BACKGROUND: Regular walking in different types of footwear may increase the mediolateral shear force, knee adduction moment, or vertical ground-reaction forces that could increase the risk of early development of knee osteoarthritis (OA). PURPOSE: To compare kinematic and kinetic parameters that could affect the development of knee OA in 3 footwear conditions. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 40 asymptomatic participants performed walking trials in the laboratory at self-selected walking speeds under barefoot (BF), minimalistic (MF), and neutral (NF) footwear conditions. Knee joint parameters were described using discrete point values, and continuous curves were evaluated using statistical parametric mapping. A 3 × 1 repeated-measures analysis of variance was used to determine the main effect of footwear for both discrete and continuous data. To compare differences between footwear conditions, a post hoc paired t test was used. RESULTS: Discrete point analyses showed a significantly greater knee power in NF compared with MF and BF in the weight absorption phase (P < .001 for both). Statistical parametric mapping analysis indicated a significantly greater knee angle in the sagittal plane at the end of the propulsive phase in BF compared with NF and MF (P = .043). Knee joint moment was significantly greater in the propulsive phase for the sagittal (P = .038) and frontal planes (P = .035) in BF compared with NF and MF and in the absorption phase in the sagittal plane (P = .034) in BF compared with MF and NF. A significant main effect of footwear was found for anteroposterior (propulsion, ↑MF, NF, ↓BF [P = .008]; absorption, ↑BF, MF, ↓NF [P = .001]), mediolateral (propulsion, ↑MF, NF, ↓BF [P = .005]; absorption, ↑NF, MF, ↓BF [P = .044]), and vertical (propulsion, ↑NF, BF, ↓MF [P = .001]; absorption, ↑MF, BF, ↓NF [P < .001]) ground-reaction forces. Knee power showed a significant main effect of footwear (absorption, ↑NF, MF, ↓BF [P = .015]; propulsion, ↑MF, NF, ↓BF [P = .039]). CONCLUSION: Walking in MF without sufficient accommodation affected kinetic and kinematic parameters and could increase the risk of early development of knee OA.

Department of Diagnostic Radiology Oulu University Hospital Oulu Finland

Department of Neurosciences Biomedicine and Movement Sciences University of Verona Verona Italy

Human Motion Diagnostic Center Department of Human Movement Studies University of Ostrava Ostrava Czech Republic

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Altman R, Alarcón G, Appelrouth D, et al.The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991;34(5):505–514. PubMed

Altman R, Asch E, Bloch D, et al.Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum. 1986;29(8):1039–1049. PubMed

Andriacchi TP, Koo S, Scanlan SF. Gait mechanics influence healthy cartilage morphology and osteoarthritis of the knee. J Bone Jt Surg. 2009;91(suppl 1):95–101. PubMed PMC

Boyer KA, Andriacchi TP, Beaupre GS. The role of physical activity in changes in walking mechanics with age. Gait Posture. 2012;36(1):149–153. PubMed

Browning RC, Kram R. Effects of obesity on the biomechanics of walking at different speeds. Med Sci Sports Exerc. 2007;39(9):1632–1641. PubMed

Chehab EF, Andriacchi TP, Favre J. Speed, age, sex, and body mass index provide a rigorous basis for comparing the kinematic and kinetic profiles of the lower extremity during walking. J Biomech. 2017;58:11–20. PubMed

Chen TLW, Sze LKY, Davis IS, Cheung RTH. Effects of training in minimalist shoes on the intrinsic and extrinsic foot muscle volume. Clin Biomech. 2016;36:8–13. PubMed

Cotton FJ. Foot statics and surgery. N Engl J Med. 1936;214(8):353–362.

