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Background: In recent years, minimalist footwear has been increasingly promoted for its use in sportive and recreational activities. These shoes are considered to function naturally like barefoot walking while providing a protective surface. Despite a growing popularity of these shoes in the older population, little is known about the influence of minimalist footwear on gait patterns. This study investigated whether overground walking with minimalist shoes is comparable to barefoot walking regarding gait stability and variability parameters. Methods: In a randomized within-subject study design, 31 healthy younger (29 ± 4 years) and 33 healthy community-dwelling older adults (71 ± 4 years) volunteered. Participants walked on flat ground, once barefoot and once with minimalist shoes. Gait variability of minimum toe clearance (MTC), stride length, stride time, and local dynamic gait stability were analysed. Results: The results for both age groups showed significant condition effects (minimalist shoes vs. barefoot walking) for the outcomes of local dynamic stability (p = .013), MTC variability (p = .018), and stride length variability (p < .001) indicating increased local dynamic stability and decreased gait variability during the minimalist shoe condition. Group effects (young vs. older adults) were detected in all gait outcomes. Conclusion: Walking with minimalist shoes appeared to be associated with better gait performance than walking barefoot in both age groups. Thus, walking with minimalist shoes is not similar to barefoot walking. With respect to reducing the risk of falling, we suggest that minimalist shoes could be an alternative to barefoot walking or a transition option between shoes to barefoot for older adults.
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R E S E A R C H A R T I C L E Open Access
Walking barefoot vs. with minimalist
footwear influence on gait in younger
and older adults
Evi Petersen
1*
, Astrid Zech
2
and Daniel Hamacher
2
Abstract
Background: In recent years, minimalist footwear has been increasingly promoted for its use in sportive and
recreational activities. These shoes are considered to function naturally like barefoot walking while providing a
protective surface. Despite a growing popularity of these shoes in the older population, little is known about the
influence of minimalist footwear on gait patterns. This study investigated whether overground walking with minimalist
shoes is comparable to barefoot walking regarding gait stability and variability parameters.
Methods: In a randomized within-subject study design, 31 healthy younger (29 ± 4 years) and 33 healthy community-
dwelling older adults (71 ± 4 years) volunteered. Participants walked on flat ground, once barefoot and once with
minimalist shoes. Gait variability of minimum toe clearance (MTC), stride length, stride time, and local dynamic gait
stability were analysed.
Results: The results for both age groups showed significant condition effects (minimalist shoes vs. barefoot walking)
for the outcomes of local dynamic stability (p=.013),MTCvariability(p= .018), and stride length variability (p<.001)
indicating increased local dynamic stability and decreased gait variability during the minimalist shoe condition. Group
effects (young vs. older adults) were detected in all gait outcomes.
Conclusion: Walking with minimalist shoes appeared to be associated with better gait performance than walking
barefoot in both age groups. Thus, walking with minimalist shoes is not similar to barefoot walking. With respect to
reducing the risk of falling, we suggest that minimalist shoes could be an alternative to barefoot walking or a transition
option between shoes to barefoot for older adults.
Keywords: Elderly, Community-dwelling, Inertial sensors, Leguano, Minimalist shoes, Barefoot
Background
Bipedal gait is one of the most fundamental sensori-
motor tasks performed every day [1]. Especially in older
adults, a well-functioning gait pattern is recognized to
be essential for autonomous participation in daily life
[2]. With an increase in age, however, deficiencies in gait
frequently evolve while the risk of falling increases [3].
Due to degenerative processes of the neuromuscular sys-
tem and other age-related adaptations, older adults typ-
ically exhibit the following gait characteristics: (i) a
wider stance and extended bipedal ground contact with
shorter steps [4] as well as (ii) a diminished swing phase
[5]. Besides internal factors, evidence reveals that foot-
wear as an external criterion has a significant impact on
the gait pattern [6,7].
Footwear has been implicated as a factor in falls, which
again is a crucial issue affecting health and quality of life
in older adults [8,9]. In relation to this, older adults are
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data made available in this article, unless otherwise stated in a credit line to the data.
* Correspondence: evi.petersen@usn.no
1
Institute of Sports, Physical Education and Outdoor Life, University of
South-Eastern Norway, Bø and Telemark, Norway
Full list of author information is available at the end of the article
Petersen et al. BMC Geriatrics (2020) 20:88
https://doi.org/10.1186/s12877-020-1486-3
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
often advised to wear shoes with low heels and firm slip-
resistant soles [10]. McKeon et al. [11] noted that per-
manent support to the foot might result in degenerative
efficiency in foot muscles and sensitivity, and therefore
carry a potential of adverse effects on the gait pattern.
Accordingly, [11] suggest that walking barefoot is less
restricting for motion control, which increases the sensi-
tivity of the sensory mechanisms and activates the foot
and lower leg muscles. Both sensory feedback sensitivity
[12] and increased foot strength [13] showed to improve
balance in older adults, and are therefore significant pre-
dictors in the prevention of falls. Thus, barefoot walking
might result in beneficial effects on sensorimotor
control.
