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The effects of habitual footwear use: Foot shape and function in native barefoot walkers

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The human foot was anatomically modern long before footwear was invented, and is adapted to barefoot walking on natural substrates. Understanding the biomechanics of habitually barefoot walkers can provide novel insights both for anthropologist and for applied scientists, yet the necessary data is virtually non-existent. To start assessing morphological and functional effects of the habitual use of footwear, we have studied a population of habitually barefoot walkers from India (n ¼ 70), and compared them with a habitually shod Indian control group (n ¼ 137) and a Western population (n ¼ 48). We focused on foot metrics and on the analysis of plantar pressure data, which was performed using a novel, pixel based method (Pataky and Goulermas 2008, Journal of Biomechanics, 41, 2136). Habitually shod Indians wore less often, and less constricting shoes than Western people. Yet, we found significant differences with their habitually barefoot peers, both in foot shape and in pressure distribution. Barefoot walkers had wider feet and more equally distributed peak pressures, i.e. the entire load carrying surface was contributing more uniformly than in habitually shod subjects, where regions of very high or very low peak pressures were more apparent. Western subjects differed strongly from both Indian populations (and most from barefoot Indians), by having relatively short and, especially, slender feet, with more focal and higher peak pressures at the heel, metatarsals and hallux. The evolutionary history of humans shows that barefoot walking is the biologically natural situation. The use of footwear remains necessary, especially on unnatural substrates, in athletics, and in some pathologies, but current data suggests that footwear that fails to respect natural foot shape and function will ultimately alter the morphology and the biomechanical behaviour of the foot.
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... Authors of prior studies raised concerns that habitual, cushioned footwear, shoe inserts, and orthotics, which often do not support the natural shape of the foot and impair flexibility, might lead to anatomical and functional changes and contribute to the weakness of the intrinsic foot muscles (IFM) [2][3][4][5][6], which is associated with orthopedic foot diseases (e.g., hallux valgus) [4,7,8]. Populations wearing minimalist shoes (MS), which are characterized by a light weight, flexible sole, no cushioning, and no motion control [9][10][11], show differences in foot statics, e.g., wider feet [12] and a decreased hallux angle [13,14]. ...
... This seems logical due to the altered strike pattern and shoe flexibility in MS compared to cushioned shoes. Nevertheless, prior studies also found no significant influence of MS on the static MLA parameters (i.e., Arch Height Index, navicular height, and navicular drop) [3,12]. According to these and our studies' findings, one could discuss if the IFM have the strength capacity to increase the height of a fully loaded MLA during static stance. ...
... Nevertheless, although the MLA does not seem to change when wearing MS, the literature suggests that wearing MS influences general foot posture and leads to fewer foot deformities. D'AoÛ t, Pataky [12] report that populations wearing MS show shorter and wider feet and a greater foot area. Further, the hallux angle decreases with the habitual use of MS [13,14]. ...
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Introduction Minimalist shoes (MS) are beneficial for foot health. The foot is a part of the posterior chain. It is suggested that interventions on the plantar foot sole also affect the upper segments of the body. This study aimed to investigate the local and remote effects along the posterior chain of four weeks of MS walking in recreationally active young adults. Methods 28 healthy participants (15 female, 13 male; 25.3 ± 5.3 years; 70.2 ± 11.9 kg; 175.0 ± 7.8 cm) were randomly assigned to a control- or intervention group. The intervention group undertook a four-week incremental MS walking program, which included 3,000 steps/day in the first week, increasing to 5,000 steps/day for the remaining three weeks. The control group walked in their preferred shoe (no MS). We assessed the following parameters in a laboratory at baseline [M1], after the four-week intervention [M2], and after a four-week wash-out period [M3]: Foot parameters (i.e., Foot Posture Index-6, Arch Rigidity Index), static single-leg stance balance, foot-, ankle-, and posterior chain range of motion, and muscle strength of the posterior chain. We fitted multiple hierarchically built mixed models to the data. Results In the MS group, the Foot Posture Index (b = -3.72, t(51) = -6.05, p < .001, [-4.94, 2.51]) and balance (b = -17.96, t(49) = -2.56, p = .01, [-31.54, 4.37]) significantly improved from M1 to M2, but not all other parameters (all p >.05). The improvements remained at M3 (Foot Posture Index: b = -1.71, t(51) = -2.73, p = .009, [-4,94,0.48]; balance: b = -15.97, t(49) = -2.25, p = .03, [-29.72, 2.21]). Discussion Walking in MS for four weeks might be advantageous for foot health of recreationally active young adults but no chronic remote effects should be expected.
