1. bookVolume 64 (2018): Edizione 1 (September 2018)
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Do Strike Patterns or Shoe Conditions Have a Predominant Influence on Foot Loading?

Pubblicato online: 15 Oct 2018
Volume & Edizione: Volume 64 (2018) - Edizione 1 (September 2018)
Pagine: 13 - 23
Dettagli della rivista
License
Formato
Rivista
eISSN
1899-7562
Prima pubblicazione
13 Jan 2009
Frequenza di pubblicazione
5 volte all'anno
Lingue
Inglese
Abstract

This study aimed to explore the effects of strike patterns and shoe conditions on foot loading during running. Twelve male runners were required to run under shoe (SR) and barefoot conditions (BR) with forefoot (FFS) and rearfoot strike patterns (RFS). Kistler force plates and the Medilogic insole plantar pressure system were used to collect kinetic data. SR with RFS significantly reduced the maximum loading rate, whereas SR with FFS significantly increased the maximum push-off force compared to BR. Plantar pressure variables were more influenced by the strike patterns (15 out of 18 variables) than shoe conditions (7 out of 18 variables). The peak pressure of midfoot and heel regions was significantly increased in RFS, but appeared in a later time compared to FFS. The influence of strike patterns on running, particularly on plantar pressure characteristics, was more significant than that of shoe conditions. Heel-toe running caused a significant impact force on the heel, whereas wearing cushioned shoes significantly reduced the maximum loading rate. FFS running can prevent the impact caused by RFS. However, peak plantar pressure was centered at the forefoot for a long period, thereby inducing a potential risk of injury in the metatarsus/phalanx.

Key words

Introduction

Running is considered to be one of the most important recreational activities (De et al., 2000). It is an increasingly popular activity worldwide due to its high accessibility and low cost. However, the majority of recreational as well as elite runners experience a high incidence of running injury (Fredericson and Misra, 2007). Up to 79% of endurance runners are injured annually, and 46% of these injuries are recurrences (Van Gent et al., 2007). Nearly 80% of running injuries are overuse injuries, which are caused by overloading of the musculoskeletal system of lower extremities (Davis et al., 2017).

Repetitive impact forces experienced during long distance running normally reach the level of magnitude ranging from two to three times the body mass and are considered to induce damage to the musculoskeletal system of the lower extremity (Nordin et al., 2017). In order to reduce the magnitude of impact force and a corresponding high loading rate, the concept of “cushioning” was proposed in shoe manufacturing to reduce such impacts and potential impact-related running injuries. However, no scientific consensus with regard to the effect of cushioned shoes on the impact force and external loading currently exists. Clarke et al. (1983) showed that highly-cushioned shoes did not significantly change the peak impact force during heel-toe running, whereas Shorten and Mientje (2011) found that the peak impact force in cushioned shoes was significantly reduced during running compared with that in standard shoes. During the past 50 years, the incidence of running injuries has not decreased significantly in spite of the emergence of cushion sports shoes (Nigg, 2001). Thus, the role of cushioned shoes in reducing impact force and the rate of running injury remains controversial.

Recently, professional runners and researchers have advocated barefoot running in training, recreation activities, and competitions (Hamill and Gruber, 2017; Lieberman et al., 2010), claiming that it is an effective approach to reduce impact-related injuries (Altman and Davis, 2016; Bonacci et al., 2014). From a biomechanical perspective, one of the clearest differences between barefoot and conventional shod running is the way the foot strikes the ground. Specifically, most barefoot runners use a forefoot strike pattern (Lieberman et al., 2015), whereas approximately 90% of shod runners land on their heels (Hasegawa et al., 2007). Thus, the foot strike pattern was considered to be a key factor that contributed to the benefit of barefoot running (Shih et al., 2013). The forefoot strike decreases effective mass in the lower extremities, prevents the occurrence of repetitive impact forces during running, and reduces injury rates in runners (Lieberman et al., 2010), particularly patellofemoral pain (Bonacci et al., 2014). However, forefoot runners have higher Achilles tendon loading (Kulmala et al., 2013) and greater ankle joint contact forces (Rooney, 2013) than rearfoot runners. Therefore, the appropriateness for traditionally shod amateur runners to convert to a forefoot strike pattern or barefoot running is questionable. Furthermore, little evidence on the predominant influences of shoe conditions or foot strike patterns on foot loading during running is available. Plantar pressure measurement has been widely used to examine the actual loading applied to the feet (Mei et al., 2015; Queen et al., 2007). Knowledge on how plantar pressure combined with impact forces occur in response to different foot strike patterns and shoe conditions would be useful to better understand variations in foot and lower extremity loading and running-related injuries from both movement control and shoe roles.

The purpose of this study was to determine whether strike patterns or shoe conditions had a significant influence on foot loading. Under different strike patterns, ground reaction force, plantar pressure, and impulse during barefoot running (BR) were compared with those during shod running (SR). We hypothesized that 1) SR would significantly reduce the maximum loading rate, and 2) foot strike patterns would have a more pronounced influence than shoe conditions on overall plantar pressure characteristics during running.