In recent years, minimalist footwear (characterized by
light weight, high flexibility and absence of cushioning
material) has been increasingly promoted for its use in
sportive and recreational activities. Wear of such foot-
wear has been shown to be closely related to barefoot
running conditions [1416]. Therefore, it considered to
function naturally like barefoot walking while providing
a protective surface. Despite the growing popularity of
these shoes in the older population, little is known about
the influence of minimalist footwear on gait patterns
and performance [17,18]. In relation to this, local dy-
namic gait stability, as well as gait variability measures,
were associated with gait performance and the likelihood
of falling [19,20]. More specifically, measures of local
dynamic gait stability (LDS) are capable of distinguishing
between cohorts of younger and older adults, while
lower levels of LDS are associated with a higher risk of
falling [21]. Furthermore, the minimum foot clearance
(MFC) variability is a promising gait variable that can
predict the risk of falling, with greater variabilities of
MFC indicating a higher risk of falling [22].
In conclusion, walking with minimalist shoes seems
to merge the positive effects of barefoot walking while
providing a protective surface. However, the effects
on the gait pattern were not sufficiently studied yet.
Consequently, the primary aim of our study was to
investigate if overground walking with minimalist
shoes is comparable to barefoot walking regarding
gait stability and variability. A study by Smith et al.
[23] showed that minimalist shoes provided better
overall and anterior-posterior static balance than
walking barefoot. Additionally, [17]suggestedthat
wearing minimalist shoes could provide benefits of
barefoot walking in respect to fall prevention, while
simultaneously offering some protection and support
to the feet. Therefore, we predicted that overground
walking with minimalist shoes is associated with
higher gait stability and lower gait variability. We fur-
thermore analyzed whether this relationship is similar
in young and older adults.
Methods
Participants
In a randomized within-subject study design, gait data of
31 healthy younger (17 female, 14 male, age: 29 ± 4 years;
BMI: 23 ± 2) and 33 healthy community-dwelling older
(20 female, 13 male, age: 71 ± 4 years; BMI: 27 ± 4) par-
ticipants were collected. We advertised in the local
newspaper and at a local sport club to recruit the partic-
ipants of this study.
Inclusion criteria were the age of 35 years for the
younger group and 65 years for the older group. Partic-
ipants had to be able to walk throughout 5 minutes
without the need to pause or the use of assisting equip-
ment. Additionally, participants had to be unfamiliar
with regular barefoot walking or walking with minimalist
shoes. Any self-reported motor-functional impairments
that could affect gait performance, such as acute muscu-
loskeletal disorders or neurological diseases, led to ex-
clusion from the study. All subjects provided their
written informed consent to their voluntary participation
in this study as well as their allowance for publication,
which has been approved by the local ethics committee
(protocol no. FSV 16/13) and followed the principles of
the Helsinki Declaration.
Testing procedure
To capture kinematic data, wireless inertial sensors
(MTw2, Xsens Technologies B.V., Enschede, The
Netherlands, range of measurement of angular velocity: ±
1200 deg/s, sampling rate: 100 Hz) were attached to the
participantsright forefeet using tape. The participants
were block randomized to the different test condition se-
quences by using the computer-based program Research
Randomizer (https://www.randomizer.org/). Further, par-
ticipants were asked to walk at their preferred walking
pace back and forth on a 25 m track inside a sports hall
with flat ground. The following test conditions were per-
formed in a randomized and balanced order: 1) barefoot
walking and 2) walking with minimalist shoes (leguano
classic, leguano GmbH, Buchholz, Germany; material:
53% polyamide, 38% lyocell, 7% polypropylene, 2% elas-
tane, Sole: 100% LIFOLIT®). Participants walked for 3 mi-
nutes under each condition. The resting time between the
test conditions was 5 minutes. Prior to each of the testing
conditions, participants walked for approximately 1 mi-
nute back and forth the track to familiarize themselves
with the corresponding test condition and to improve reli-
ability [24].
Data analysis and statistics
The data analysis included gait variability measures as
well as the local dynamic gait stability for which the lar-
gest Lyapunov exponent (λ) was calculated. We removed
the first strides (from the start to the first turn after 25
Petersen et al. BMC Geriatrics (2020) 20:88 Page 2 of 6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
m) of each trial as well as the last strides (from the last
turn to the stop) to avoid possible transients, e.g. to
analyze steady-state gait [25]. Furthermore, we removed
the first 2.5 m of each section between two successive
turns to exclude the acceleration periods after turning
[26]. To account for possible deceleration periods before
turning, the last 2.5 m were excluded from the subse-
quent analysis as well. At least 50 strides should be ana-
lyzed for gait variability measures [27]. In this study, the
first 80 valid strides within each trial were analyzed.
