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Effect of neutral-cushioned running shoes on plantar pressure loading and comfort in athletes with cavus feet: a crossover randomized controlled trial
Wegener C, Burns J, Penkala S
The American Journal of Sports Medicine 2008 Nov;36(11):2139-2146
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: Yes; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: High injury rates observed in athletes with cavus feet are thought to be associated with elevated plantar pressure loading. Neutral-cushioned running shoes are often recommended to manage and prevent such injuries. PURPOSE: To investigate in-shoe plantar pressure loading and comfort during running in 2 popular neutral-cushioned running shoes recommended for athletes with cavus feet. STUDY DESIGN: Controlled laboratory study. METHODS: Plantar pressures were collected using the in-shoe Novel Pedar-X system during overground running in 22 athletes with cavus feet in 2 neutral-cushioned running shoes (Asics Nimbus 6 and Brooks Glycerin 3) and a control condition (Dunlop Volley). Comfort was measured using a validated visual analog scale. RESULTS: Compared with the control, both neutral-cushioned running shoes significantly reduced peak pressure and pressure-time integrals by 17% to 33% (p < 0.001). The Brooks Glycerin most effectively reduced pressure beneath the whole foot and forefoot (p < 0.01), and the Asics Nimbus most effectively reduced rearfoot pressure (p < 0.01). Both neutral-cushioned running shoes reduced force at the forefoot by 6% and increased it at the midfoot by 12% to 17% (p < 0.05). Contact time and area increased in both neutral-cushioned running shoes (p < 0.01). The Asics Nimbus was the most comfortable, although both neutral-cushioned running shoes were significantly more comfortable than the control (p < 0.001). CONCLUSION: Two popular types of neutral-cushioned running shoes were effective at reducing plantar pressures in athletes with cavus feet. CLINICAL RELEVANCE: Regional differences in pressure reduction suggest neutral-cushioned running shoe recommendation should shift from being categorical in nature to being based on location of injury or elevated plantar pressure.

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