... From a biomechanical perspective, footwear can constrict the foot's structure and function. During barefoot walking, pressure is transferred mainly to the front of the foot, thereby decreasing pressure on the heel [13,14]. Barefoot walking improves strength of the foot's intrinsic muscles, proprioception, and balance [5,14,15]. ...
... During barefoot walking, pressure is transferred mainly to the front of the foot, thereby decreasing pressure on the heel [13,14]. Barefoot walking improves strength of the foot's intrinsic muscles, proprioception, and balance [5,14,15]. To date, most studies reporting on barefoot activities have focused on the acute effects of barefoot running and walking [16]. ...
... The significant increases in PPTh and PPT observed in the BWG indicate that local tissue sensitivity in the heel was significantly reduced. This may be explained by the fact that the biomechanics of barefoot walking transfers force absorption to the front of the foot and decreases pressure on the heels [13,14]. Our 4-week walking program may have allowed the heel tissues sufficient time to recover and desensitize. ...
... However, with snakebite mortality consistently high year on year, few studies have explored affected communities' willingness to adopt prevention measures to inform snakebite prevention efficacy (Malhotra et al., 2021). For example, physical discomfort and deep-rooted cultural beliefs can reduce the adoption of protective clothing by at-risk communities (Ayode et al., 2013;D'Août et al., 2009), and financial limitations limit the scalability of other purchased prevention products (Wood et al., 2022). To reduce snakebites and facilitate snake conservation, it is crucially important to understand the drivers of effective snakebite prevention. ...
... Practicality, financial limitations, familiarity, physical comfort, social pressure, and cultural beliefs are all key barriers reported for specific prevention measures. This is especially true for the implementation of protective clothing (boots/gloves), while commonly recommended for use within snakebite literature (Malhotra et al., 2021), where our findings show these measures carried the greatest number of barriers for implementation and reinforce the negative influence of physical discomfort alongside impracticality for future adoption (Ayode et al., 2013;D'Août et al., 2009). It is possible that such barriers are use-case specific, and it will be important to consider these factors in relation to the nature of local agricultural practice employed by affected communities as dry ground conditions may improve adoption feasibility. ...
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Negative interactions between humans and venomous snakes are increasing, with the World Health Organization committed to halving snakebite deaths and disabilities by 2030. Evidence‐based strategies are thus urgently required to reduce snakebite events in high‐risk areas, while promoting snake conservation. Understanding the factors that drive the adoption of snakebite prevention measures is critical for the effective implementation of snakebite management strategies. We conducted in‐person questionnaires ( n = 535 respondents) with rural agricultural communities within the Thiruvarur District of Tamil Nadu, India, a national snakebite hotspot. Using a health belief model framework, we explored current snakebite prevention measures and factors impacting their adoption. The majority of respondents reported using multiple snakebite prevention measures. Perceived self‐efficacy and perceived risk frequency of snakebites were important overall predictors of future adoption, whereas education, gender, relative wealth, and current adoption were important for specific measures. Achieving international commitments to support human–snake coexistence will require collective and collaborative action (e.g., governments, donor agencies, civil society organizations, researchers, and communities) underpinned by behavioural insights and context‐specific solutions.
... Additionally, variation in MLA height is also assumed to be related to footwear, lifestyles and subsistence strategies. For example, most barefoot hunter-gatherers show wider and flatter feet compared to shod populations 29,30 . However, conflicting evidence exists regarding an increased foot width in barefoot populations, and only a few studies have controlled for confounding variables (e.g., sex, ethnicity, BMI) 31,32 . ...
... Indeed, it has been demonstrated that most barefoot hunter-gatherers display wider and flatter foot strikes with respect to shod populations. This condition likely helps the foot conform to irregular natural surfaces (such as an unbroken forest floor) and promotes more tactile environmental stimuli, contributing to maintaining foot stability during substrate contacts 29,30,51 . Likely, foot joint kinematics and morphological foot features of unshod or minimally shod hunter-gatherers are more representative of the biomechanical circumstances in which the H. sapiens foot evolved compared to H. sapiens in modern industrialised societies, and in this sense, the similarity the former share with the congenital flexible flatfoot group is especially intriguing. ...
