (p < 0.05). We found similar distributions of the different DP shapes in the three groups. Conclusions Our results suggest that the use of constrictive TBS, even if used only occasionally, could change hallux anatomy from a young age increasing MTPA, IPA and AP2. Moreover, we have found that DP exostoses are present as a “normal variation” in patients who wear an open TBS, but their prevalence is higher in those wearing constrictive toe-box shoes. This could be due to a reactive bone formation secondary to the friction caused by the inner border of the shoe. Level of clinical evidence 3.
... This is especially true of women, who should decide to change their past habits when they wore high-heeled shoes with narrow toes [16,17]. In order to neutralize the effects of progressive involutional changes and maintain the optimal-in relation to age-level of quality of life and functional fitness, the younger-old should be guided by functionality and comfort instead of fashion or aesthetic considerations in the decision to choose footwear [18][19][20][21][22]. ...
Article
Full-text available
Objective: The present study aimed to analyze the relationships between the perceptions of footwear comfort with fear of falls in younger-old women and men. Participants: the population sample involved 100 free-living community dwellers aged 65-74. Design: the Falls Efficacy Scale-International and a visual analogue scale to assess perception of footwear comfort were used as research tools. Results: there were statistically significant differences in the FES-I results in people who suffered a fall in the last year compared to those who did not experience a fall (p < 0.001), as well as in the subjective assessment of mediolateral control in people who have suffered and have not suffered a fall in the last year (p = 0.033). In women, statistically significant relationships were found in the subjective assessment of shoe comfort in terms of arch height (p = 0.025) and material properties of the footwear (p = 0.036) with the results of FES-I. Conclusions: People who have fallen show a higher level of fear of falling. The assessment of footwear comfort in terms of mediolateral control was lower in the younger-old who had experienced a fall in the last year. In women, a worse assessment of arch height and material properties of the footwear is accompanied by greater fear of falling.
... The narrowed sole likely increased mediolateral constraint on the calcaneus, and the pointed toe likely increased mediolateral constraint on the forefoot as well as potentially compressed the foot anteroposteriorly. Modern studies of the effects of footwear type on plantar pressure have found that pointed Tarsal metric trends over the Medieval-Post-Medieval transition toes were associated with higher peak pressures at the medial heel compared to round and square toes (Branthwaite et al. 2013). High status individuals can compromise their podiatric health and mobility for the sake of footwear fashions and the resulting social capital they accrue by participating (Riello 2006). ...
Article
Full-text available
The Medieval-Post-Medieval transition in England was an important shift in the human biocultural environment. With urbanization and industrialization came resultant changes in living and working conditions and subsequent effects on the skeleton. In addition, the Post-Medieval period ushered in changes in footwear and activity patterns, with potential consequences on foot bone morphology. The objective of this study is to compare calcaneal and talar lengths between the Medieval and Post-Medieval periods to determine whether there are quantifiable differences that correspond to shifting footwear and activity patterns. T-tests and ANCOVAs (and their non-parametric equivalents) were used to compare calcaneal and talar lengths of 1086 adults from 14 London cemeteries (Medieval n = 8, Post-Medieval n = 6), available in the Oracle Wellcome Osteological Research Database (WORD) curated by the Museum of London. Males and females were also analyzed separately. In the total sample, tali and calcanei are longer in the Medieval period (p < 0.001 for both tarsals). When males and females are analyzed separately, male talar length is greater in the Post-Medieval period (p < 0.001). The difference in talar length between periods is not statistically significant for females (p = 0.093). These differences in talar and calcaneal lengths between periods likely reflect differences in footwear between the Medieval and Post-Medieval periods. The magnitude of these differences varies according to sex, indicating that the change in footwear had differential impacts on men and women. Together, these results suggest that Medieval and Post-Medieval tarsals physically incorporated their respective cultural environments and gendered differences in cultural practice, particularly related to the footwear characteristic of each period.
... The hallux valgus angle (HVA), also called first metatarsophalangeal angle, first toe angle, or toe #1 angle, is the most significantly different measurement between habitually shod and barefoot population [1]. Shoe toe box shape [2], opened-toed versus closed-toed shoes [3] and shoe fitting [4] are essential factors influencing HVA to increase. Hallux valgus angle is related to plantar pressure during walking and running [1]. ...
Preprint
Full-text available
Background The forefoot is the foot most affected part by ill-fitting shoes. Footwear fitting standards have the measurements of length, width and arch length. Toe shape has not yet been used in footwear measurement. This study aims at investigating the variation in toe shape, as measured by the hallux valgus angle. Methods 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, it can detect the medial contour along the proximal phalanx even in extreme cases. Results The hallux valgus angle has a normal distribution with long tails on both sides in the general population. In the three regions (North America, Europe, Asia), the mean and standard deviation of this angle are 9° ± 6°, 8 ° ± 6°, 12° ± 6° for males and 11 ° ± 7°, 12 ° ± 7°, 16° ± 7° for females. Conclusions The hallux valgus angle has a broad distribution in the general population. Females have larger hallux valgus angle than males, and people from Asia have larger hallux valgus angle than people from North America and Europe.
... The purchase of footwear cannot be guided solely by aesthetic considerations. The basic features that lead to a decision about purchase should include its functionality and prophylaxis and health-promoting properties (Branthwaite, Chockalingam & Greenhalgh, 2013;Menz et al., 2015;López-López et al., 2016;Hurst et al., 2017). During this period, it is important to neutralize the effects of progressive involution changes in order to ensure the comfort and quality of life, as well as to maintain optimal functional fitness for the next stages of old age. ...