To calculate the gait measures a) stride length, b)
stride time and c) minimum toe clearance (MTC), we
used a published algorithm [25]. As gait variability mea-
sures, the intraindividual standard deviations of each gait
measure were analysed. To quantify λ,we time-
normalized the three-dimensional angular velocity data
of the 80 valid strides to 8000 samples. To reconstruct
the state space, we applied the embedding approach.
The time delay (9 samples) and the embedded dimen-
sion (dE = 6) were determined, using the first minimum
mutual information [28] and the global false nearest
neighbors method, respectively [29]. The λwas deter-
mined using the Rosensteins algorithm [30], which we
implemented in MATLAB (version 2016a, TheMath-
Works BV, Natrick, USA). The Euclidean distance of
each nearest neighbor state space was tracked while the
mean of the logarithm of the divergence curve was
calculated. λis defined as the slope (linear fit) through
00.5 strides. The implementation was validated previ-
ously [25]. Using IBM SPSS Statistics (V 21.0) for all
statistical procedures, a two factor (condition: barefoot
and minimalist footwear; age: younger and older adults)
variance analysis with repeated measures was applied to
identify differences across the two conditions.
Results
As Fig. 1illustrates, the results show significant condi-
tion effects (minimalist shoes vs. barefoot walking) for
the outcomes of local dynamic stability (p= .013, partial
η
2
= 0.10), MTC variability (p= .018, partial η
2
= 0.09),
and stride length variability (p< .001, partial η
2
= 0.26).
These outcomes indicate increased local dynamic stabil-
ity (lower largest Lyapunov exponent) and decreased gait
variability during the minimalist shoe condition. There
was no condition effect on stride time variability. Group
effects (young vs. older adults) in all gait outcomes
(LDS: p< .001, partial η
2
= 0.30; MTC variability:
p= .006, partial η
2
= 0.12; stride length variability:
p= .004, partial η
2
= 0.13; stride time variability:
p= <.001, partial η
2
= 0.26) were found. These effects in-
dicate better LDS in younger participants and, surpris-
ingly, better (lower) gait variability in older participants.
There was no significant interaction effect between the
walking condition and the group condition.
Fig. 1 Gait stability and variability in younger and older adults barefoot vs. minimalist shoes
Petersen et al. BMC Geriatrics (2020) 20:88 Page 3 of 6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Discussion
To the best of our knowledge, this is the first study that
investigated whether overground walking with minimal-
ist shoes is comparable to barefoot walking regarding
gait stability and variability parameters in both younger
and older adults. Current research discussed the use of
minimalist shoes as an alternative to barefoot running or
a method of transitioning between shod and barefoot
running for athletes [23]. Overall and valid for both age
groups, our results suggest that walking with minimalist
shoes is associated with better gait stability and variabil-
ity measures, thus, with a lower risk of falling [21,22].
Consequently, walking with minimalist shoes is not simi-
lar to barefoot walking, and the positive effects of bare-
foot walking [11] are not necessarily generalizable to
walking with minimalist shoes.
In order to reduce the risk of falling, we suggest that
walking training with minimalist shoes could be an alter-
native to barefoot walking or a transition option between
shoes to barefoot for older adults. Our proposition is in
line with [17], who state that wearing minimalist shoes
could provide benefits of barefoot walking in respect of
fall prevention, while simultaneously offering some pro-
tection and support to the feet. Further, wearing minim-
alist shoes might help older adults to overcome different
barriers, which are associated with walking barefoot.
Often reported barriers are being ashamed of ones own
feet, fear of falling or fear of instability as well as the
sense of having cold feet [10,31].
Research on younger adults and children [15] showed
that barefoot training can result in long-term outcomes,
such as reduced ankle dorsiflexion at foot strike. That
points to the prospect that wearing minimalist footwear
regularly could have a positive impact on reducing the
risk of falling. In one of their recent studies, Franklin
et al. [32] investigated whether wearing minimalist shoes
daily for 4 months could lead to improvements in bal-
ance and foot strength, which are both critical variables
concerning a functional gait pattern. Preliminary results
show that training with minimalist shoes can improve
both parameters and thereby emphasize the potential of
minimalist shoe use to reduce the risk of falling. That is
in line with our results, which show that the use of min-
imalist shoes improved gait stability compared to bare-
foot walking.
We found less LDS in older adults compared to youn-
ger adults. This outcome has been frequently reported
[1921]. In contrast, it is surprising that older adults
showed better (lower) gait variability than younger
adults. A recent study by Hamacher et al. [33] reported
similar outcomes. In their study, younger and older par-
ticipants walked in their own shoes; however, the same
system and algorithms were applied [33]. In the current
study, younger adults show a much higher MTC, stride
length and stride time variability during barefoot walking
and walking with minimalist shoes compared to the
younger participants of [33], walking in their own shoes.
