UNASSIGNED: Allergic contact dermatitis of the feet is a significant problem that affects the quality of life and requires attention from the medical community due to the number of studied and still unidentified allergens. The purpose of this review article is to summarize the available scientific data regarding the most common allergens that cause ACD of the feet.
UNASSIGNED: Nickel sulphate, neomycin sulphate, thiuram mix and colophony occupy a significant place in the prevalence of allergies. The prevalence of sensitization to rubber and leather products can vary depending on the ethno-demographic characteristics of the country, as well as the specifics of a person\'s professional activity, such as the use of protective waterproof shoes, increased humidity of the microclimate, and atopy in anamnesis.
UNASSIGNED: Patch testing has been shown to be an important method for identifying allergens, however, not all footwear components are tested during patch testing with standard allergen series, requiring the use of patches made from patient shoe samples.
UNASSIGNED: Expanding the scope of patch testing to include other possible allergens is important for the accurate diagnosis of ACD of the feet and a more detailed study of those allergens that were previously considered rare.

The Nike Vaporfly 4% (VP4) shoe is popular due to its unique design and reported performance benefits. However, the underlying mechanisms responsible for the improvements remain unclear. One proposed mechanism is the teeter-totter effect. This study aimed to 1) experimentally test the teeter-totter theory by estimating the teeter-totter moment (MTT) in the VP4 compared to a flat shoe (CONTROL) and 2) quantify the change in the anterior-posterior position of the centre of pressure (Δxa-p) in the VP4 compared to the CONTROL. Plantar pressures and high-speed video were recorded from 15 runners in two shoe conditions. The VP4 generated a larger propulsion moment, MP, (∫MPdt = 90.46 ± 38.87 Nms; p < 0.001, d = 1.95), suggesting the presence of an MTT in the VP4 (∫MTTdt = 57.16 ± 24.35 Nms) when compared to the CONTROL (∫MPdt = 33.30 ± 14.52 Nms). Δxa-p was greater in the VP4 (Δxa-p = 9.48 ± 6.08 mm; p < 0.001, d = 2.07) compared to the CONTROL (Δxa-p = 0.54 ± 0.67 mm). This study provides a methodological proof-of-concept for the teeter-totter theory. The findings highlight the possibility of a teeter-totter effect resulting in greater heel propulsion while running in an AFT shoe construction, assuming a constant muscle moment and pivot point.

Background/Objectives: Plantar fasciitis (PF) is a common condition that causes heel pain. While various conservative treatment modalities for PF exist, no previous studies have investigated the effectiveness of shoe rotation (ShR) in patients with PF pain. This study aimed to compare the therapeutic effectiveness of ShR with that of two conventional treatments for PF-namely, foot orthosis (FO) and physical therapy (PT). Methods: Charts of 42 patients with heel pain were retrospectively reviewed. Participants were allocated to one of three treatment groups: the ShR group, the customized FO group, and the PT group. Pain and functional outcomes were assessed using the Visual Analog Scale (VAS), Digital Pain Scale (DPS), Foot Function Index (FFI), Foot Pain and Function Scale (FPFS), and American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) at baseline and at 4 and 12 weeks after the intervention. Results: The ShR, FO, and PT groups all showed improvements, with statistically significant decreases in VAS, DPS, and FFI scores and significant increases in FPFS and AOFAS-AHS scores over time (p < 0.05). All three interventions resulted in significant improvements from baseline to 4 weeks and further to 12 weeks (p < 0.05). The ShR group exhibited a slightly larger effect on all measurements than the other groups. Conclusions: ShR, FO, and PT contributed to pain reduction and functional improvement, and alternating the shoes alleviated PF pain. These results suggest a new approach to managing PF and serve as a basis for providing convenient treatment for patients with PF.

UNASSIGNED: Adherence to therapeutic footwear is vital for effective diabetic foot ulcer prevention and treatment. Understanding the key adherence factors and potential barriers is important for footwear design and implementation. Our team is creating intelligent offloading footwear to prevent lower extremity amputations in people living with diabetes (PLwD). This exploratory study assessed the ability of the established Unified Theory of Acceptance and Use of Technology (UTAUT) model to predict behavioral intention to use or recommend this intelligent offloading footwear by PLwD, caregivers of PLwD, or medical professionals treating PLwD.
UNASSIGNED: Online and paper questionnaires were implemented to assess the impact of the UTAUT model factors (performance expectancy, effort expectancy, social influence, facilitating conditions) and psychosocial factors (attitude, anxiety, self-efficacy) on the overall behavioral intention to use the footwear. Furthermore, factors influencing potential acceptance and rejection of the footwear were explored.
UNASSIGNED: Patients (4.0/5) and medical professionals (4.1/5) showed a behavioral intention to \"agree\" to use or recommend the footwear when it becomes available. Structural equation modeling showed that the UTAUT constructed model may not be the best indicator for behavioral intention here based on a lack of statistical significance. However, the logistic regression modeling showed that the social influence for PLwD (p=0.004) and the attitude toward the footwear for medical professionals (p=0.001) may be the most important when designing and implementing the footwear, though several other factors (performance expectancy, effort expectancy, facilitating conditions, and self-efficacy) were also important for one or both of these populations. Additionally, cost and clinician support were shown to be important factors influencing potential acceptance of the footwear.
UNASSIGNED: The study found promising intention to use the intelligent footwear in the future. This highlights the need to continue future development and implementation of the footwear to incorporate these results, thus improving the likelihood of high adherence of the footwear.