Article
Full-text available
Background Adequate footwear comfort and functionality are important regardless of age, but they become particularly important in the youngest-old women and men, mainly due to the fact that this age range is the initial period of old age with changes in shoe preferences. The aim of this study was to assess the perception of footwear comfort and its relationship with the feet structure in youngest-old women and men. Methods The cross-sectional study covered community dwellers living on their own aged 65–74 years (50 women; 50 men). The feet characteristics were measured using the CQ-ST podoscope (Electronic System, Ltd, EU), and the perception of footwear comfort was assessed with a visual analogue scale. The assessment took into account gender-specific footwear of a certain brand (Befado Dr orto). Results Statistically significant intergender differences were observed in the perception of footwear comfort with respect to the shoe heel width ( p = 0.022), the arch height ( p = 0.013), the overall comfort ( p = 0.049) and the material properties of the footwear ( p = 0.017). In women, there were statistically significant positive relationships among the heel angle ( γ ) and the perception of footwear comfort in terms of heel cushioning ( p = 0.021), forefoot cushioning ( p = 0.015), arch height ( p = 0.029). In men, there was a statistically significant negative relationship of the left foot Clarke’s angle with the heel height ( p = 0.043), and a positive relationship between the right foot width and the arch height ( p = 0.044). Conclusions Youngest-old women, compared to men of the same age range, have a higher perception of shoe comfort in terms of the shoe heel width, the arch height, the overall comfort of the footwear and the material properties of the footwear. The appropriate profile and construction of the shoe allows for an increase in the contact surface of the foot with the shoe, hence the improvement in the perception of footwear comfort in people with lowered arch or widened forefoot.
... In recent literature, toe box design and shape have also attracted further research attention. For example, Branthwaite et al. (2013) investigated the effect of toe box shape on plantar and interdigital pressure in healthy females. Their findings suggested that the toe box shape of shoe should be rounded on the medial border and pointed styling on the lateral border to minimise pressure in the digital area (Branthwaite et al., 2013), although this type of toe box shaping may require new last design. ...
... For example, Branthwaite et al. (2013) investigated the effect of toe box shape on plantar and interdigital pressure in healthy females. Their findings suggested that the toe box shape of shoe should be rounded on the medial border and pointed styling on the lateral border to minimise pressure in the digital area (Branthwaite et al., 2013), although this type of toe box shaping may require new last design. In addition, given that the participants in their study were healthy individuals without foot deformities, achieving the same results could not be guaranteed in patients with structural foot deformities. ...
... However, further research is warranted to determine the most appropriate footwear style and design characteristics. Accordingly, the present study aimed to compare the effectiveness of the two footwear designs recommended in the previous literature (Branthwaite et al., 2013;Hurst et al., 2017), namely shoes with round toe box and shoes with highly compliant upper, on dorsal and interdigital pressure. Since people with HAV often have difficulty finding comfortable footwear, our study included a sample of people with moderate to severe HAV. ...
Article
Although shoes act as a protective covering for the feet, they can be an important source of pain and foot disorder if not properly fitted. The purpose of this study was to investigate the effect of a shoe with highly compliant upper on the dorsal digital and interdigital pressure in comparison with shoes with a rounded toe box and participant’s own shoes in patients with Hallux Abducto Valgus (HAV) deformity. Eighteen participants with moderate to severe HAV were recruited. The patients’ perceived comfort and interdigital forefoot pressure were measured using force sensitive resistance sensors while wearing shoes with a round toe box and shoes with stretchable fabric upper and were compared to when the participants were wearing their own preferred shoes. Shoes with stretchable fabric upper significantly reduced the dorsal digital and interdigital pressure and increased perceived comfort. The results of the present study showed the superiority of shoes with stretchable fabric upper in reducing the pressure on the forefoot and the overall comfort compared to shoes with a round toe box and participant’s own shoes in people with HAV. It, therefore, seems that shoes with stretchable fabric upper can be recommended to ameliorate the treatment outcome in people with HAV.
... Wearing tight footwear in the middle age is more likely to develop the bunion foot deformity later in life. Another interesting study reported that shoes with pointed shape developed pressure on the lateral aspect of the toes and a round toe box shoes created pressure on the medial aspects of the toes (Branthwaite et al., 2013). Therefore, many factors that need to be considered to avoid the footrelated pain or other foot pathological deformities, especially for diabetic patients. ...
Chapter
This chapter mainly focuses on common orthopedic problems in ankle and foot. The human foot is composed of bones, joints, muscles, tendons, ligaments, and other soft tissues that help us to stand, support the body's weight, and perform activities like walking, running, and jumping. There are various types of foot deformities, such as hallux valgus, hallux varus, pes cavus, pes planus, hallux rigidus, hammertoe, claw toe, mallet toe, plantar fasciitis, metatarsalgia, foot arthritis, congenital clubfoot, metatarsus adductus, and diabetic foot, that affect children, adults, and elderly population. These foot deformities limit the functions of their daily activities due to pain, discomfort, recurrent injuries, limited range of motion of the foot, or impairment and disability. Footwear play a crucial role in protecting the foot and ankle from mechanical injuries, high-level temperature, and extremely cold weather, however, the deformation of the foot caused by footwear is considered the most important causative risk factor for developing several types of foot pathology. Wearing inappropriately sized footwear causes pain in the foot and ankle, discomfort, corns and calluses formation, ulcer formation, and other foot deformities. Furthermore, footwear modifications have been prescribed as a conservative method to correct foot deformities. Although orthopedic physicians or podiatrists have been deciding the conservative treatment method, footwear designer must understand the knowledge of different foot types and foot deformities for designing appropriate footwear. In this chapter, we provide different types of common orthopedic problems in ankle and foot, causes, prevalence, and management techniques. With this knowledge, sensible and informed decisions can be made while selecting appropriate footwear or designing the footwear.