Methods
Participants

Twelve healthy male recreational runners (age: 21.0 ± 1.3 years, body height: 177.1 ± 4.2 cm, and body mass: 68.1 ± 7.4 kg) volunteered to participate in this study. They all had 3-4 years of running experience and ran with regular RFS. All subjects reported no history of lower extremity injury within the previous 6 months and no vigorous exercise within 24 hours before the experiment. Before the start of the study, participants were familiarized with the experimental protocol and potential risks. Informed written consent was obtained from each participant and approved by the Institutional Review Board of the Shanghai University of Sport. Instrumentation

Two 90 × 60 × 10 cm 3D force plates (9287B, Kistler Corporation, Switzerland) embedded in the laboratory floor were used to register the ground reaction force (GRF) data at 1200 Hz. An in-shoe plantar pressure measuring system (T&T Medilogic Medizintechnik GmbH, Schönefeld, Germany) was used to collect plantar pressure data at 120 Hz during SR and BR with rearfoot and forefoot strike patterns (RFS and FFS, respectively). An insole contained a maximum of 240 force sensors, the number of which depended on insole size and shape, with dimensions of 0.6 × 0.4 cm and a working dynamic range of 6–640 kPa (Figure 1). Each insole was calibrated using the manufacturer’s calibration device prior to the study. A small portable datalogger was attached to the waist of each subject to transfer data to a computer through a wireless connection. The size of the pressure insole was selected according to the shoe code, and the thickness of the insole was 1.2 mm. A timing system with two sets of photocells (Witty-Manual, Microgate, Italy) was used to monitor the running speed. It collected the time elapsed while the participants ran at 3 m/s ± 5% along a 20 m runway (Figure 2). The standard running shoes, each with a full-length highly-cushioning unit, were used in this study (Figure 3). All the participants adopted the same lacing pattern and wore the same type of running socks to avoid the influence of various shoelaces and socks.

Figure 1

Insole pressure sensors and plantar regions.

Figure 2

Experimental set-up.

Figure 3

Experimental shoes (left), barefoot (right), and the set-up of the plantar pressure system.

Experimental procedure

Prior to the test, the participants were required to warm up on a treadmill at a running speed of 2.2 m/s for 3 min. They then ran at 3 m/s for 1 min to familiarize themselves with the target speed in the formal test. Subsequently, each performed BR and SR with FFS or RFS at 3 m/s ± 5% along a 20 m runway (Figure 4). The order of the foot strike patterns and the barefoot/shod condition was randomized. For each participant, three successful trials in which the foot was completely on the force plate were included for each condition.

Figure 4

(a) SR with RFS; (b) SR with FFS; (c) BR with RFS; (d) BR with FFS.

Data reduction

GRF data were normalized to body mass (BM). Figure 5 presents a representative vertical GRF (vGRF) time curve during the stance phase of running in different foot strike and shod conditions. The stance phase was identified when vGRF exceeded a threshold of 10 N. The variables of interest included: 1) total contact time (CT); 2) the first peak vGRF (FP), that is, the local maximum vGRF that was commonly obtained from the first 25% of the stance phase, and the occurrence time (tFP); 3) the second peak vGRF (SP), that is, the overall maximum vGRF, and its occurrence time (tSP); and 4) the peak vertical loading rate (LR) and its occurrence time (tLR), which was defined as the peak instantaneous slope of the vGRF time curve before the occurrence of FP.

Figure 5

Comparison of the 1st peak vGRF (FP), the corresponding occurrence time (tFP), the peak vertical loading rate (LR) and the occurrence time (tLR) between BR and SR with RFS.

The plantar pressure data were analyzed using Medilogic software (version 4.4). The plantar pressure was calculated dividing the insole area. A regional analysis of each insole was performed by dividing the plantar surface into five regions, namely, forefoot (40% of the foot length), midfoot (30% of the foot length), rearfoot (30% of the foot length), medial (50% of the foot width), and lateral (50% of the foot width). Plantar pressure variables of interest included the following: 1) the peak pressure (PP) of each region and its occurrence time (tPP); and 2) the pressure-time integral (PTI50), which was defined as the impulse of pressure, and was calculated from 0 to 50 ms after the foot contact.

Statistics

All the data were presented as mean ± standard deviation (SD). A two-way ANOVA with repeated measures was used to examine the effect of foot strike patterns and barefoot or shod conditions on running forces and plantar pressure characteristics (SPSS 17.0, SPSS Inc., Chicago, IL, USA). The intra-class correlation coefficient (ICC) was calculated using absolute agreement in a two-way model. The significance level α was set at 0.05.

Results
Ground reaction force

Overall, the FP and SP were approximately 2 and 2.5 times BM during running with RFS at 3 m/s, respectively. However, the tFP occurred earlier in the barefoot condition than in the shod condition. SP occurred during running with FFS, but FP did not (Figure 5). A significantly less CT with FFS was observed compared with RFS during both SR and BR (Table 1).

Comparison of the 2nd peak vGRF (SP), the occurrence time (tSP), and contact time (CT) among the four conditions

BRSR
VariablesRFSFFSRFSFFS
SP (BM)

Significant difference between BR and SR with RFS.

Significant difference between BR and SR with FFS.

2.49 ± 0.132.54 ± 0.342.62 ± 0.202.81 ± 0.14
tSP (ms)

Significant difference between RFS and FFS in SR.

Significant difference between RFS and FFS in BR.

Significant difference between BR and SR with RFS.

100.3 ± 5.4113.1 ± 7.7116.6 ± 10.9108.8 ± 7.1
CT (ms)

Significant difference between RFS and FFS in SR.

