OBJECTIVES: Previous studies reported inconsistent findings about the effects of footwear on running economy, which is a surrogate measure of running performance. This meta-analytical review compared the running economy between running in barefoot, minimalists, and standard running shoes. DESIGN: Meta-analysis. METHODS: Electronic searches on Medline, CINAHL, SPORTDiscus, and Cochrane Library databases were performed and the reference lists of the screened articles were also scrutinized. Two reviewers screened clinical trials that measured the oxygen cost of runners in different footwear conditions. RESULTS: Thirteen studies were selected in this meta-analysis with a total of 168 runners included. Barefoot running was shown to be more economic than shod running (p < 0.01; standardized mean difference -0.43; 95% confidence interval -0.21 to -0.64; z = 3.96). Similar pattern was found when comparing minimalist and shoe (p < 0.01; standardized mean difference -0.49; 95% confidence interval -0.29 to -0.70; z = 4.64). The observed changes were of small effect. Conversely, no significant difference in the metabolic cost was found between running in minimalists and barefoot running (p = 0.45). CONCLUSIONS: Barefoot running or running in minimalist may require lower utilization of oxygen than shod running. Theoretically, the lower oxygen cost may improve long distance running performance. However, more than half of the runners in the included studies had previous barefoot experience and the findings may not apply to those habitual shod runners who are undergoing the transition. In addition, high risk of bias was reported in the included studies and quality study in the future is still warranted.

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