Crane EA, Cassidy RB, Rothman ED, Gerstner GE. Effect of registration on cyclical kinematic data. J Biomech. 2010;43(12):2444–2447. PubMed PMC

Davis IS, Hollander K, Lieberman DE, Ridge ST, Sacco ICN, Wearing SC. Stepping back to minimal footwear: applications across the lifespan. Exerc Sport Sci Rev. 2021;49(4):228–243. PubMed

Dixon PC, Böhm H, Döderlein L. Ankle and midfoot kinetics during normal gait: a multi-segment approach. J Biomech. 2012;45(6):1011–1016. PubMed

Dixon PC, Stebbins J, Theologis T, Zavatsky AB. Spatio-temporal parameters and lower-limb kinematics of turning gait in typically developing children. Gait Posture. 2013;38(4):870–875. PubMed

Donà G, Preatoni E, Cobelli C, Rodano R, Harrison AJ. Application of functional principal component analysis in race walking: an emerging methodology. Sports Biomech. 2009;8(4):284–301. PubMed

Dore D, Quinn S, Ding C, et al.Natural history and clinical significance of MRI-detected bone marrow lesions at the knee: a prospective study in community dwelling older adults. Arthritis Res Ther. 2010;12(6):R223. PubMed PMC

Dunlop DD, Song J, Semanik PA, et al.Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study. BMJ. 2014;348(apr28 6):g2472–g2472. PubMed PMC

Esculier JF, Dubois B, Dionne CE, Leblond J, Roy JS. A consensus definition and rating scale for minimalist shoes. J Foot Ankle Res. 2015;8(1):42. PubMed PMC

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–191. PubMed

Favre J, Erhart-Hledik JC, Andriacchi TP. Age-related differences in sagittal-plane knee function at heel-strike of walking are increased in osteoarthritic patients. Osteoarthritis Cartilage. 2014;22(3):464–471. PubMed PMC

Felson DT, Chaisson CE, Hill CL, et al.The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med. 2001;134(7):541. PubMed

Felson DT, Niu J, Guermazi A, et al.Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging. Arthritis Rheum. 2007;56(9):2986–2992. PubMed

Fong Yan A, Sinclair PJ, Hiller C, Wegener C, Smith RM. Impact attenuation during weight bearing activities in barefoot vs. shod conditions: a systematic review. Gait Posture. 2013;38(2):175–186. PubMed

Franklin S, Grey MJ, Heneghan N, Bowen L, Li FX. Barefoot vs common footwear: a systematic review of the kinematic, kinetic and muscle activity differences during walking. Gait Posture. 2015;42(3):230–239. PubMed

Gruber AH, Silvernail JF, Brueggemann P, Rohr E, Hamill J. Footfall patterns during barefoot running on harder and softer surfaces. Footwear Sci. 2013;5(1):39–44.

Guermazi A, Eckstein F, Hellio Le Graverand-Gastineau MP, et al.Osteoarthritis: current role of imaging. Med Clin North Am. 2009;93(1):101–126. PubMed

Hafer JF, Kent JA, Boyer KA. Physical activity and age-related biomechanical risk factors for knee osteoarthritis. Gait Posture. 2019;70:24–29. PubMed

Hannigan JJ, Pollard CD. Gait Posture. 2021;83:245–249. PubMed

Harrison AJ, Ryan W, Hayes K. Functional data analysis of joint coordination in the development of vertical jump performance. Sports Biomech. 2007;6(2):199–214. PubMed

Holowka NB, Wynands B, Drechsel TJ, et al.Foot callus thickness does not trade off protection for tactile sensitivity during walking. Nature. 2019;571(7764):261–264. PubMed

Huber G, Jaitner T, Schmidt M. Full step cycle kinematic and kinetic comparison of barefoot walking and a traditional shoe walking in healthy youth: insights for barefoot technology. Footwear Sci. 2022;14(2):123–130. PubMed PMC

Hunter DJ. Osteoarthritis. Best Pract Res Clin Rheumatol. 2011;25(6):801–814. PubMed

Jandacka D, Plesek J, Skypala J, Uchytil J, Silvernail JF, Hamill J. Knee joint kinematics and kinetics during walking and running after surgical Achilles tendon repair. Orthop J Sports Med. 2018;6(6):232596711877986. PubMed PMC