Significant difference between RFS and FFS in BR.

255.5 ± 19.7241.3 ± 18.2272.1 ± 17.5242.1 ± 13.4

BR, barefoot running; SR, shod running; RFS, rearfoot strike pattern; FFS, forefoot strike pattern.

No significant differences in FP were found between BR and SR with RFS. Moreover, tFP occurred earlier during BR than SR with RFS (p < 0.01, ICC > 0.5, Figure 6), whereas LR was higher and tLR occurred earlier during BR compared to during SR (p < 0.01, ICC > 0.6).

Figure 6

The GRF time curve of barefoot (BR) and shod running (SR) with the rearfoot strike pattern (left) and with forefoot strike pattern (right).

The SP was significantly higher in SR than in BR with both RFS and FFS (p = 0.008, ICC > 0.7, Table 1). The tSP occurred later in the shod condition than in the barefoot condition with RFS (p = 0.001, ICC > 0.6) and during BR with FFS compared to RFS (p = 0.001, ICC > 0.6), but occurred earlier during SR (p = 0.028, ICC > 0.5).

Plantar pressure

In summary, foot strike patterns (15 of the 18 variables) had a more significant effect on the plantar pressure characteristics (Figure 7) than shod conditions (7 of the 18 variables).

Figure 7

Comparison of peak pressure, occurrence time of peak pressure (tPP), and pressure-time integral during BR and SR with FFS and RFS. Note: Entire, entire foot; Fore, forefoot; Mid, midfoot; Rear, rearfoot; Lateral, lateral foot; Medial, medial foot. Meanwhile, no plantar pressure data in the rearfoot region was available during running with FFS. * Significant difference between FFS and RFS in running. # Significant difference between SR and BR.

First, a significant effect of the foot strike pattern on the PP was found at all plantar regions (Figure 7). Specifically, the PP at the entire foot (p = 0.012, ICC > 0.7), midfoot (p < 0.001, ICC > 0.6), rearfoot (p = 0.004, ICC > 0.8), and lateral (p = 0.004, ICC > 0.6) regions was lower in FFS than in RFS in both BR and SR, except for an increased PP at the forefoot (p = 0.002, ICC > 0.6) region in FFS. Additionally, the PP at the medial foot was higher in FFS compared with RFS in SR (p = 0.018, ICC > 0.6), and a significant shoe effect on the PP was found at the midfoot (p = 0.013, ICC > 0.6), rearfoot (p < 0.001, ICC > 0.8), and medial regions (p = 0.003, ICC > 0.6). Specifically, the PP at these regions was higher in SR than in BR with RFS. Only the PP at the midfoot region was higher in SR than in BR with FFS (p = 0.013, ICC > 0.6).

Second, foot strike patterns also had a significant effect on tPP at four plantar regions (Figure 7). Specifically, the tPP at the forefoot (p < 0.001, ICC > 0.6), midfoot (p = 0.038, ICC > 0.5), and rearfoot (p = 0.001, ICC > 0.6) regions occurred later in RFS compared to FFS in SR and BR. However, the tPP at the medial foot (p < 0.001, ICC > 0.6) region occurred earlier in RFS than in FFS during BR. A significant shoe effect on the tPP was found at the forefoot (p = 0.039, ICC > 0.6) and medial (p < 0.001, ICC > 0.6) foot regions, that is, the tPP at these regions occurred later in SR than in BR with RFS. The tPP at the forefoot occurred later in SR than in BR with FFS (p = 0.005, ICC > 0.6), whereas the tPP at the medial region occurred earlier (p = 0.038, ICC > 0.6).

Similar to the PP results, a significant effect of the foot strike pattern on the PTI50 was found at the five plantar regions (Figure 7). Specifically, the PTI50 at the entire foot (p = 0.004, ICC > 0.6), rearfoot (p = 0.013, ICC > 0.7), lateral (p = 0.044, ICC > 0.6), and medial (p = 0.004, ICC > 0.6) foot regions was lower in FFS than in RFS in both BR and SR, except for a higher PTI50 at the forefoot (p < 0.001, ICC > 0.7). Moreover, a significant shoe effect on the PTI50 was found at the forefoot and rearfoot regions. Specifically, the PTI50 at the forefoot region was higher in BR than in SR both with RFS and FFS (p = 0.011, ICC > 0.7); however, the PTI50 at the rearfoot region was lower in BR compared to SR (p < 0.001, ICC > 0.7).

Discussion

The purpose of this study was to examine whether strike patterns or shoe conditions had a significant influence on foot loading. Our hypothesis was supported by the results which indicated that SR significantly reduced the maximum LR and extended the occurrence of tFP and tLR. Moreover, the foot strike patterns (15 out of 18 variables) had a more significant influence than shoe conditions (7 out of 18 variables) on overall plantar pressure characteristics during running.