The older adults of the current study, on the other hand,
show only a minor increase in gait variability compared
to the older participants of the other study. We conclude
that the group effect of the gait variability measures
could be the result of younger adults adapting more
quickly to an unfamiliar walking condition (walking
barefoot / walking with minimalist shoes) to maintain
local dynamic stability. This effect seems to be less pro-
nounced in older adults. Since this is speculative, more
research is needed to investigate the issue.
Study limitations and future research implications
We want to acknowledge four main study limitations.
First, this research involved healthy community-dwelling
older adults. Therefore, our current findings may not
apply to older adults with health issues or already exist-
ing impairments. Most older adults have a higher risk of
falling when confronted with existing dysfunctions con-
cerning the gait pattern [34]. This fact points to the po-
tential of future research within clinical settings.
Second, the participants of this study did not walk in their
own shoes. Implementing this third condition to the testing
procedure could have revealed more knowledge of how
minimalist shoes influence gait in comparison to normal
shoes, which are worn in daily life. Additionally, it would
have made our results even more comparable to other stud-
ies. However, this question was not subject of our current
study. We also ran our tests for only one type of minimalist
shoe. Considering the growth of diversity in products, we
encourage future research to compare the influence of dif-
ferent minimalist footwear as well as to include aspects of
practicability regarding minimalist shoes for older adults.
Third, the application side in this study was a gym,
proving a flat ground. Thus, our findings are limited to
overground walking on an even surface. According to
Zurales et al. [35], however, uneven surfaces are strong
predictors of falls among older adults. Additionally and
in line with Li et al. [36], falls occurred more often out-
doors than indoors among older adults. Thus, future re-
search should consider testing on an uneven surface, for
instance, outdoors.
Last, this study focused on short-term effects. We sug-
gest that future research should target long-term effects
of fall prevention training with minimalist shoes or ex-
tended periods of wearing minimalist shoes during daily
activity. Certainly, a systematic overview of the existing
literature would enrich this scope of research.
Conclusion
This study demonstrates for walking in a straight line on
flat ground that minimalist shoes, as compared to
Petersen et al. BMC Geriatrics (2020) 20:88 Page 4 of 6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
walking barefoot, have significantly different effects on
gait and fall predicting parameters such as gait stability
(LDS) and variability (MTC). Effects were observed for
the group of younger as well as older adults. Walking
with minimalist shoes was overall associated with better
gait performance than walking barefoot. This finding
hence demonstrates the potential of minimalist shoes as
a means to prevent falls. We conclude that there is a
need for future research to investigate the benefits of
minimalist shoes for more complex walking tasks such
as walking on uneven ground. Further, the long-term ef-
fects of minimalist usage need to be explored, particulary
in relation to standard footwear. Simultaneously, we
make a call for a systematic review of the literature con-
cerned with minimalist footwear and the risk of falling.
Abbreviations
LDS: Local dynamic gait stability; MFC: Minimum foot clearance;
MTC: Minimum toe clearance; λ: Lyapunov exponent
Acknowledgments
We thank all participants of this study and the two reviewer.
Authorscontributions
EP, DH and AZ were all fully involved in the planning of the study and
preparation of the manuscript. EP collected the data for this study. EP and
DH wrote the first draft of the manuscript and AZ advised. Each of the
authors has read and concurs with the content in the final manuscript. The
author(s) read and approved the final manuscript.
Funding
This research did not receive any grant from funding agencies in the public,
commercial, or not-for-profit sectors.
Availability of data and materials
The dataset for this manuscript is not publicly available, however, requests to
access the datasets can be directed to Evi Petersen (evi.petersen@usn.no).
Ethics approval and consent to participate
All subjects provided their written informed consent to their voluntary
participation in this study and for the publication of their data. The study has
been approved by the local ethics committee of Faculty of Social and Behavioural
Sciences, Friedrich Schiller University Jena (protocol number: FSV 16/13) and
followed the principles of the Helsinki Declaration.
Consent for publication
Not applicable.
Competing interests
None. The authors declare that the research was conducted in the absence
of any commercial or financial relationships that could be construed as a
potential conflict of interest.
Author details
1
Institute of Sports, Physical Education and Outdoor Life, University of
South-Eastern Norway, Bø and Telemark, Norway.
2
Institute of Sports Science,
Friedrich-Schiller University of Jena, Jena, Thuringia, Germany.
Received: 13 May 2019 Accepted: 20 February 2020
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... In contrast, compared to a conventional shoe, better static and dynamic stability, as well as, greater functional ability in minimal footwear has been reported in a cross-sectional study in middle age and older adults (Cudejko et al., 2020). In addition, minimal shoes have shown both positive and negative outcome in stability measures in healthy young adults (Chander et al., 2016;Huber et al., 2022;Park et al., 2023;Petersen et al., 2020). Petersen et al., reported improved local dynamic stability in minimal shoes compared to barefoot walking (Petersen et al., 2020). ...
