The long-term effects of wearing moderate minimalist shoes on a child's foot strength, muscle structure and balance: A randomised controlled trial

Shayan Quinlan; Peter Sinclair; Adrienne Hunt; Alycia Fong Yan

doi:10.1016/j.gaitpost.2021.12.009

The long-term effects of wearing moderate minimalist shoes on a child's foot strength, muscle structure and balance: A randomised controlled trial

Gait Posture. 2022 Feb:92:371-377. doi: 10.1016/j.gaitpost.2021.12.009. Epub 2021 Dec 15.

Authors

Shayan Quinlan¹, Peter Sinclair², Adrienne Hunt², Alycia Fong Yan³

Affiliations

¹ Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia. Electronic address: squi6126@uni.sydney.edu.au.
² Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia.
³ Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia. Electronic address: alycia.fongyan@sydney.edu.au.

PMID: 34923257
DOI: 10.1016/j.gaitpost.2021.12.009

Abstract

Background: From retrospective research, it is believed that children who predominantly spend their time shod have poorer foot strength and performance than those who are predominantly barefoot. Children's foot motion has been shown to be adversely affected by standard school shoes; however, the long-term effect of moderate minimalist shoes on foot strength, muscle structure and balance in children is unknown.

Research question: Does wearing moderate minimalist shoes, compared to stiff shoes, benefit a child's foot strength, muscle structure and performance over time?

Methods: Seventy healthy children (9-12 yr) were randomly assigned to wear standard (control), or minimalist shoes (experimental) at school, for nine months. Cross-sectional areas (CSA) of Abductor Hallucis (AH) and Flexor Digitorum Brevis (FDB) muscles, and toe flexor strength (TFS) of hallux and lesser toes separately, were primary outcome measures. Single leg balance (SLB), Y-balance test (YBT) and standing long jump (SLJ) were secondary outcome measures. Pre- and post-intervention measurements were analysed for between group differences with ANCOVA.

Results: Minimalist shoes resulted in moderate but statistically non-significant increases in muscle CSA (AH η²_p =.04, FDB η²_p =.05) and TFS (hallux η²_p =.05, lesser toes η²_p =.04). Significant moderate to large improvements in YBT in the experimental group were found in the postero-medial (P = .04, η²_p =.07) and postero-lateral (P = .01, η²_p =.10) directions. YBT (anterior, postero-medial and postero-lateral) was correlated with hallux TFS (R =.29,.27 and.33 respectively), lesser toes TFS (R =.28,.35 and.38 respectively) and SLJ (R =.30,.39 and.57 respectively). CSA of FDB was correlated with SLJ (R =.34) and SLB (R =.42).

Significance: Wearing moderate minimalist shoes long-term improves balance in children. TFS is correlated with better balance and SLJ. Moderate minimalist school shoes are recommended for children.

Keywords: Balance; Child; Footwear; Performance outcomes; Toe flexor strength; Ultra-sound.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Biomechanical Phenomena / physiology
Child
Humans
Muscle Strength
Muscle, Skeletal* / physiology
Retrospective Studies
Shoes*

Associated data

ANZCTR/ANZCTR12618001096246