For the impact forces, no significant difference on FP was observed between BR and SR at RFS; however, tFP appeared earlier during BR compared to SR. The lack of significant differences for the FP between shoe conditions supports the results from the majority of impact-related studies. For instance, De et al. (2000) observed no significant main effect of condition (barefoot vs. shod) for the impact force, which may be because the impact force varies substantially for different effective masses (Lieberman et al., 2010), touchdown speeds (Bruggemann et al., 2011), and lower limb postures (Derrick et al., 2002), but is relatively insensitive to changes in shoe cushioning (Henniget al., 1996). The cushioned shoes were originally designed to attenuate impact force and reduce impact-related injuries (Clarke et al., 1983). Our results, together with those previously mentioned, indicate that cushioned running shoes do not significantly change the FP. On the other hand, LR and tLR were higher and occurred earlier during BR than SR. Similarly, the external loading rate was significantly higher in BR than in SR (De et al., 1994; Komi et al., 1987; Lees, 1988). More compliant shoe cushioning has been found to delay the time at which the tFP occurs and hence reduced the overall loading rate, whereas the magnitude of the impact force was unaffected (Heidenfelder et al., 2010; Wit et al., 2010). In addition, a meta-analysis reported a significant relationship between vertical load rates and tibial stress fractures in RFS runners (Zadpoor and Nikooyan, 2011). Our results suggest that SR does not change peak impacts, yet reduces the LR and extends the occurrence of tLR, indicating that RFS is not suitable for BR, whereas cushioned shoes can be beneficial in reducing the LR for runners with RFS.

For the FFS, no FP occurred (Figure 5). Thus, switching the foot strike to FFS may prevent vertical peak impact and decrease the peak loading rate, reducing the risk for impact-related injuries compared with RFS (Boyer et al., 2014; Cheung and Davis, 2011; Crowell and Davis, 2011; Giandolini et al., 2013; Lieberman et al., 2010). Some studies reported the benefits of using FFS. Daoud et al. (2012) reported that in a collegiate cross country team, RFS runners sustained medically diagnosed repetitive stress injuries twice as often as FFS runners. Moreover, transitioning from RFS to FFS prevents running injuries. Diebal et al. (2012) investigated a group of U.S. military cadets who presented anterior compartment syndrome and high intracompartmental pressures and who underwent transition to FFS. All the subjects demonstrated significant reduction in their intracompartmental pressure and were able to complete a 5 km run without pain.

On the other hand, our findings showed the SP was significantly larger in SR than in BR with FFS. A possible explanation is that the cushioning attribute in the forefoot of shoes enables forefoot landing with a flat placement and stimulates the foot to push off the ground rapidly and heavily (Keijsers et al., 2013; Shorten, 2011). Meanwhile, a significantly less CT occurred with FFS compared with RFS during SR and BR. These results indicate that SR with FFS can prevent peak impact, that is, FP, and produce large active forces, that is, SP, which may reduce the incidence of running injuries and improve performance.

The PP, its occurrence time (tPP), and PTI50 were also recorded for the analysis of foot loading characteristics. Based on the results, we found that foot strike patterns had a more significant effect on plantar pressure characteristics compared with shod conditions. In particular, of the 18 variables, 15 were significantly affected by the foot strike pattern, and seven were significantly affected by shoe conditions.

During RFS running, the pressure center moved from the rearfoot to the forefoot, whereas during FFS running, the pressure was concentrated in the forefoot region (Figure 7). Generally, plantar pressure provides information on the distribution of force, and this information can be related to potential damaging effects to local tissues (Rosenbaum and Becker, 2010). In the current study, we found that the PP in the forefoot was the greatest (Figure 7). The higher forefoot loads may be relevant to metatarsal stress fractures (Hockenbury, 1999). With regard to the effect of foot strike patterns on regional pressure in our study, significant reductions in PP and PTI50 were observed in the entire foot, rearfoot, and lateral regions in FFS in both BR and SR, except for an increased PP at the forefoot region in FFS. Similar findings were reported by Kernozek et al. (2014), who showed that PP and PTI at heel and midfoot regions were higher in RFS than in FFS during running when a minimalist footwear was used, but were lower in PP and PTI at the forefoot. Furthermore, Warne et al. (2013) found that the increase in plantar pressure in the forefoot region during running altered the foot strike pattern from RFS to FFS with barefoot-simulated minimalistic shoes on a treadmill. Changes in plantar pressure can provide accurate data on how the foot is loaded with respect to the supporting surface, given that unnatural or localized loading may predict or indicate injury risk (Orlin and Mcpoil, 2000), particularly tibial and metatarsal stress fractures (Davis et al., 2011). The reduction in plantar pressure during running may represent a possibility for injury reduction as impact and pressure have been linked to running-related injury (Davis et al., 2004; Macdermid et al., 2017). Collectively, our findings indicate that FFS may reduce the risk of impact-related injuries in contrast to RFS. However, transitioning from RFS to FFS acutely may also increase forefoot loading.

Regarding the shoe effect on regional pressure with RFS, the PPs at midfoot, rearfoot, and medial regions were significantly reduced in BR compared to SR. The PP at the midfoot region was lower in BR than in SR with FFS, and the PTI50 at the forefoot region was higher in BR than in SR with both RFS and FFS. However, the PTI50 at the rearfoot region was lower in BR than in SR. These findings are partially supported by the study of Bergstra et al. (2015), who showed that the PP and PTI of the forefoot region increased with the minimalist shoes in contrast to those in standard shoes. The PP and PTI in the heel region did not differ between the two shoe types. In the midfoot region, PP was reduced in minimalist running shoes. The difference between our results and those of Bergstra et al. (2015) may be attributed to differences in gender, testing shoes, and running speed.

