Hollander Karsten, Heidt Christoph, VAN DER Zwaard Babette C, Braumann Klaus-Michael, Zech Astrid
1Department of Sports and Exercise Medicine, Institute of Human Movement Science, University of Hamburg, GERMANY; 2Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, SWITZERLAND; 3Department of Sport Science, Stellenbosch University, Stellenbosch, SOUTH AFRICA; and 4Institute of Sport Science, Friedrich Schiller University Jena, GERMANY.
Med Sci Sports Exerc. 2017 Apr;49(4):752-762. doi: 10.1249/MSS.0000000000001141.
Barefoot locomotion is widely believed to be beneficial for motor development and biomechanics but are implied to be responsible for foot pathologies and running-related injuries. Although most of available studies focused on acute effects of barefoot running and walking little is known regarding the effects of long-term barefoot versus shod locomotion. The purpose of this study was to systematically review the literature to evaluate current evidence of habitual barefoot (HB) versus habitual shod locomotion on foot anthropometrics, biomechanics, motor performance, and pathologies.
Four electronic databases were searched using terms related to habitually barefoot locomotion. Relevant studies were identified based on title, abstract, and full text, and a forward (citation tracking) and backward (references) search was performed. Risk of bias was assessed, data pooling, and meta-analysis (random effects model) performed and finally levels of evidence determined.
Fifteen studies with 8399 participants were included. Limited evidence was found for a reduced ankle dorsiflexion at footstrike (pooled effect size, -3.47; 95% confidence interval [CI], -5.18 to -1.76) and a lower pedobarographically measured hallux angle (-1.16; 95% CI, -1.64 to -0.68). HB populations had wider (0.55; 95% CI, 0.06-1.05) but no shorter (-0.22; 95% CI, -0.51 to 0.08) feet compared with habitual shod populations. No differences in relative injury rates were found, with limited evidence for a different body part distribution of musculoskeletal injuries and more foot pathologies and less foot deformities and defects in HB runners.
Only limited or very limited evidence is found for long-term effects of HB locomotion regarding biomechanics or health-related outcomes. Moreover, no evidence exists for motor performance. Future research should include prospective study designs.
人们普遍认为赤脚行走对运动发育和生物力学有益，但也被认为是足部病变和与跑步相关损伤的原因。尽管大多数现有研究关注赤脚跑步和行走的急性影响，但对于长期赤脚与穿鞋行走的影响知之甚少。本研究的目的是系统回顾文献，以评估习惯性赤脚（HB）与习惯性穿鞋行走对足部人体测量学、生物力学、运动表现和病变的现有证据。
使用与习惯性赤脚行走相关的术语搜索四个电子数据库。根据标题、摘要和全文确定相关研究，并进行向前（引用追踪）和向后（参考文献）搜索。评估偏倚风险，进行数据合并和荟萃分析（随机效应模型），最后确定证据水平。
纳入了15项研究，共8399名参与者。发现有限的证据表明在着地时踝关节背屈减少（合并效应量，-3.47；95%置信区间[CI]，-5.18至-1.76）以及通过足压测量的拇趾角度较低（-1.16；95%CI，-1.64至-0.68）。与习惯性穿鞋人群相比，HB人群的脚更宽（0.55；95%CI，0.06 - 1.05）但并不短（-0.22；95%CI，-0.51至0.08）。未发现相对损伤率有差异，仅有有限的证据表明HB跑步者的肌肉骨骼损伤在身体部位分布不同，足部病变更多，足部畸形和缺陷更少。
关于HB行走对生物力学或与健康相关结果的长期影响，仅发现有限或非常有限的证据。此外，没有证据表明对运动表现有影响。未来的研究应包括前瞻性研究设计。