... In addition, minimal shoes have shown both positive and negative outcome in stability measures in healthy young adults (Chander et al., 2016;Huber et al., 2022;Park et al., 2023;Petersen et al., 2020). Petersen et al., reported improved local dynamic stability in minimal shoes compared to barefoot walking (Petersen et al., 2020). Chander et al., also observed improved postural stability in minimal shoes compared to flip flops and Crocs (Chander et al., 2016). ...
... This indicates, under safe environmental conditions inside the laboratory, participants reduced their gait speed for maintaining stability during barefoot walking, as this strategy is also observed when stability were challenged by inducing unexpected perturbation (Madehkhaksar et al., 2018). Better dynamic stability and gait variability in minimal shoes are also reported in another study compared to barefoot (Petersen et al., 2020). The second hypothesis of the study, i.e. use of textured and supportive insoles with minimal shoes will improve gait parameters compared to minimal shoes was drawn based on the previous positive effects of textured and supportive insoles on gait and stability, especially in older adults (Ma et al., 2020;Qu, 2015). ...
... Regarding the immediate impact of different footwear conditions (barefoot, minimalist, and standard shoes), a 3D biomechanical analysis during running revealed that 3-year-olds exhibited lower impact barefoot compared to minimalist and standard shoes, suggesting that minimalist shoes do not replicate barefoot running in early developmental stages. [7] However, the influence of walking barefoot versus with minimalist footwear in younger and older adults found that there is increased local dynamic stability and decreased gait variability in minimalist footwear [14]. Minimal footwear has shown to have a positive effect on stability and physical function in older individuals as they were found to enhance stability during standing and walking compared to conventional shoes, and certain minimal shoe features improved performance on the Timed Up and Go test designed by Cudejko et. ...
Conference Paper
Full-text available
The direct contact with the Earth’s surface, or grounding, has been studied to have potential beneficial effects on human health. However, there is limited research on establishing a connection through the foot, which is usually a person’s most common interaction with the ground. This paper presents an investigation into the interplay between the human foot and the ground, the effects of grounding on various diseases, and proposes a novel sole design as a potential solution. Using copper as the main link for the earthing sole, the difference between a regular sole and the proposed sole is highlighted with force analysis and temperature tests. The results show the proposed sole does not adversely impact human foot while providing the benefits of grounding studied. The sole is the first step to a novel shoe design that can allow humans to enjoy the benefits of grounding without giving up the comfort of footwear. This analysis aims to provide targeted insights for healthcare and footwear engineering professionals alike.
... In the long term, when adopted as daily footwear, minimal footwear will increase foot strength and arch stiffness by approximately 60% [73,74] and improve balance [75]. Minimally shod walking is generally found not to be identical to barefoot walking; it can often be seen as intermediate between barefoot and conventionally shod walking [63] and, in older people, can improve gait performance [76] and balance [70] more than barefoot walking (reviewed in [77]). ...
Article
Full-text available
Background/objectives: In this paper, we review and discuss epidemiological and experimental evidence on the effects of daily footwear on gait and life-long health. We consider different types of footwear, including “minimal shoes”, and their design features, comparing them to barefoot walking, with a focus on overall gait and the function of the heel pad. Methods: Narrative review. Results: We find little evidence for health benefits of most typical shoe design features (e.g., cushioning, raised heels or arch support) for normal walking in healthy individuals, and in several cases (e.g., high heels), there is evidence of detrimental health effects. Conclusions: Based on currently available evidence, we recommend minimal footwear as the default for the general population to stimulate healthy biomechanical aging, with other types of footwear used infrequently or when there is an individual or clinical need.
... Vyznačuje se nízkou vahou, dostatečným prostorem pro celou nohu a flexibilitou. Tím se chůze v barefoot obuvi dokonale podobá chůzi naboso (Petersen et al., 2020). Hollander et al. (2017) poukazují na chůzi naboso, která má u prvopočátků chůze přímý a velmi zásadní vliv na vývoj nohy. ...
Chapter
Full-text available
Úvod: Správné postavení těla je ideální poloha během každodenních činností, která zajišťuje lepší funkci tělesných systémů. U dětí je klíčové během školní docházky, kdy nesprávné návyky mohou vést k posturálním vadám, zejména během kritických období růstu. Včasná a správná edukace o držení těla může sloužit jako prevence těchto problémů, avšak současný nedostatek relevantních zdrojů vyžaduje vytvoření přehledové studie pro poskytování uspokojivých doporučení v pedagogické praxi. Metodika: Pro přehledovou studii byly analyzovány zahraniční články publikované v databázi Web of Science mezi lety 2020 a 2024, které se týkaly ergonomie, držení těla a školního prostředí. Výsledky: Bylo dohledáno 22 studií zabývají se tématem ovlivnění vadného držení těla, které lze aplikovat v rámci vzdělávacího procesu. Na základě zaměření byly studie rozřazeny do několika oblastí: ergonomie školního nábytku, rozměry školního batohu, pohybová aktivita a edukace a výchova. Výsledky ukázaly, že většina školního nábytku neodpovídá antropometrickým hodnotám dětí a nošení těžkých batohů negativně ovlivňuje držení těla, což zdůrazňuje potřebu revize normativů a zvýšení povědomí o správném držení těla. Závěr: Pro prevenci a nápravu těchto problémů je důležitá správná edukace o posturální hygieně a ergonomii, pravidelná pohybová aktivita a správné používání školních batohů.