The key outcome of this study was that the average PP and average PTI50 of the entire foot were significantly reduced with FFS compared to RFS. Moreover, the lowest PP and PTI50 were obtained during SR with FFS. Combined with the results of the impact and maximum vertical GRF, SR with FFS may prevent impact and improve performance. The current findings indicate that FFS may be the main factor that contributes to the benefit of BR. Meanwhile, the pressure concentrated at the forefoot for a long time with FFS increases the risk of overuse injury at the metatarsal area (Shakoor and Block, 2006). Therefore, a suitable pair of running shoes is needed for runners with either FFS or RFS to reduce plantar pressure during running.

The limitations of the current study are acknowledged along with proposed future directions for research. First, we only considered the acute effects of shoe and foot strike pattern condition on running impacts. Therefore, the assessment of lower limb kinematics, accompanied with joint kinetics and muscle forces or activation, is warranted to provide further evidence of neuro-musculoskeletal reactions. Second, a long-term effect of the shoe and foot strike pattern should be considered. Highlighting the effect of gender is highly recommended.

Conclusion

The influence of strike patterns on running is more significant than shoe conditions, which was observed in plantar pressure characteristics. Heel-toe running caused a significant impact force on the heel, but cushioned shoes significantly reduced the maximum loading rate. Meanwhile, although forefoot running can prevent impact, peak plantar pressure was centered at the forefoot for a long period, inducing a potential risk of injury in the metatarsus/phalanx. Plantar pressure on the forefoot with RFS was lesser and push-off force was greater when cushioned shoes were used than when running barefoot.

Figure 1

Insole pressure sensors and plantar regions.
Insole pressure sensors and plantar regions.

Figure 2

Experimental set-up.
Experimental set-up.

Figure 3

Experimental shoes (left), barefoot (right), and the set-up of the plantar pressure system.
Experimental shoes (left), barefoot (right), and the set-up of the plantar pressure system.

Figure 4

(a) SR with RFS; (b) SR with FFS; (c) BR with RFS; (d) BR with FFS.
(a) SR with RFS; (b) SR with FFS; (c) BR with RFS; (d) BR with FFS.

Figure 5

Comparison of the 1st peak vGRF (FP), the corresponding occurrence time (tFP), the peak vertical loading rate (LR) and the occurrence time (tLR) between BR and SR with RFS.
Comparison of the 1st peak vGRF (FP), the corresponding occurrence time (tFP), the peak vertical loading rate (LR) and the occurrence time (tLR) between BR and SR with RFS.

Figure 6

The GRF time curve of barefoot (BR) and shod running (SR) with the rearfoot strike pattern (left) and with forefoot strike pattern (right).
The GRF time curve of barefoot (BR) and shod running (SR) with the rearfoot strike pattern (left) and with forefoot strike pattern (right).

Figure 7

Comparison of peak pressure, occurrence time of peak pressure (tPP), and pressure-time integral during BR and SR with FFS and RFS. Note: Entire, entire foot; Fore, forefoot; Mid, midfoot; Rear, rearfoot; Lateral, lateral foot; Medial, medial foot. Meanwhile, no plantar pressure data in the rearfoot region was available during running with FFS. * Significant difference between FFS and RFS in running. # Significant difference between SR and BR.
Comparison of peak pressure, occurrence time of peak pressure (tPP), and pressure-time integral during BR and SR with FFS and RFS. Note: Entire, entire foot; Fore, forefoot; Mid, midfoot; Rear, rearfoot; Lateral, lateral foot; Medial, medial foot. Meanwhile, no plantar pressure data in the rearfoot region was available during running with FFS. * Significant difference between FFS and RFS in running. # Significant difference between SR and BR.

Comparison of the 2nd peak vGRF (SP), the occurrence time (tSP), and contact time (CT) among the four conditions

BRSR
VariablesRFSFFSRFSFFS
SP (BM)

Significant difference between BR and SR with RFS.

Significant difference between BR and SR with FFS.

2.49 ± 0.132.54 ± 0.342.62 ± 0.202.81 ± 0.14
tSP (ms)

Significant difference between RFS and FFS in SR.

Significant difference between RFS and FFS in BR.

Significant difference between BR and SR with RFS.

100.3 ± 5.4113.1 ± 7.7116.6 ± 10.9108.8 ± 7.1
CT (ms)

Significant difference between RFS and FFS in SR.

Significant difference between RFS and FFS in BR.

255.5 ± 19.7241.3 ± 18.2272.1 ± 17.5242.1 ± 13.4

Altman AR, Davis IS. Prospective comparison of running injuries between shod and barefoot runners. Br J Sports Med 2016; 50: 476-480AltmanARDavisISProspective comparison of running injuries between shod and barefoot runnersBr J Sports Med20165047648010.1136/bjsports-2014-09448226130697Search in Google Scholar

Bergstra SA, Kluitenberg B, Dekker R, Bredeweg SW, Postema K. Running with a minimalist shoe increases plantar pressure in the forefoot region of healthy female runners. J Sci Med Sport 2015; 18: 463-468BergstraSAKluitenbergBDekkerRBredewegSWPostemaKRunning with a minimalist shoe increases plantar pressure in the forefoot region of healthy female runnersJ Sci Med Sport20151846346810.1016/j.jsams.2014.06.00725024135Search in Google Scholar

Bonacci J, Vicenzino B, Spratford W, Collins W. Take your shoes off to reduce patellofemoral joint stress during running. Br J Sports Med 2014; 48: 425-428BonacciJVicenzinoBSpratfordWCollinsWTake your shoes off to reduce patellofemoral joint stress during runningBr J Sports Med20144842542810.1136/bjsports-2013-09216023850795Search in Google Scholar

