Effects of shoe-length mismatch on gait speed and sagittal-plane lower-limb joint motion in healthy adults.
Tsuyoshi Ohmura, Satoshi Kojima, Sayaka Futatsuya and 3 others
PMID 42544280WHAT IT FOUND
Shoes 1, 2, or 3 cm too long slowed 10 m walking and increased knee and hip range of motion in 30 healthy adults.
Effects appeared at just 1 cm during fast walking. Check shoe fit when assessing gait.
Key findings
01During comfortable walking, gait time over 10 m was significantly longer with shoes 2 cm (p=0.027) and 3 cm (p=0.017) too long, but not with shoes 1 cm too long (p=0.577).
02During maximal-effort walking, gait time was significantly longer in all three oversized conditions compared with the appropriate size (all p<0.001), meaning even a 1 cm oversize slowed fast walking.
03Knee range of motion increased significantly with oversizing in both walking conditions: the left knee went from 70.3° to 74.8° during comfortable walking and from 72.0° to 76.6° during maximal-effort walking, with significant differences at +1, +2, and +3 cm.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
All participants were healthy adults with a mean age of 21.1 years; the authors note the effects may differ in older adults or people with neurological or musculoskeletal conditions. Only one measurement trial per condition was recorded, so trial-to-trial variability is not captured. Foot slip within the shoe, ground reaction forces, and muscle activity were not directly measured; the proposed mechanisms are inferred from prior literature. Results may depend on the specific educational shoe design used and may not generalise to other footwear types. The sample of 30 was above the a priori minimum of 20 but is still modest, and the study was single-centre.
Declared interests
The author declared no funding from any commercial entity and no conflicts of interest.
The easy way to misread this
Do not conclude that a 1 cm shoe oversize significantly impairs comfortable walking in your patients. In this study of healthy adults (mean age 21.1 years), the +1 cm condition did not significantly change comfortable-walking gait time (p=0.577), and the authors note the effects may differ in older or clinical populations.