... Vyznačuje se nízkou vahou, dostatečným prostorem pro celou nohu a flexibilitou. Tím se chůze v barefoot obuvi dokonale podobá chůzi naboso (Petersen et al., 2020). Hollander et al. (2017) poukazují na chůzi naboso, která má u prvopočátků chůze přímý a velmi zásadní vliv na vývoj nohy. ...
Chapter
Full-text available
Úvod: Ortopedie se zabývá prevencí a léčbou onemocnění pohybového ústrojí. Důležitost dětské ortopedie je zřejmá zejména v kontextu nárůstu vadného držení těla u dětí po vstupu do školního věku, což je přičítáno sedavému životnímu stylu a dlouhodobému sezení v nevhodných pozicích. Tento článek se zaměřuje na analýzu hlavních ortopedických problémů u dětí, jejich léčbu a prevenci, a na roli rehabilitace a ergonomických opatření v rámci zlepšení pohybového aparátu. Metodika: Přehledová studie využila odborné zahraniční články z databáze EBSCO Discovery Service. Z počátečních 24 600 zdrojů bylo po několika kolech selekce vybráno 7 relevantních studií publikovaných mezi lety 2011 a 2023. Výsledky: Studie ukázaly význam ergonomie v prevenci ortopedických problémů u školních dětí. Zdůrazněna byla důležitost edukace dětí a rodičů o ergonomických zásadách a multioborová spolupráce odborníků. Klíčovými faktory prevence jsou fyzická aktivita a rehabilitační intervence. Intervenční programy zaměřené na ergonomii ve školách prokázaly zlepšení držení těla a snížení výskytu bolestí zad. Závěr: Ergonomie hraje klíčovou roli v prevenci ortopedických problémů u dětí školního věku. Edukace a praktická aplikace ergonomických opatření ve školách a domácnostech jsou zásadní pro snižování rizik spojených s nevhodnými pohybovými stereotypy a inaktivitou. Je nezbytné, aby ergonomická opatření byla systematicky implementována a podporována jak ve školním prostředí, tak i v rodinném životě, čímž lze výrazně přispět k prevenci ortopedických problémů u dětí.
... HV, as a 2 common musculoskeletal disorder, may also present with abnormalities in muscle neuromodulation, which in turn may manifest as gait abnormalities. Bipedal gait represents one of the most fundamental sensorimotor tasks that humans perform daily [23]. Walking is a complex task that requires coordinated movements of multiple muscles and joints [24]. ...
Article
Full-text available
italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Objective: To investigate the biomechanical mechanisms underlying the pathogenesis and explore the effects of kinesiology taping (KT) on neuromuscular control in HV patients. Methods: The study population consisted of 16 young controls (YC group) and 15 patients with hallux valgus (HV group). All subjects underwent natural velocity gait assessment. Additionally, 11 patients from the HV group received KT intervention over a period of one month, consisting of 15 sessions administered every other day. After the one-month intervention, these patients underwent a gait assessment and were included in the HV-KT group. The electromyography (EMG) and joint motion were evaluated using non-negative matrix factorization (NNMF) to compare the difference in muscle and kinematic synergy among the three groups. The center of plantar pressure (COP) and ground reaction force (GRF) were measured by the force platform. Results: The number of synergies did not differ within the three groups, but the structure of muscle synergies and kinematic synergies differed in the HV group. The KT intervention (HV-KT group) altered the structure of synergies. The correlation between kinematic synergies and muscular synergies was lower in the HV group than in the YC group, whereas the correlation between the two increased after the KT intervention in the HV group. During gait, the HV group tended to activate more muscles around foot joints to maintain body stability. The visual analogue scale (VAS) scores, hallux valgus angle (HVA), and COP were significantly decreased after the intervention ( P <0.05). Conclusion: HV patients exhibited altered kinematic and muscular synergies structures as well as muscle activation. Also, it weakened the balance and athletic ability of HV patients. KT intervention improved neuromuscular control to provide a better gait performance.