Boyer ER, Rooney BD, Derrick TR. Rearfoot and midfoot or forefoot impacts in habitually shod runners. Med Sci Sports Exerc 2014; 46: 1384-1391BoyerERRooneyBDDerrickTRRearfoot and midfoot or forefoot impacts in habitually shod runnersMed Sci Sports Exerc2014461384139110.1249/MSS.000000000000023424300124Search in Google Scholar

Brüggemann GP, Brüggemann L, Heinrich K, Mller M, Niehoff A. Biological tissue response to impact like mechanical loading. Footwear Science 2011; 3: 13-22BrüggemannGPBrüggemannLHeinrichKMllerMNiehoffABiological tissue response to impact like mechanical loadingFootwear Science20113132210.1080/19424280.2011.555248Search in Google Scholar

Cheung RT, Davis IS. Landing pattern modification to improve patellofemoral pain in runners: a case series. J Orthop Sports Phys Ther 2011; 41: 914-919CheungRTDavisISLanding pattern modification to improve patellofemoral pain in runners: a case seriesJ Orthop Sports Phys Ther20114191491910.2519/jospt.2011.377122031595Search in Google Scholar

Clarke TE, Frederick EC, Cooper LB. Effects of shoe cushioning upon ground reaction forces in running. Int J Sports Med 1983; 4: 247-251ClarkeTEFrederickECCooperLBEffects of shoe cushioning upon ground reaction forces in runningInt J Sports Med1983424725110.1055/s-2008-10260436654550Search in Google Scholar

Crowell HP, Davis IS. Gait retraining to reduce lower extremity loading in runners. Clin Biomech 2011; 26: 78-83CrowellHPDavisISGait retraining to reduce lower extremity loading in runnersClin Biomech201126788310.1016/j.clinbiomech.2010.09.003301439920888675Search in Google Scholar

Daoud AI, Geissler GJ, Wang F, Saretsky J, Daoud YA, Lieberman DE. Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc 2012; 44: 1325-1334DaoudAIGeisslerGJWangFSaretskyJDaoudYALiebermanDEFoot strike and injury rates in endurance runners: a retrospective studyMed Sci Sports Exerc2012441325133410.1249/MSS.0b013e318246511522217561Search in Google Scholar

Davis I, Milner CE, Hamill J. Does increased loading during running lead to tibial stress fractures? Med Sci Sports Exerc 2004; 36: 58DavisIMilnerCEHamillJDoes increased loading during running lead to tibial stress fractures?Med Sci Sports Exerc2004365810.1097/00005768-200405001-00271Search in Google Scholar

De CD, Aerts P, Kunnen M. The mechanical characteristics of the human heel pad during foot strike in running: an in vivo cineradiographic study. J Biomech 1994; 27: 1213-1222DeCDAertsPKunnenMThe mechanical characteristics of the human heel pad during foot strike in running: an in vivo cineradiographic studyJ Biomech1994271213122210.1016/0021-9290(94)90275-5Search in Google Scholar

De WB, De WB, Aerts P. Biomechanical analysis of the stance phase during barefoot and shod running. J Biomech 2000; 33: 269-278DeWBDeWBAertsPBiomechanical analysis of the stance phase during barefoot and shod runningJ Biomech20003326927810.1016/S0021-9290(99)00192-XSearch in Google Scholar

Derrick TR, Dereu D, Mclean SP. Impacts and kinematic adjustments during an exhaustive run. Med Sci Sports Exerc 2002; 34: 998-1002DerrickTRDereuDMcleanSPImpacts and kinematic adjustments during an exhaustive runMed Sci Sports Exerc200234998100210.1097/00005768-200206000-0001512048328Search in Google Scholar

Diebal AR, Gregory R, Alitz C, Gerber JP. Forefoot running improves pain and disability associated with chronic exertional compartment syndrome. Am J Sports Med 2012; 40: 1060-1067DiebalARGregoryRAlitzCGerberJPForefoot running improves pain and disability associated with chronic exertional compartment syndromeAm J Sports Med2012401060106710.1177/036354651243918222427621Search in Google Scholar

Fredericson M, Misra AK. Epidemiology and aetiology of marathon running injuries. Sports Med 2007; 37: 437-439FredericsonMMisraAKEpidemiology and aetiology of marathon running injuriesSports Med20073743743910.2165/00007256-200737040-0004317465629Search in Google Scholar

Giandolini ME, Horvais N, Farges Y, Samozino P, Morin JB. Impact reduction through long-term intervention in recreational runners: midfoot strike pattern versus low-drop/low-heel height footwear. Eur J Appl Physiol 2013; 113: 2077-2090GiandoliniMEHorvaisNFargesYSamozinoPMorinJBImpact reduction through long-term intervention in recreational runners: midfoot strike pattern versus low-drop/low-heel height footwearEur J Appl Physiol20131132077209010.1007/s00421-013-2634-723584279Search in Google Scholar

Giuliani J, Masini B, Alitz C, Owens BD. Barefoot-simulating footwear associated with metatarsal stress injury in 2 runners. Orthopedics 2011; 34: 320-323GiulianiJMasiniBAlitzCOwensBDBarefoot-simulating footwear associated with metatarsal stress injury in 2 runnersOrthopedics20113432032310.3928/01477447-20110526-2521717998Search in Google Scholar

