This review maps 29 original studies comparing barefoot, minimalist, mobility, and conventional footwear across gait biomechanics, foot morphology, stability, knee loading, and performance. It shows where barefoot-like footwear may be useful — fall-risk stability, intrinsic foot strength, and knee OA load reduction — and where conventional shoes still matter, especially for impact moderation and postoperative walking capacity.
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Abstract: To evaluate the impact of barefoot and minimalist footwear versus conventional shoes on foot morphology, gait biomechanics, postural stability, and athletic performance. The review utilises 29 original studies with 566 total participants (topic deduplicated ΣN). The mapped evidence indicates that barefoot and minimalist footwear conditions are consistently associated with morphological adaptations such as larger intrinsic foot muscles and stiffer longitudinal arches, improved postural and walking stability in middle-aged and older adults, and reduced medial knee loading, with mobility shoes lowering peak knee adduction moment by approximately 8% and adduction angular impulse by 7% versus conventional shoes. Conversely, conventional footwear was associated with longer step length, reduced cadence, and lower vertical instantaneous loading rates in adolescent runners alongside greater loading-rate asymmetry, suggesting trade-offs rather than uniform superiority of either condition. Topic-level signals further indicate that performance benefits in short-duration tasks such as 30 m sprinting and conventional deadlifting are limited, while postoperative populations may walk farther in conventional shoes than barefoot. Clinically, these patterns support a role for minimalist or mobility footwear as adjunct strategies for fall prevention in older adults and for offloading the medial knee compartment in symptomatic knee osteoarthritis, while recognizing that responses are highly individual. The dominant uncertainty across the map is the lack of long-term data linking acute biomechanical shifts to durable morphological, performance, or injury outcomes, compounded by small samples and heterogeneous footwear definitions. Future research should prioritize longitudinal, individually profiled trials that track morphological adaptation, injury incidence, and functional stability across structured transitions between conventional and minimalist footwear in distinct age and clinical populations.
Final search date and database lock: 2026-04-29 22:46:47 CEST
Plan: Pro (expanded craft tokens; source: Semantic Scholar)
Source: Semantic Scholar
Total Abstracts/Papers: 118
Downloaded Abstracts/Papers: 118
Included original and non-original Abstracts/Papers (all): 32
Included original Abstracts/Papers (Vote counting by direction of effect): 29
Reference Index (links used in paper): 26
Total participants (topic deduplicated ΣN): 566
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[2] Can the hoof be shod without limiting the heel movement? A comparative study between barefoot, shoeing with conventional shoes and a split-toe shoe. — https://doi.org/10.1016/j.tvjl.2019.01.012
[3] Adolescents running in conventional running shoes have lower vertical instantaneous loading rates but greater asymmetry than running barefoot or in partial-minimal shoes — https://doi.org/10.1080/02640414.2023.2240174
[4] Plantar pressures in three types of indigenous footwear, commercial minimal shoes, and conventional Western shoes, compared to barefoot walking — https://doi.org/10.1080/19424280.2020.1825535
[6] Acute effects of minimalist shoes on biomechanical gait parameters in comparison to walking barefoot and in cushioned shoes: a randomised crossover study — https://doi.org/10.1080/19424280.2022.2057593
[8] Comparison of foot loading and foot strike pattern in women running in minimalist and conventional sports shoes — https://doi.org/10.5507/ag.2019.003
[9] Differences in stride length and lower limb moments of recreational runners during over-ground running while barefoot, in minimalist and in maximalist running shoes — https://doi.org/10.1080/19424280.2021.1878285
[11] Enhanced Foot Proprioception Through 3-Minute Walking Bouts with Ultra-Minimalist Shoes on Surfaces That Mimic Highly Rugged Natural Terrains — https://doi.org/10.3390/biomimetics9120741
[15] The effects of shoes on knee pain and medial joint loading in persons with knee osteoarthritis: A systematic review with meta-analysis — https://doi.org/10.1016/j.joca.2015.02.711
[16] Foot strength and stiffness are related to footwear use in a comparison of minimally- vs. conventionally-shod populations — https://doi.org/10.1038/s41598-018-21916-7
[30] Effects of a new unstable sandal construction on measures of postural control and muscle activity in women. — https://doi.org/10.4414/smw.2011.13182
[32] Forefoot Reconstruction Following Metatarsal Head Resection Arthroplasty With a Plantar Approach—A 20-Year Follow-Up — https://doi.org/10.1177/1071100719840814