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The evolution of the medial longitudinal arch (MLA) is one of the most impactful adaptations in the hominin foot that emerged with bipedalism. When and how it evolved in the human lineage is still unresolved. Complicating the issue, clinical definitions of flatfoot in living Homo sapiens have not reached a consensus. Here we digitally investigate the navicular morphology of H. sapiens (living, archaeological, and fossil), great apes, and fossil hominins and its correlation with the MLA. A distinctive navicular shape characterises living H. sapiens with adult acquired flexible flatfoot, while the congenital flexible flatfoot exhibits a ‘normal’ navicular shape. All H. sapiens groups differentiate from great apes independently from variations in the MLA, likely because of bipedalism. Most australopith, H. naledi, and H. floresiensis navicular shapes are closer to those of great apes, which is inconsistent with a human-like MLA and instead might suggest a certain degree of arboreality. Navicular shape of OH 8 and fossil H. sapiens falls within the normal living H. sapiens spectrum of variation of the MLA (including congenital flexible flatfoot and individuals with a well-developed MLA). At the same time, H. neanderthalensis seem to be characterised by a different expression of the MLA.
... Vários estudos transversais avaliaram o efeito de viver habitualmente descalço na postura e na mecânica do pé e há um consenso de que indivíduos habitualmente descalços têm pés mais fortes e menos deformidades 11,12 . A diferença mais evidente é a região do antepé mais larga para indivíduos que habitualmente andam descalços 13 , e um arco longitudinal medial (ALM) mais alto para pés habitualmente descalços em crianças 11 , além de serem mais flexíveis 14 . ...
... Porém, o uso de calçados continua necessário, especialmente em solos não naturais, dessa forma, quando o terreno não permitir a locomoção com os pés descalços, deve-se optar por modelos que protejam os pés de lesões, mas que seja irrestrito, permitindo que o pé funcione tanto quanto na condição descalça 13 . Isso pode explicar uma menor porcentagem de indivíduos que tem como preferência o sapato como modelo mais utilizado no grupo GPE possivelmente para minimizar a dor e assim direcionar para uma reflexão sobre o a escolha do tipo/modelo de calçado apropriado para garantir a saúde dos pés. ...
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O objetivo deste estudo foi avaliar o perfil funcional, características do pé, o hábito de andar descalço de indivíduos com alterações musculoesqueléticas nos pés e comparar com indivíduos controle. Os participantes foram avaliados por meio de questionário eletrônico. Dados antropométricos, funcionalidade dos pés, hábito de andar descalço, tipo de calçado, tipo de pé e pisada e qual comprometimento do pé foram coletados. A amostra total foi composta por 160 indivíduos divididos em grupo controle (GC) (n=82) e grupo problemas no pé (GPE) (n=78). O hálux valgo foi o principal tipo de problema no grupo GPE (24,4%), com uma maior porcentagem de participantes com doença crônica (35,9%), tipos de pés cavos (pé esquerdo (PE) 16,7% e pé direito (PD) 19,2%) ou planos (PE 21,8% e PD 21,8%) e com o Índice de função do pé comprometido em 7% (P =0,001). Ambos os grupos consideram o hábito de andar descalço saudável (72% GC e 66,7% GPE), porém não são adeptos deste hábito (93,9% GC e 91% GPE). O sapato foi o modelo menos utilizado pelo GPE (10,3%). Concluímos que indivíduos do grupo GPE apresentaram maior associação de alterações morfofuncionais com a presença de distúrbios nos pés e que o hábito de andar descalço apesar de ser considerado um aspecto positivo para a saúde dos pés de ambos os grupos, nenhum destes o praticam.
... Vários estudos transversais avaliaram o efeito de viver habitualmente descalço na postura e na mecânica do pé e há um consenso de que indivíduos habitualmente descalços têm pés mais fortes e menos deformidades 11,12 . A diferença mais evidente é a região do antepé mais larga para indivíduos que habitualmente andam descalços 13 , e um arco longitudinal medial (ALM) mais alto para pés habitualmente descalços em crianças 11 , além de serem mais flexíveis 14 . ...
