Barefoot versus Shod Training: Effects on Navicular Drop and Foot Pressure Analysis

Background and Purpose: Running is a popular form of exercise around the world. The running population generally runs in a rear-foot strike pattern (RFSP), yet there is questioning on the possible benefits of running in a forefoot strike pattern (FFSP). The main goal of FFSP is the possible reduction of running related injuries by reducing the stress on the medial longitudinal arch. The purpose of this research study is to determine if a barefoot running retraining program will have an effect on navicular drop height, plantar pressure area, and peak plantar pressure of the medial aspect of the foot. Material/Methods: Eleven first and second year physical therapy students participated in this study. Each subject was randomly assigned to a barefoot running group (N = 6) and shod running group (N =5). Measurements of foot pronation were taken using the navicular drop test. Spatiotemporal foot pressures and area were evaluated through the GAITRite® system to measure plantar pressure area and peak plantar pressure. Each subject completed pre-testing a week prior to beginning a 5-week retraining program designed from relevant literature. Post-testing was completed one week following the retraining program to assess changes in arch dynamics. The data collected from the pre- and post-testing was processed and analyzed using the Statistical Package for Social Sciences (SPSS) software. An alpha (α) level \u3c0.05 was used to determine statistical significance. Following the completion of the study, a post survey was used to determine subject’s perception of this study. Results: The statistically significant result came from the barefoot running group, in which peak plantar pressure decreased in foot division 6 from 0.70 to 0.2920 (p=0.035). There were no other statistically significant changes to note from the plantar pressure area or navicular drop examinations. The post survey results included the perceived adverse effects of pain along the heads of metatarsals, blisters and, muscle tightness. Discussion: There may be clinical relevance for barefoot running versus shod running despite the lack of statistically significant results from this study. Due to the one statistically significant result coming from a dynamic assessment, it may be possible that barefoot running has more of an effect on foot pronation during dynamic activities as opposed to static activities. This increase in dynamic stability may lead to a decrease in running related injuries thus possibly making barefoot running a clinically relevant intervention. Limitations of this study included: a small sample size, narrow population, too rapid of running progression, running on treadmills with socks on, researcher did not remain blinded to subject group, length of the study was too short, inability to directly measure dynamic navicular drop, and GAITRite® mapping system provided occasionally inconsistent measurements with additional running/walking trials needed. Future research could address these limitations through creation of an ongoing study and/or open it to the public to improve subject population