Hamill J, Gruber AH. Is changing footstrike pattern beneficial to runners? J Sport Health Sci 2017; 6: 146-153HamillJGruberAHIs changing footstrike pattern beneficial to runners?J Sport Health Sci2017614615310.1016/j.jshs.2017.02.004618900530356626Search in Google Scholar

Hasegawa H, Yamauchi T, Kraemer WJ. Foot strike patterns of runners at the 15-km point during an elite-level half marathon. J Strength Cond Res 2007; 21: 888-893HasegawaHYamauchiTKraemerWJFoot strike patterns of runners at the 15-km point during an elite-level half marathonJ Strength Cond Res200721888893Search in Google Scholar

Heidenfelder J, Sterzing T, Milani TL. Systematically modified crash-pad reduces impact shock in running shoes. Footwear Science 2010; 2: 85-91HeidenfelderJSterzingTMilaniTLSystematically modified crash-pad reduces impact shock in running shoesFootwear Science20102859110.1080/19424281003781543Search in Google Scholar

Hennig EM, Valiant GA, Liu Q. Biomechanical variables and the perception of cushioning for running in various types of footwear. J Appl Biomech 1996; 12: 143-150HennigEMValiantGALiuQBiomechanical variables and the perception of cushioning for running in various types of footwearJ Appl Biomech19961214315010.1123/jab.12.2.143Search in Google Scholar

Hockenbury RT. Forefoot problems in athletes. Med Sci Sports Exerc 1999; 31: 448-458HockenburyRTForefoot problems in athletesMed Sci Sports Exerc19993144845810.1097/00005768-199907001-0000610416546Search in Google Scholar

Keijsers NL, Stolwijk NM, Louwerens JW, Duysens J. Classification of forefoot pain based on plantar pressure measurements. Clin Biomech 2013; 28: 350-356KeijsersNLStolwijkNMLouwerensJWDuysensJClassification of forefoot pain based on plantar pressure measurementsClin Biomech20132835035610.1016/j.clinbiomech.2013.01.01223434343Search in Google Scholar

Kernozek TW, Meardon S, Vannatta CN. In-shoe loading in rearfoot and non-rearfoot strikers during running using minimalist footwear. Int J Sports Med 2014; 35: 1112-1117KernozekTWMeardonSVannattaCNIn-shoe loading in rearfoot and non-rearfoot strikers during running using minimalist footwearInt J Sports Med2014351112111710.1055/s-0034-137262724977946Search in Google Scholar

Komi PV, Gollhofer A, Schmidtbleicher D, Frick U. Interaction between man and shoe in running: considerations for a more comprehensive measurement approach. Int J Sports Med 1987; 8: 196-202KomiPVGollhoferASchmidtbleicherDFrickUInteraction between man and shoe in running: considerations for a more comprehensive measurement approachInt J Sports Med1987819620210.1055/s-2008-10256553623781Search in Google Scholar

Kulmala JP, Avela J, Pasanen K, Parkkari J. Forefoot strikers exhibit lower running-induced knee loading than rearfoot strikers. Med Sci Sports Exerc 2013; 45: 2306-2313KulmalaJPAvelaJPasanenKParkkariJForefoot strikers exhibit lower running-induced knee loading than rearfoot strikersMed Sci Sports Exerc2013452306231310.1249/MSS.0b013e31829efcf723748735Search in Google Scholar

Lees A. The role of athlete response tests in the biomechanical evaluation of running shoes. Ergonomics 1988; 31: 1673-1681LeesAThe role of athlete response tests in the biomechanical evaluation of running shoesErgonomics1988311673168110.1080/00140138808966817Search in Google Scholar

Lieberman DE, Castillo ER, Otarolacastillo E, Sang MK, Sigei TK. Variation in foot strike patterns among habitually barefoot and shod runners in Kenya. Plos One 2015; 10: e0131354LiebermanDECastilloEROtarolacastilloESangMKSigeiTKVariation in foot strike patterns among habitually barefoot and shod runners in KenyaPlos One201510e013135410.1371/journal.pone.0131354449598526154285Search in Google Scholar

Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, Andrea SD, Davis IS. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature 2010; 463: 531-535LiebermanDEVenkadesanMWerbelWADaoudAIAndreaSDDavisISFoot strike patterns and collision forces in habitually barefoot versus shod runnersNature201046353153510.1038/nature0872320111000Search in Google Scholar

Macdermid PW, Fink PW, Stannard SR. Shock attenuation, spatio-temporal and physiological parameter comparisons between land treadmill and water treadmill running. J Sport Health Sci 2017; 6: 482-488MacdermidPWFinkPWStannardSRShock attenuation, spatio-temporal and physiological parameter comparisons between land treadmill and water treadmill runningJ Sport Health Sci2017648248810.1016/j.jshs.2015.12.006618924230356623Search in Google Scholar

Mei Q, Fernandez J, Fu W, Feng N, Gu Y. A comparative biomechanical analysis of habitually unshod and shod runners based on a foot morphological difference. Hum Mov Sci 2015; 42: 38-53MeiQFernandezJFuWFengNGuYA comparative biomechanical analysis of habitually unshod and shod runners based on a foot morphological differenceHum Mov Sci201542385310.1016/j.humov.2015.04.00725964998Search in Google Scholar

