The effects of shoes and barefoot on postural stability

I have no doubt about the importance of plantar sensory input has on normal gait, balance and postural stability; having spent many years looking at the impacts of diabetes and what the sensory neuropathy does to gait and balance. What I do have doubts about, and will address this in greater detail in a future post, is the role that footwear, especially softer footwear, has on attenuating that sensory input. The rhetoric and propaganda is all around that we need to feel the ground to have those appropriate sensations for normal function and postural stability. However, simply stating that its important and then wishing it was true does not make it true and is a logical fallacy. The fan boys go as far as saying we need barefoot or minimalism to improve “proprioception”. I am not sure how that actually is supposed to work as there are no proprioceptive sensors in the skin on the sole of the foot….but will leave ridiculing that woo to another day when I feel better! Which brings me to this study that appeared a few weeks ago:

Minimalist, standard and no footwear on static and dynamic postural stability following jump landing
Astrid Zech, Andreas Argubi-Wollesen & Anna-Lina Rahlf
European Journal of Sport Science Published online: 10 Jul 2014
In recreational sports, uncushioned, light-weight and minimalist shoes are increasingly used to imitate barefoot situations. Uncertainty exists whether these shoes provide sufficient stability during challenging movements. In this randomised crossover study, 35 healthy distance runners performed jump landing stabilisation and single-leg stance tests on a force plate, using four conditions in random order: barefoot, uncushioned minimalist shoes, cushioned ultraflexible shoes and standard running shoes. Ground reaction force (GRF) and centre of pressure (COP) data were used to determine unilateral jump landing stabilisation time and COP sway velocity during single-leg stance. Repeated measures analysis of variance revealed significant footwear interactions for medial–lateral (p < 0.001) and anterior–posterior COP sway velocity during standing (p < 0.001). The barefoot condition produced significantly greater postural sway velocities (p < 0.001) compared to all footwear conditions. No significant effects were found for jump landing stabilisation time. In conclusion, the results of this study indicate that increased shoe flexibility and reduced sole support have no, or only minor influence on static and dynamic postural control, and therefore, may not increase the risk of traumatic events during sports activities. However, barefoot conditions should be considered carefully when adequate postural control is needed.

These authors wanted to look at the effects of minimalist shoes on postural stability. They recruited 35 distance runners and tested them in 4 conditions: barefoot; minimalist shoes (Leguano); Nike Free 3.0; Asics GT-2160; and then performed jumping and single leg standing tasks while kinematic and kinetic data was collected.

Nothing in the methods and the analysis jumps out at me as being problematic.

Without getting in the complexity of the reported findings and details of the measurements (they are in the full publication), what the authors found was clear: “The major finding of this study is that, compared to barefoot conditions, shoes improve postural control during single-leg stance in distance runners” and “Our findings suggest that footwear is beneficial for the maintenance of static balance but has no noticeable impact on dynamic postural stability” and “Therefore, it is concluded that shoe flexibility and cushioning has little or no impact on postural stability.”

In other words, being able to “feel” the ground more in the barefoot or minimalist condition did not improve postural stability (or “proprioception” if you want to believe in that woo) compared to having a softer shoe on the foot. Which is the opposite of what the propaganda, rhetoric and wishful thinking predicted.

As always, I go where the evidence takes me until convinced otherwise and this study tells me that barefoot or minimalist shoes do not enhance postural stability due to being able to “feel” the ground more.

Zech, A., Argubi-Wollesen, A., & Rahlf, A. (2014). Minimalist, standard and no footwear on static and dynamic postural stability following jump landing European Journal of Sport Science, 1-7 DOI: 10.1080/17461391.2014.936322

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4 Responses to The effects of shoes and barefoot on postural stability

  1. Simon BArtold August 5, 2014 at 5:11 am #

    why are they using the Gt-2160? A 3 year old shoe??

    • Craig Payne August 5, 2014 at 5:59 am #

      It was probably the”current” shoe when the study was done. The study would have been done at least a year if not longer ago given the time frame to do and publish research.

  2. Roman R. August 5, 2014 at 10:44 am #

    The problem with all those balance tests is that they mostly do not correlate between each other…
    Actually I’m sometimes not sure what they are measuring and if that what they are measuring has a practical relevance.
    I’m not surprised that the static balance is better with shoes because of the bigger contact area (e.g., where would I have a better balance? With my x-country or my big freeride ski?).
    It is also questionable if the landing on an even surface can reflect real life situations or would you expect twisting your ankle on a paved road?
    In my experience it is easier balancing on a thin slackline while barefoot since you can kind of enclose the line and fixate it between the transversal arch of the forefoot. In this respect it might be advantageous to have a more flexible sole on a rocky terrain which can adjust and build a bigger contact area compared with a very stiff sole that would only make contact with the tip of a rock.
    Another aspect worthwhile considering are control mechanisms. In terms of energy management total control is costly and not needed in every situation. While running on a paved road you can basically turn your brain off, whereas running on steep rocky trail where a miss step can be fatal the degree of control applied is much greater. The theory behind this is, that you control your movements adjusted to the situation, allowing greater movement variance and inaccuracy on a paved road because a high level of control would be unreasonable and inefficient.
    Based on these considerations the (also mentioned in the paper) time to boundary test was developed, which is a measurement for the range of motion that you allow while not tipping and still feeling comfortable.
    There is probably a big difference in performance depending on how you define postural stability. Is it the ability to stand still in one place with the least variations in COP or the dynamic control of sway and its boundary before you fall over?
    In my little experience balance ability (= postural stability?) is very situational and has a great habitation component. There is not the one golden test which makes it quantifiable. Therefore the practical value of the results of the study are in my opinion questionable….

  3. blaise Dubois August 6, 2014 at 12:17 pm #

    Some points
    1. The conclusions are the same than their hypotheses (based on no science back ground… need explanation about “We also expected that barefoot situations negatively influence postural stability in comparison to all shoe conditions”)… it’s make me skeptical of what they find… OR want to find
    2. This study was supported by the Leguano GmbH, Germany, a minimalist shoe company (is it not the best conclusion for them to show that their shoes are as good (or better) than other popular shoes… and better than nothing/barefoot?) … keu line in their conclusion : Moreover, the fact that uncushioned minimalist shoes (the sponsored) with direct skin contact at the foot and ankle joint resulted in the lowest postural sway during standing emphasises the importance of cutaneous feedback for standing stability.
    3. Habits of participants are probably the most important factors that influence the results. (they probably (99% chance) test on shod population). Are the results the same if they was tested people used to be barefoot?
    4. I’m a clinician and one way to increase instability and to stimulate proprioception is to integrate an new, unstable environment like a cushioned mat… hummm
    5. In tehir conclusion they mentione “Therefore, the barefoot condition should be considered cautiously when adequate postural control is needed.”… Note that cause of injuries like an ankle sprain are not just related to cutaneous feedback… mechanical levers are also involve

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