Jandacka D, Uchytil J, Zahradnik D, et al.Running and physical activity in an air-polluted environment: the biomechanical and musculoskeletal protocol for a prospective cohort study 4HAIE (Healthy Aging in Industrial Environment—Program 4). Int J Environ Res Public Health. 2020;17(23):9142. PubMed PMC

Kavounoudias A, Roll R, Roll J. Foot sole and ankle muscle inputs contribute jointly to human erect posture regulation. J Physiol. 2001;532(3):869–878. PubMed PMC

Keenan GS, Franz JR, Dicharry J, Croce UD, Kerrigan DC. Lower limb joint kinetics in walking: the role of industry recommended footwear. Gait Posture. 2011;33(3):350–355. PubMed

Kirtley C. The temporal-spatial parameters. In: Clinical Gait Analysis. Elsevier; 2006: 15–24.

Lementowski PW, Zelicof SB. Obesity and osteoarthritis. Am J Orthop Belle Mead NJ. 2008;37(3):148–151. PubMed

Lieberman DE. Strike type variation among Tarahumara Indians in minimal sandals versus conventional running shoes. J Sport Health Sci. 2014;3(2):86–94.

Lynn SK, Reid SM, Costigan PA. The influence of gait pattern on signs of knee osteoarthritis in older adults over a 5–11 year follow-up period: a case study analysis. Knee. 2007;14(1):22–28. PubMed

Malus J, Skypala J, Silvernail JF, et al.Marker placement reliability and objectivity for biomechanical cohort study: Healthy Aging in Industrial Environment (HAIE—Program 4). Sensors. 2021;21(5):1830. PubMed PMC

Manoli A, Graham B. The subtle cavus foot, “the underpronator,” a review. Foot Ankle Int. 2005;26(3):256–263. PubMed

Mckeon PO, Hertel J, Bramble D, Davis I. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med. 2014;(49):290. PubMed

Miller EE, Whitcome KK, Lieberman DE, Norton HL, Dyer RE. The effect of minimal shoes on arch structure and intrinsic foot muscle strength. J Sport Health Sci. 2014;3(2):74–85.

Murphy L, Schwartz TA, Helmick CG, et al.Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59(9):1207–1213. PubMed PMC

Murray MP, Gardner GM, Mollinger LA, Sepic SB. Strength of isometric and isokinetic contractions. Phys Ther. 1980;60(4):412–419. PubMed

Nigg B. Biomechanical considerations on barefoot movement and barefoot shoe concepts. Footwear Sci. 2009;1(2):73–79.

Nyland J, Franklin T, Short A, Calik M, Kaya D. Posture, kinesthesia, foot sensation, balance, and proprioception. In: Kaya D, Yosmaoglu B, Doral MN. eds. Proprioception in Orthopaedics, Sports Medicine and Rehabilitation. Springer, 2018: 13–24.

Oliveria SA, Felson DT, Reed JI, Cirillo PA, Walker AM. Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum. 1995;38(8):1134–1141. PubMed

Pataky TC. Generalized n-dimensional biomechanical field analysis using statistical parametric mapping. J Biomech. 2010;43(10):1976–1982. PubMed

Pataky TC, Vanrenterghem J, Robinson MA. Zero- vs. one-dimensional, parametric vs. non-parametric, and confidence interval vs. hypothesis testing procedures in one-dimensional biomechanical trajectory analysis. J Biomech. 2015;48(7):1277–1285. PubMed

Petersen E, Zech A, Hamacher D. Walking barefoot vs. with minimalist footwear—influence on gait in younger and older adults. BMC Geriatr. 2020;20(1):88. PubMed PMC

Richter C. The Search for Performance Related Factors [dissertation]. Dublin City University; 2014.

