The Effects of Minimal Shoes on Ankle Kinematics During Running: A Systematic Review

Minimal shoes may alter ankle kinematics while running. This study aimed to systematically review studies investigating ankle kinematics in runners while wearing minimalist shoes versus traditional shoes and barefoot. Four databases including PubMed (128 studies), Web of science (224), Scopus (242 studies) and Embase (148 studies) were searched from inception to Aug 9, 2022. Two reviewers screened studies to identify studies reporting the effects of minimal shoes on ankle kinematics during running. Eleven studies with a total of 203 (wearing minimal shoes) participants and 18 controls (8 participants wearing minimal shoes without gait training and 10 wearing standard shoes) were included. The study design of the included studies were RCTs (2 studies), prospective study (1), cross-sectional study (5), and crossover (3). The Downs and Black appraisal scale was applied to assess the quality of included studies. The results showed that minimal shoe was capable of changing the kinematics of ankle while running. Uncushioned minimal shoes decreased ankle dorsiflexion at initial contact and ankle adduction, and increased plantarflexion moment, strike index, total ROM and joint excursion in stance phase compared to traditional shoes. Standardizing shoes and speeds are needed for reliable comparisons among studies. Because most studies examining the efficacy of minimal shoes, had a low level of evidence, further studies providing valid and high-quality evidence which include RCTs are required to support clinical practice in the use of minimal shoes. Uncushioned minimal shoes are better replicating barefoot running. Therefore, it is recommended for runners since they can change their foot strike pattern to mid-foot or forefoot and consequently reduce peak impact force, resulting in preventing future injuries especially in the knee.