... Porém, o uso de calçados continua necessário, especialmente em solos não naturais, dessa forma, quando o terreno não permitir a locomoção com os pés descalços, deve-se optar por modelos que protejam os pés de lesões, mas que seja irrestrito, permitindo que o pé funcione tanto quanto na condição descalça 13 . Isso pode explicar uma menor porcentagem de indivíduos que tem como preferência o sapato como modelo mais utilizado no grupo GPE possivelmente para minimizar a dor e assim direcionar para uma reflexão sobre o a escolha do tipo/modelo de calçado apropriado para garantir a saúde dos pés. ...
Article
Full-text available
O objetivo deste estudo foi avaliar o perfil funcional, características do pé, o hábito de andar descalço de indivíduos com alterações musculoesqueléticas nos pés e comparar com indivíduos controle. Os participantes foram avaliados por meio de questionário eletrônico. Dados antropométricos, funcionalidade dos pés, hábito de andar descalço, tipo de calçado, tipo de pé e pisada e qual comprometimento do pé foram coletados. A amostra total foi composta por 160 indivíduos divididos em grupo controle (GC) (n=82) e grupo problemas no pé (GPE) (n=78). O hálux valgo foi o principal tipo de problema no grupo GPE (24,4%), com uma maior porcentagem de participantes com doença crônica (35,9%), tipos de pés cavos (pé esquerdo (PE) 16,7% e pé direito (PD) 19,2%) ou planos (PE 21,8% e PD 21,8%) e com o Índice de função do pé comprometido em 7% (P =0,001). Ambos os grupos consideram o hábito de andar descalço saudável (72% GC e 66,7% GPE), porém não são adeptos deste hábito (93,9% GC e 91% GPE). O sapato foi o modelo menos utilizado pelo GPE (10,3%). Concluímos que indivíduos do grupo GPE apresentaram maior associação de alterações morfofuncionais com a presença de distúrbios nos pés e que o hábito de andar descalço apesar de ser considerado um aspecto positivo para a saúde dos pés de ambos os grupos, nenhum destes o praticam.
... Therefore, our findings along with others on the biomechanics of walking among African women (Maloiy et al., 1986), Nepalese porters (Bastien et al., 2005) and members of populations who walk and run with bare feet (D'Aout et al., 2009;Hatala et al., 2013) highlight the need to investigate the nonmechanised populations in order to obtain a broader understanding of human variety. Populations living in natural settings are more appropriate for paleoanthropological studies than urban cases, because of their life conditions in terms of feeding habits (substantial amounts of dairy products), high levels of physical activity and minimum use of mechanised tools in their daily tasks. ...
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Infant carrying and more generally load carrying may impact bipedal locomotion and thus the energy cost of the daily activities, in living people but also in our ancestors. In order to improve our knowledge of infant carrying strategies we investigate the biomechanics of infant carrying in a non-mechanised group. The Qashqai are nomadic people who still carry loads and infants habitually without any daily assistance in varied natural environments. Our analysis focuses on the sagittal kinematics using a high-speed camera (joint angles, speed, position of the centre of mass) and kinetics (ground reaction forces and displacement of the centre of mass) using a six-degree of freedom force plate. We assessed the unloaded and loaded (infant) walking of 26 Qashqai women, living in the Fars province (Iran). The results demonstrate that different mechanisms of walking exist that are related to the mode of carrying and the weight of the infant, by which step length, walking speed and the lower limb angles are not affected. The displacement of the total centre of mass remains unchanged. This supports the hypothesis that the Qashqai have developed mechanisms of load carrying that limit the increase in energy consumption. This could be related to the usual high level of daily activity.
... This concept is particularly relevant to military boots, which impose significant restrictions on both the sole and the upper part of the boot. These restrictions likely profoundly impact on the foot structure of military personnel [36,37]. ...