... Several studies have investigated the effects of barefoot walking on various aspects of health, including balance control, gait efficiency, and foot and ankle function [12,13]. For example, a study by Petersen et al. [14] found that barefoot walking can improve balance and postural control in healthy young adults. Another study by McNab et al. [15] showed that barefoot walking can increase gait efficiency and reduce the risk of falls in older adults. ...
Article
Introduction: Research on athletic footwear familiarisation within an older population is sparse. This is problematic because unfamiliar footwear may act as a new perturbation and modify older adults' walking gait and stability. In addition, while athletic footwear has been suggested to enhance older adults' comfort and support during activities of daily living, the necessary period for familiarisation with athletic footwear is unknown. Therefore, this study aimed to identify the number of steps required for older adults to be familiarised with athletic footwear of different midsole thicknesses. Methods: Twenty-six healthy and physically active community-dwelling older adults, 21 females (71.1 ± 4.5 years; 164.5 ± 5.3 cm; 68.4 ± 11.4 kg) and five males (70.6 ± 2.3 years; 175.2 ± 7.8 cm; 72.8 ± 9.7 kg), completed a walking-based protocol. Participants walked two trials of 200 steps at their habitual speed on a 10-m track of an optical measurement system in three footwear conditions: (1) New Balance® REVlite 890v6 (thick midsole); (2) New Balance® REVlite 1400v5 (moderate midsole); and (3) New Balance® Minimus 20v7 (thin midsole). Gait speed (m.s-1) and walking time (min) were analysed for each participant over the 400 steps. Number of required familiarisation steps were established over three analysis phases, consisting of steady-state gait assessment, averaging and analysis of blocks of 40 steps, and sequentially comparing these steps with a predetermined threshold. Footwear familiarisation was assumed when the mean gait speed fell within an acceptable level (±2 SD from 320 to 360 step values) and subsequently maintained. Results: Most participants were familiarised with all three footwear conditions (thick n = 18; moderate and thin n = 20) after walking 80 steps. For all participants, the moderate midsole had the shortest familiarisation period (160 steps). The highest number of familiarisation steps was found in the thick (320 steps) and thin midsoles (240 steps) for some participants. Conclusion: A minimum of 320 familiarisation steps is recommended to account for both individual differences and midsole thicknesses. Implementing this walking-based footwear familiarisation protocol would improve validity of future studies, ensuring they analyse footwear effects rather than familiarisation with the footwear.
Article
Full-text available
Introduction: Barefoot locomotion is widely believed to be beneficial for motor development and biomechanics but are implied to be responsible for foot pathologies and running-related injuries. While most of available studies focused on acute effects of barefoot running and walking little is known regarding the effects of long-term barefoot vs. shod locomotion. The purpose of this study was to systematically review the literature to evaluate current evidence of habitual barefoot (HB) vs. habitual shod locomotion on foot anthropometrics, biomechanics, motor performance and pathologies. Methods: Four electronic databases were searched using terms related to habitually barefoot locomotion. Relevant studies were identified based on title, abstract and full text and a forward (citation tracking) and backward (references) search was performed. Risk of bias was assessed, data pooling and meta-analysis (random effects model) performed and finally levels of evidence determined. Results: Fifteen studies with 8399 participants were included. Limited evidence was found for a reduced ankle dorsiflexion at footstrike (pooled effect size -3.47 (95% CI -5.18 to -1.76)) and a lower pedobarographically measured hallux angle (-1.16 (95% CI -1.64 to -0.68)). HB populations had wider (0.55 (95% CI 0.06 to 1.05) but no shorter (-0.22 (95% CI -0.51 to 0.08)) feet compared to habitual shod populations. No differences in relative injury rates were found, with limited evidence for a different body part distribution of musculoskeletal injuries and more foot pathologies and less foot deformities and defects in HB runners. Conclusions: Only limited or very limited evidence is found for long-term effects of HB locomotion regarding biomechanics or health-related outcomes. Moreover, no evidence exists on any beneficial effects for motor performance. Future research should include prospective study designs.