Minimalist walking shoes have been shown to improve foot muscle size and strength in active adults, but not in our previous study involving children, which could relate to the more structured footwear used in our study. Hence, this study examined the effects of true minimalists on intrinsic foot muscle size and strength, foot arch integrity, and physical function among primary school children. After a baseline assessment, 30 primary school students aged between 9 and 12 were given a pair of minimalist shoes (minimalist index = 92%) as their regular school shoes for two school terms, followed by a re-assessment. Seventeen of the 30 participants in the minimalist group completed the study. Compared to the control group, the minimalist group showed significantly increased cross-sectional area of abductor hallucis (p = 0.047, Cohen\'s d = 0.57) and flexor digitorum brevis (p = 0.037, Cohen\'s d = 0.80), increased strength of the hallux (p = 0.015, Cohen\'s d = 0.76) and lesser toes (p = 0.014, Cohen\'s d = 0.66), greater arch height (p = 0.020, Cohen\'s d = 0.52) and standing long jump distance (p = 0.001, Cohen\'s d = 9.79). The control group exhibited improved standing long jump performance only (p = 0.020, Cohen\'s d = 10.70). Minimalist shoes worn daily to school promote intrinsic foot muscle size and strength, and improve foot arch integrity among primary school students.

BACKGROUND: Research on athletic footwear familiarisation within an older population is sparse. This is problematic because unfamiliar footwear may act as a new perturbation and modify older adults\' walking gait and stability. In addition, while athletic footwear has been suggested to enhance older adults\' comfort and support during activities of daily living, the necessary period for familiarisation with athletic footwear is unknown. Therefore, this study aimed to identify the number of steps required for older adults to be familiarised with athletic footwear of different midsole thicknesses.
METHODS: Twenty-six healthy and physically active community-dwelling older adults, 21 females (71.1 ± 4.5 years; 164.5 ± 5.3 cm; 68.4 ± 11.4 kg) and five males (70.6 ± 2.3 years; 175.2 ± 7.8 cm; 72.8 ± 9.7 kg), completed a walking-based protocol. Participants walked two trials of 200 steps at their habitual speed on a 10-m track of an optical measurement system in three footwear conditions: (1) New Balance® REVlite 890v6 (thick midsole); (2) New Balance® REVlite 1400v5 (moderate midsole); and (3) New Balance® Minimus 20v7 (thin midsole). Gait speed (m.s-1) and walking time (min) were analysed for each participant over the 400 steps. Number of required familiarisation steps were established over three analysis phases, consisting of steady-state gait assessment, averaging and analysis of blocks of 40 steps, and sequentially comparing these steps with a predetermined threshold. Footwear familiarisation was assumed when the mean gait speed fell within an acceptable level (±2 SD from 320 to 360 step values) and subsequently maintained.
RESULTS: Most participants were familiarised with all three footwear conditions (thick n = 18; moderate and thin n = 20) after walking 80 steps. For all participants, the moderate midsole had the shortest familiarisation period (160 steps). The highest number of familiarisation steps was found in the thick (320 steps) and thin midsoles (240 steps) for some participants.
CONCLUSIONS: A minimum of 320 familiarisation steps is recommended to account for both individual differences and midsole thicknesses. Implementing this walking-based footwear familiarisation protocol would improve validity of future studies, ensuring they analyse footwear effects rather than familiarisation with the footwear.

OBJECTIVE: Incorrectly fitting footwear (IFF) poses a risk of trauma to at-risk feet with diabetes. The aim of this systematic review was to summarise and assess the evidence that IFF is a statistically significant cause of ulceration.
METHODS: We searched PubMed, Scopus, Web of Science and Google Scholar for English-language peer-reviewed studies reporting the number or percentage of people with diabetes-related foot ulceration (DFU) attributed to wearing IFF and included a physical examination of the footwear worn. Two independent reviewers assessed the risk of bias using the Newcastle-Ottawa scale.
RESULTS: 4318 results were retrieved excluding duplicates with 45 studies shortlisted. Ten studies met the inclusion criteria with most rated as fair (n = 6) or good (n = 3). There is some evidence that DFU is significantly associated with IFF, but this is limited: only 3 of 10 included studies found a statistically significant percentage of those with DFU were wearing IFF or inappropriate footwear which included fastening, material, type or fit (15.0%-93.3%). Risk of bias in these three studies ranged from \'fair\' to \'poor\'. IFF definitions were often unreported or heterogeneous. Only one study reported IFF-related ulcer sites: 70% were at plantar hallux/toes and 10% at plantar metatarsal heads.
CONCLUSIONS: There is some evidence that IFF is a cause of DFU, but further research is needed, which defines IFF, and methodically records footwear assessment, ulcer location and physical activity. Researchers need to uncover why IFF is worn and if this is due to economic factors, a need for footwear education or other reasons.