Ridge ST, Olsen MT, Bruening DA, et al.Walking in minimalist shoes is effective for strengthening foot muscles. Med Sci Sports Exerc. 2019;51(1):104–113. PubMed

Robinson MA, Vanrenterghem J, Pataky TC. Sample size estimation for biomechanical waveforms: current practice, recommendations and a comparison to discrete power analysis. J Biomech. 2021;122:110451. PubMed

Ryan W, Harrison A, Hayes K. Functional data analysis of knee joint kinematics in the vertical jump. Sports Biomech. 2006;5(1):121–138. PubMed

Sacco IC, Akashi PM, Hennig EM. A comparison of lower limb EMG and ground reaction forces between barefoot and shod gait in participants with diabetic neuropathic and healthy controls. BMC Musculoskelet Disord. 2010;11(1):24. PubMed PMC

Sacco ICN, Sartor CD, Cacciari LP, et al.Effect of a rocker non-heeled shoe on EMG and ground reaction forces during gait without previous training. Gait Posture. 2012;36(2):312–315. PubMed

Sayer TA, Hinman RS, Paterson KL, et al.Differences and mechanisms underpinning a change in the knee flexion moment while running in stability and neutral footwear among young females. J Foot Ankle Res. 2019;12(1):1. PubMed PMC

Shakoor N, Block JA. Walking barefoot decreases loading on the lower extremity joints in knee osteoarthritis. Arthritis Rheum. 2006;54(9):2923–2927. PubMed

Shakoor N, Lidtke RH, Sengupta M, Fogg LF, Block JA. Effects of specialized footwear on joint loads in osteoarthritis of the knee. Arthritis Rheum. 2008;59(9):1214–1220. PubMed PMC

Shakoor N, Lidtke RH, Wimmer MA, et al.Improvement in knee loading after use of specialized footwear for knee osteoarthritis: results of a six-month pilot investigation. Arthritis Rheum. 2013;65(5):1282–1289. PubMed

Spector TD, Hart DJ, Doyle DV. Incidence and progression of osteoarthritis in women with unilateral knee disease in the general population: the effect of obesity. Ann Rheum Dis. 1994;53(9):565–568. PubMed PMC

Theodore D. Anatomy of the Moving Body: A Basic Course in Bones, Muscles, and Joints. North Atlantic Books; 2008.

Trinkaus E, Shang H. Anatomical evidence for the antiquity of human footwear: Tianyuan and Sunghir. J Archaeol Sci. 2008;35(7):1928–1933.

Urbaniak GC, Plous S. Research randomizer. Version 4.0. Retrieved fromhttp://www.randomizer.org/.

Wallace IJ, Koch E, Holowka NB, Lieberman DE. Heel impact forces during barefoot versus minimally shod walking among Tarahumara subsistence farmers and urban Americans. R Soc Open Sci. 2018;5(3):180044. PubMed PMC

Wallace IJ, Worthington S, Felson DT, et al.Knee osteoarthritis has doubled in prevalence since the mid-20th century. Proc Natl Acad Sci. 2017;114(35):9332–9336. PubMed PMC

Weir G, van Emmerik R, Jewell C, Hamill J. Coordination and variability during anticipated and unanticipated sidestepping. Gait Posture. 2019;67:1–8. PubMed

Wirth B, Hauser F, Mueller R. Back and neck muscle activity in healthy adults during barefoot walking and walking in conventional and flexible shoes. Footwear Sci. 2011;3(3):159–167.

Wolf S, Simon J, Patikas D, Schuster W, Armbrust P, Döderlein L. Foot motion in children shoes—a comparison of barefoot walking with shod walking in conventional and flexible shoes. Gait Posture. 2008;27(1):51–59. PubMed

Xu Y, Hou Q, Wang C, et al.Full step cycle kinematic and kinetic comparison of barefoot walking and a traditional shoe walking in healthy youth: insights for barefoot technology. Appl Bionics Biomech. 2017:1–7. PubMed PMC

Zhang X, Paquette MR, Zhang S. A comparison of gait biomechanics of flip-flops, sandals, barefoot and shoes. J Foot Ankle Res. 2013;6(1):45. PubMed PMC