Article
Full-text available
Habitual footwear use has been reported to influence foot structure with an acute exposure being shown to alter foot position and mechanics. The foot is highly specialised thus these changes in structure/position could influence functionality. This review aims to investigate the effect of footwear on gait, specifically focussing on studies that have assessed kinematics, kinetics and muscle activity between walking barefoot and in common footwear. In line with PRISMA and published guidelines, a literature search was completed across six databases comprising Medline, EMBASE, Scopus, AMED, Cochrane Library and Web of Science. Fifteen of 466 articles met the predetermined inclusion criteria and were included in the review. All articles were assessed for methodological quality using a modified assessment tool based on the STROBE statement for reporting observational studies and the CASP appraisal tool. Walking barefoot enables increased forefoot spreading under load and habitual barefoot walkers have anatomically wider feet. Spatial-temporal differences including, reduced step/stride length and increased cadence, are observed when barefoot. Flatter foot placement, increased knee flexion and a reduced peak vertical ground reaction force at initial contact are also reported. Habitual barefoot walkers exhibit lower peak plantar pressures and pressure impulses, whereas peak plantar pressures are increased in the habitually shod wearer walking barefoot. Footwear particularly affects the kinematics and kinetics of gait acutely and chronically. Little research has been completed in older age populations (50+ years) and thus further research is required to better understand the effect of footwear on walking across the lifespan. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
Article
Background and purpose: Falls in older adults is a major issue for health care organisations. Footwear is often reported as a contributing factor to falls in older adults; however, the reporting of footwear styles that are proposed to increase falls and falls risk is confusing. Moreover, these reports have been used to inform falls guidelines and recommendations by health practitioners. A systematic review was performed to identify and synthesize the available evidence examining whether there was support of a causal or correlational relationship between different styles of footwear and falls in older adults in real-life settings. Method: The databases included in the search were Ovid MEDLINE, PubMed, Scopus and Web of Science. The inclusion criteria were papers with falls outcomes, healthy adults that were 65 years or older. The footwear styles included slippers, Oxford/lace ups, high heels, boots and sandals. The exclusion criteria were laboratory studies and papers with primary focus on gait issues that increased falls likelihood. Results and discussion: Nine studies met the inclusion criteria and were included in the review from a total of 363 papers identified in the database search. The results of this review suggest that there is inadequate evidence to link any particular footwear style with falls. However, it may be possible that it was not the style of footwear, rather how accustomed the individual was to wear that particular style of footwear. Conclusion: There is limited evidence supporting footwear recommendations as a discrete falls prevention strategy. Clinicians should be pragmatic in their advice to healthy older adults about footwear styles and their potential to reduce falls or falls risk.
Article
The aim of the current study was to evaluate the effect of a cognitive dual task on minimum toe clearance (MTC) variability while walking. In a randomized cross-over design, gait kinematics of 25 older (70 ± 6 years) and 45 younger adults (25 ± 2 years) were captured during normal walking and dual-task walking. Variability of stride time, stride length, and MTC were calculated. Differences between normal versus dual-task walking were assessed using Wilcoxon tests. Compared with normal walking, dual-task walking caused an increase in stride time variability (older adults: p < .001 and younger adults: p < .001), while the variability of MTC decreased (older adults: p = .032 and younger adults: p = .012). MTC seems to be a task-relevant gait parameter that is controlled with high priority to preserve its variability under challenging conditions.
Article
Gait variability is an important measure in clinical settings to diagnose older individuals with fall risk. This study examines whether a familiarization trial improves test-retest reliability of gait variability. Twenty-two older participants walked twice at 1 day and twice 7 days later. The standard deviations of stride length, swing time, stance time, stride time and minimum foot clearance were calculated. The test-retest reliability of (1) between-day comparison of the first trials and (2) between-day comparison of the second trials of all gait variability measures was quantified with the intraclass-correlation coefficient (ICC), the smallest detectable differences (SDD) and the bias and the limits of agreement (LoA). The between-day comparison of the second trials per day showed higher ICC values, lower LoA values and lower SDD values in all analyzed parameters. Our data suggest that the reliability of gait variability in an older population can be considerably improved just with the aid of one familiarization trial.
Article
Since the first edition of this very successful book was written to synthesise and review the enormous body of work covering falls in older people, there has been an even greater wealth of informative and promising studies designed to increase our understanding of risk factors and prevention strategies. This new edition is written in three parts: epidemiology, strategies for prevention, and future research directions. New material includes the most recent studies covering: balance studies using tripping, slipping and stepping paradigms; sensitivity and depth perception visual risk factors; neurophysiological research on automatic or reflex balance activities; and the roles of syncope, vitamin D, cataract surgery, health and safety education, and exercise programs. This new edition will be an invaluable update for clinicians, physiotherapists, occupational therapists, nurses, researchers, and all those working in community, hospital and residential or rehabilitation aged care settings.
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Local dynamic stability is a critical aspect of stable gait but its assessment for use in clinical settings has not yet been sufficiently evaluated, particularly with respect to inertial sensors applied on the feet and/or trunk. Furthermore, key questions remain as to which state-space reconstruction is most reliable and valid. In this study, we evaluated the reliability as well as the ability of different sensor placement and state-spaces to distinguish between local dynamic stability in young and older adults. Gait data of 19 older and 20 young subjects were captured with inertial sensors twice within the first day as well as after seven days. 21 different signals (and combinations of signals) were used to span the system's state-space to calculate different measures of local dynamic stability. Our data revealed moderate or high effect sizes in 12 of the 21 old vs. young comparisons. We also observed considerable differences in the reliability of these 12 results, with intra-class correlation coefficients ranging from 0.09 to 0.81. Our results demonstrate that in order to obtain reliable and valid estimates of gait stability λ of walking time series is best evaluated using trunk data or 1-dimensional data from foot sensors.