Nigg BM. The role of impact forces and foot pronation: a new paradigm. Clin J Sport Med 2001; 11: 2-9NiggBMThe role of impact forces and foot pronation: a new paradigmClin J Sport Med2001112910.1097/00042752-200101000-0000211176139Search in Google Scholar

Nordin AD, Dufek JS, Mercer JA. Three-dimensional impact kinetics with foot-strike manipulations during running. J Sport Health Sci 2017; 6: 489-497NordinADDufekJSMercerJAThree-dimensional impact kinetics with foot-strike manipulations during runningJ Sport Health Sci2017648949710.1016/j.jshs.2015.11.003618926230356650Search in Google Scholar

Orlin MN, Mcpoil TG. Plantar pressure assessment. Phys Ther 2000; 80(4): 399-409OrlinMNMcpoilTGPlantar pressure assessmentPhys Ther200080439940910.1093/ptj/80.4.39910758524Search in Google Scholar

Queen RM, Haynes BB, Hardaker WM, Garrett WE. Forefoot loading during 3 athletic tasks. Am J Sports Med 2007; 35: 630-636QueenRMHaynesBBHardakerWMGarrettWEForefoot loading during 3 athletic tasksAm J Sports Med20073563063610.1177/036354650629593817218653Search in Google Scholar

Rooney BD. Joint contact loading in forefoot and rearfoot strike patterns during running. J Biomech 2013; 46: 2201-2206RooneyBDJoint contact loading in forefoot and rearfoot strike patterns during runningJ Biomech2013462201220610.31274/etd-180810-117Search in Google Scholar

Rosenbaum D, Becker HP. Plantar pressure distribution measurements. Foot Ankle Surg 2010; 3: 1-14RosenbaumDBeckerHPPlantar pressure distribution measurementsFoot Ankle Surg2010311410.1046/j.1460-9584.1997.00043.xSearch in Google Scholar

Shakoor N, Block JA. Walking barefoot decreases loading on the lower extremity joints in knee osteoarthritis. Arthritis Rheumatol 2006; 54: 2923-2927ShakoorNBlockJAWalking barefoot decreases loading on the lower extremity joints in knee osteoarthritisArthritis Rheumatol2006542923292710.1002/art.2212316947448Search in Google Scholar

Shih Y, Lin KL, Shiang TY. Is the foot striking pattern more important than barefoot or shod conditions in running? Gait Posture 2013; 38: 490-494ShihYLinKLShiangTYIs the foot striking pattern more important than barefoot or shod conditions in running?Gait Posture20133849049410.1016/j.gaitpost.2013.01.03023507028Search in Google Scholar

Shorten M, Mientje MI. The heel impact force peak during running is neither heel nor impact and does not quantify shoe cushioning effects. Footwear Science 2011; 3: 41-58ShortenMMientjeMIThe heel impact force peak during running is neither heel nor impact and does not quantify shoe cushioning effectsFootwear Science20113415810.1080/19424280.2010.542186Search in Google Scholar

Shorten MR. Biomechanics of sports shoes, by Benno M. Nigg. Footwear Science 2011; 3: 1-2ShortenMRBiomechanics of sports shoes, by Benno MNigg. Footwear Science201131210.1080/19424280.2011.570794Search in Google Scholar

Van Gent RN, Siem D, Van MM, Van Os AG, Biermazeinstra SM. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med 2007; 41: 469-480VanGent RNSiemDVanMMVanOs AGBiermazeinstraSMIncidence and determinants of lower extremity running injuries in long distance runners: a systematic reviewBr J Sports Med20074146948010.1136/bjsm.2006.033548246545517473005Search in Google Scholar

Davis IS, Rice HM, Wearing SC. Why forefoot striking in minimal shoes might positively change the course of running injuries. J Sport Health Sci 2017; 6: 154-161DavisISRiceHMWearingSCWhy forefoot striking in minimal shoes might positively change the course of running injuriesJ Sport Health Sci2017615416110.1016/j.jshs.2017.03.013618900230356630Search in Google Scholar

Warne JP, Kilduff SM, Gregan BC, Nevill AM, Moran KA, Warrington GD. A 4-week instructed minimalist running transition and gait-retraining changes plantar pressure and force. Scand J Med Sci Sports 2013; 24: 964-973WarneJPKilduffSMGreganBCNevillAMMoranKAWarringtonGDA 4-week instructed minimalist running transition and gait-retraining changes plantar pressure and forceScand J Med Sci Sports20132496497310.1111/sms.1212124004458Search in Google Scholar

Wit BD, Clercq DD, Lenoir M. The effect of varying midsole hardness on impact forces and foot motion during foot contact in running. J Appl Biomech 2010; 11: 395-406WitBDClercqDDLenoirMThe effect of varying midsole hardness on impact forces and foot motion during foot contact in runningJ Appl Biomech20101139540610.1123/jab.11.4.395Search in Google Scholar

Zadpoor AA, Nikooyan AA. The relationship between lower-extremity stress fractures and the ground reaction force: a systematic review. Clin Biomech 2011; 26: 23-28ZadpoorAANikooyanAAThe relationship between lower-extremity stress fractures and the ground reaction force: a systematic reviewClin Biomech201126232810.1016/j.clinbiomech.2010.08.00520846765Search in Google Scholar

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