UNASSIGNED: A concern expressed by the clinical community is that the constraint of motion provided by an ankle foot orthosis (AFO) may lead the user to become dependent on its stiffness, leading to learned non-use. To examine this, we hypothesized that using an experimental AFO-footwear combination (exAFO-FC) that constrains ankle motion during walking would result in reduced soleus and tibialis anterior EMG compared to free (exAFO-FC) and control (no AFO, footwear only) conditions.
UNASSIGNED: A total of 14 healthy subjects walked at their preferred speed (1.34 ± 0.09 m·s-1) for 15 min, in three conditions, namely, control, free, and stop.
UNASSIGNED: During the stance phase of walking in the stop condition, ipsilateral soleus integrated EMG (iEMG) declined linearly, culminating in a 32.1% reduction compared to the control condition in the final 5 min interval of the protocol. In contrast, ipsilateral tibialis anterior iEMG declined in a variable fashion culminating in an 11.2% reduction compared to control in the final 5 min interval. During the swing phase, the tibialis anterior iEMG increased by 6.6% compared to the control condition during the final 5 min interval. The contralateral soleus and tibialis anterior exhibited increased iEMG in the stop condition.
UNASSIGNED: An AFO-FC functions as a biomechanical motion control device that influences the neural control system and alters the output of muscles experiencing constraints of motion.

OBJECTIVE: To investigate relationships between static foot posture, dynamic plantar foot forces and knee pain in people with medial knee osteoarthritis (OA).
METHODS: Data from 164 participants with symptomatic, moderate to severe radiographic medial knee OA were analysed. Knee pain was self-reported using a numerical rating scale (NRS; scores 0-10; higher scores worse) and the Knee Injury and Osteoarthritis Outcome Score pain subscale (KOOS; scores 0-100; lower scores worse). Static foot posture was assessed using clinical tests (foot posture index, foot mobility magnitude, navicular drop). Dynamic plantar foot forces (lateral, medial, whole foot, medial-lateral ratio, arch index) were measured using an in-shoe plantar pressure system while walking. Relationships between foot posture and plantar forces (independent variables) and pain (dependent variables) were evaluated using linear regression models, unadjusted and adjusted for sex, walking speed, Kellgren & Lawrence grade, shoe category, and body mass (for dynamic plantar foot forces).
RESULTS: No measure of static foot posture was associated with any knee pain measure. Higher medial-lateral foot force ratio at midstance, and a higher arch index during overall stance, were weakly associated with higher knee pain on the NRS (regression coefficient = 0.69, 95% confidence interval (CI) 0.09 to 1.28) and KOOS (coefficient=3.03, 95% CI 0.71 to 5.35) pain scales, respectively.
CONCLUSIONS: Dynamic plantar foot forces, but not static foot posture, were associated with knee pain in people with medial knee OA. However, the amount of pain explained by increases in plantar foot force was small; thus, these associations are unlikely to be clinically meaningful.

BACKGROUND: Minimalistic footwear provides adequate toe space, tripod function, improving foot function, muscle activation and stability during walking similarly to barefoot walking. Due to the increasing popularity of this specific footwear, there is a lack of research focusing on general users of minimalistic footwear.
OBJECTIVE: Does annual walking in minimalistic footwear affect gait biomechanics?
METHODS: Cross-sectional study involving twenty participants in a minimalistic footwear group with both experience (MFE) and no experience (NMFE). Participants walked in three different conditions (barefoot, minimalistic, and neutral footwear) in the laboratory at normal human walking speed.
RESULTS: A significant main effect of groups regardless of footwear conditions show significantly greater values during walking in minimalistic footwear and barefoot in the stride length (p=0.035, p=0.003, respectively), and stride width (p=0.047, p=0.028, respectively) in the NMFE group compared to MFE group. The significant differences in the main effects of footwear regardless of experience were found in stance time (p<0.001), steps per minute (p<0.001), stride length (<0.001), foot adduction in TO (p<0.001), foot eversion angle in IC and TO (p<0.001, p<0.001, respectively), foot progression angle (p<0.001), ankle dorsiflexion angle in IC and TO (p<0.001, p<0.001, respectively), in ankle eversion angle in IC and TO (p<0.001, p<0.001, respectively), knee flexion angle in IC and TO (p<0.001; p<0.001, respectively), and in knee flexion range of motion (p<0.001).
CONCLUSIONS: Based on our findings, barefoot walking should be used primarily during daily activities if the environment is conducive. Only one year of experience with minimalistic footwear seems insufficient and an intervention should be incorporated to change the gait pattern when transitioning to full minimalistic footwear walking.