Foot motion in children shoes - A comparison of barefoot walking with shod walking in conventional and flexible shoes

The increased prevalence for flatfoot and hallux valgus in modem societies may be the consequence of inaequate footwear in childhood. Based on the assumption that barefoot walking represents the best condition for the development of a healthy foot the objective of this study was to monitor the influence of commercial footwear on children's foot motion during walking. Furthermore, an attempt was made to reduce this influence by changing the physical properties of standard footwear. Children's barefoot motion pattern was monitored by a marker-based optical 3D-tracking method using a multi-segment foot model. In the study's first stage, barefoot walking was compared to walking with a commercial product. In the second stage it was compared to both, the pattem with the commercial product and with the shoe modified on the basis of the findings of the first stage of the study. Eighteen children (8.2 +/- 0.7 years old) with no foot deformity and with the same shoe size were recruited for this study. It was found that tibio-talar ROM increased in the commercial shoe (26.6 degrees) compared to the barefoot condition (22.5 degrees, p = 0.001) whereas the medial arch changes for push-off were diminished since the variation in arch length was reduced from 9.9% (barefoot) to 5.9% (shoe, p < 0.001). Further, ROM in foot torsion along the long foot axis was reduced from 9.8 degrees (bare) to 4.7 degrees (shoe, p < 0.001). These parameters could be improved with more flexible footwear. The present study shows that slimmer and more flexible children's shoes do not change foot motion as much as conventional shoes and therefore should be recommended not only for children in this age but for healthy children in general. (c) 2007 Elsevier B.V. All rights reserved.