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Foot structure can be influenced by various factors, such as footwear, body weight and physical activity. A change in foot structure can alter shock absorption and force transition. The main objective of this study is to investigate the effect of the long-term use of military boots on foot shape parameters. Thirty military and thirty non-military subjects participated in this case-control study. All participants had been regularly wearing military boots for the past 12 years. After introducing the experiment, static and dynamic footprints were recorded via paper and ink while standing and walking. The footprints were analysed using ImageJ software to extract foot width indices, area indices, truncated arch index, footprint index and arch angle index. The findings indicated no significant difference in comparison static and dynamic variables in the military and non-military groups (p ≥ 0.05). However, there was a significant difference between the two groups in both static (midfoot area, arch index (AI), truncated arch index, footprint index and arch angle index) and dynamic (midfoot width, Staheli Index (SAI), truncated arch index and arch angle index) conditions, when static and dynamic variable were compared (p < 0.05). Findings revealed the military personnel have low arch, making them susceptible to musculoskeletal disorders. To mitigate this risk, it is recommended that military boots be reassessed or that insoles be used. Furthermore, it is suggested that military boots be limited to specific activities and fewer hours of usage to avoid potential health issues.
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Background The adduction of the first pedal ray in humans, such that the hallux is incapable of functional opposability, is a major feature of the evolution of the hominin foot (e.g. Darwin 1872, Haeckel 1879, Latimer and Lovejoy 1990). While hallucal adduction facilitates obligate bipedalism, it inhibits but does not eliminate arboreal grasping ability. The angle of the hallux (as determined by the longitudinal axis of the first metatarsal) relative to the rest of the foot (as determined by the longitudinal axis of the second metatarsal) is a product of both hard-and soft-tissues. Given the failure of soft tissue to fossilize, direct evidence for hallucal angle evolution is scanty, and consensus has not emerged as to when and how the modern human condition of hallucal non-opposability evolved. Methodology/Principal Findings Analysis of a large sample (n = 331) of radiographs taken from the dorsal aspect of living human feet elucidates the relationship between osteological measures and the magnitude of hallucal adduction, which is resultant of both hard-and soft-tissue anatomy (Lovejoy et al. 2009). I describe the correlation of hallucal convergence with first metatarsal posterior articular facet morphology, which allows inference of hallucal convergence in the absence of the medial cuneiform. I report parameters of modern human hallucal convergence variation and offer insight into the hominin fossil record. I infer that the hallucal convergence of the recently reported specimen from Burtele (BRT-VP-2/73) falls within the range of living human variation, inconsistent with the interpretation that this hominin retained the ability to oppose its great toe for the purpose of arboreal locomotion (Haile-Selassie et al . 2012). Of the fossil hominin first metatarsals surveyed, all fall within the range of living human variation, consistent with previous research on medial cuneiform (McHenry and Jones 2006) and first metatarsal (Berillon 1999) morphology. Conclusions/Significance This study finds that the modern human condition of hallucal non-opposability was present in the genus Australopithecus . However, while the Burtele specimen (BRT-VP-2/73) falls within the range of living human variation, it displays a markedly divergent hallux compared to most living humans. This study suggests that, as in humans today, there was variation in hallucal divergence in Plio-Pleistocene hominins. Rather than using the terms ‘opposability’ and the ambiguously synonymous ‘grasping,’ I suggest here the term ‘clamping’ (as in the motion performed by a clamp) be used to describe the less powerful and less dexterous ability of modern humans to place and hold a thin, narrow object between the great toe and second toe ray in a limited, albeit functional, manner.
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Loading variables were compared for 35 elderly (71–90 years) and 35 young adult (aged 18–24) participants. Plantar pressures were measured at 70 Hz with a capacitive platform with a resolution of two sensors per square centimetre. Subjects were required to walk barefoot at their ‘preferred’ gait speed down a 15-m walkway. Gait speed was determined via a photoelectric timing system. Five right foot pressure trials were gathered and stored. During analysis seven plantar regions were identified: one heel, one midfoot, three forefoot (medial, central, and lateral), and two toe (medial toe or hallux and lesser toes). Averages were generated for each loading variable respective to each plantar region. Gait speed was significantly slower for the elderly than the young adults. Thus, gait speed was used as a covariate in a multivariate analysis of covariance (MANCOVA) to detect differences between the young adults and the elderly. Similar loading characteristics were found in the heel region of the foot. For the young adults, greater plantar loading occurred across the midfoot region. There was a difference in the loading rate across the medial forefoot region for the elderly and no differences in force or peak pressures. The medial forefoot region exhibited greatest peak pressure for the elderly. No differences were found between groups in the central forefoot. The elderly exhibited a greater contact area and less contact time. For the elderly, less force was produced relative to the medial toe region. No differences between the loading characteristics of the lateral toe region between the two groups were exhibited.