Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Porto, 2015
Soares, T.S.A. (2016). Análise cinética e cinemática da
corrida em maratonistas com calçado tradicional, minimalista
e descalço. Porto: T.S.A. Soares. Tese de Doutorado em
Ciências do Desporto apresentada à Faculdade de Desporto
da Universidade do Porto.
ii
DEDICATÓRIA
A Deus.
A meus pais.
A meu companheiro e marido.
iii
iv
AGRADECIMENTOS
Prof. Doutor Mário Casimiro da Anunciação Paiva, como o meu orientador, seu
apoio, incentivo, orientação académica e pela amizade dispensada ao longo de
toda a jornada;
Prof. Doutor João Paulo Vilas-Boas, como meu co-orientador, seu apoio,
generosidade e paciência em compartilhar seus conhecimentos nas partes
mais difíceis deste processo e ajudar-me nas últimas adversidades;
Prof. Doutor. Rui Garganta, de forma simples, prática, ele iluminou, orientou e
me ensinou a estatística;
v
À Universidade do Porto, a possibilidade de completar este PhD;
Ao atleta José Pinto Filho, amigo, colega de desporto e paciente, que há muitos
anos atras fez o meu despertar para fisioterapia desportiva;
Ao Michel Bertani pelo apoio e cuidado com esmero nos longos momentos da
recolha de dados e suas contribuições. Ele e a sua esposa acabaram por se
tornarem bons amigos;
À minha tia e madrinha Mirtes Amorim com a sua filosofia e seu despretensioso
vi
apoio sempre se mostrou solidária e presente na construção de toda minha
formação;
À minha irmã Lucila Novaes e a sua família Artur, Camila, Denise, Rodrigo. Por
ser amiga fiel, por sua alegria e força de viver, me ensinou a frase “Fazer do
azedo do limão uma doce limonada”;
À minha irmã Regina Alcântara e a sua família: Roberto, filhos e neta, Gabriel.
Por ser amiga fiel, terapeuta, por ser minha doce “secretária” que sempre se
preocupou em resolver meus problemas administrativos ou minhas bobagens,
fazendo com perfeição do outro lado do atlântico;
Aos meus pais Tabajara e Sonia Soares, apesar de eu ter dado à eles sempre
tanto trabalho e preocupação por ser sua eterna criança mas que mesmo
assim, sempre estiveram presentes, me apoiando nas minhas mais excêntricas
aventuras.
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viii
ÍNDICE GERAL
CAPÍTULO 1....................................................................................................................1
1 INTRODUÇÃO.........................................................................................................1
1.1 Definição do Problema.......................................................................................1
1.2 Justificativa e Contribuição................................................................................2
1.3 Objetivos e Hipóteses.........................................................................................2
CAPÍTULO 2....................................................................................................................5
2 REVISÃO DE LITERATURA ESTADO DA ARTE...............................................5
2.1 A Corrida de Meio-Fundo e Fundo....................................................................5
2.1.1 Génese e Evolução da Corrida ..................................................................5
2.1.2 A Maratona.................................................................................................5
2.1.3 A Corrida Descalça.....................................................................................8
2.2 Análise biomecânica da corrida.......................................................................10
2.2.1 Força de reação do solo (FRS).................................................................10
2.2.2 Padrão de pisada (passada).......................................................................14
2.3 Calçados esportivos..........................................................................................16
2.3.1 Histórico dos calçados esportivos............................................................16
2.3.2 Calçados Minimalista / FiveFingers.........................................................20
2.4 Biomecânica da corrida calçada e descalça......................................................21
2.5 Procedimentos dos autores citados...................................................................27
CAPÍTULO 3..................................................................................................................37
3 METODOLOGIA....................................................................................................37
3.1 Sujeitos.............................................................................................................37
3.2 Instrumentos.....................................................................................................38
3.2.1 Tapete Rolante..........................................................................................38
3.2.2 Sistema 3D de Captura de Movimento.....................................................40
3.2.3 Eletromiografia de superfície...................................................................41
3.2.4 Podobarometria.........................................................................................42
3.3 Procedimento Experimental.............................................................................45
3.4 Tratamento e análise estatística dos dados.......................................................45
CAPÍTULO 4..................................................................................................................47
ARTIGOS...................................................................................................................47
4.1 Acute kinematics changes in marathon runners using different footwear.......47
4.2 Kinematic and electromyographic effects of acute transition from shod to
barefoot or minimalist shoe running......................................................................65
4.3 Influence of different footwear on ground reaction force during running
analyzed through principal component analysis....................................................87
4.4 Minimalist shoes do not acutely reduce biomechanical load during running in
experienced marathon athletes.............................................................................109
ix
CAPÍTULO 5................................................................................................................131
5.1 DISCUSSÃO..................................................................................................131
5.2 CONCLUSÕES GERAIS..............................................................................135
5.3 PERSPECTIVAS...........................................................................................137
x
ÍNDICE DE FIGURAS
xi
xii
Índice de Tabelas
xiii
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ABREVIATURAS E SIGLAS
BF - Bíceps Femoral
BMI – Body Mass Index (Índice de Massa Corporal)
DP – Desvio Padrão
EMG – Eletromiografia
GL - Gastrocnêmio Lateral
GM - Gastrocnêmio Medial
xv
Biomecânica)
PC – Peso Corporal
PF – Plataforma de Força
PU – Poliuretano
R – Comprimento do pé
RF – Reto Femoral
SD - Standard Deviation
SO – Soleus
TA - Tibial Anterior
TPU – Termopoliuretano
xvi
RESUMO
xvii
xviii
ABSTRACT
The growing number of runners in road racing has led to an increase of skeletal
muscle injury. Therefore, some strategies have been described to prevent injury
in runners, such as retraining strategies using shoes with fewer cushioning or
even running barefoot. It is known that minimalist shoes and shoeless
conditions may alter the running kinematics. However, findings are not
consensual. Possibly, the sort of cushioning or even the lack thereof has effects
on lesion prevention. Thus, a better knowledge about the foot strike pattern and
the biomechanical comportment associated with differently shod or barefoot
conditions might be helpful for developing preventive measures and avoid
lesions. Therefore, the aim of this thesis is to analyze the acute effect on
marathoners that usually uses sports shoes when running barefoot or with
minimalist shoes. Our specific objectives compared the three conditions: (1) to
study the kinematics of the lower limb in marathon runner; (2) to analyze the
electrical activity in the main involved muscles; (3) to characterize the ground
reaction forces (GRF): vertical, mediolateral and anteroposterior and (4) to
analyze the plantar pressure distribution. Our experimental tests took place with
1 2 high-level male marathon runners at their average marathon pace in three
different footwear conditions studied: habitual running shoes, wearing minimalist
shoes, and barefoot. The data was recorded and compared using the split-belt
AMTI Force-Sensing Tandem Treadmill for GRF; the 3D Qualisys motion
capture system for kinematical data; the EMG Delsys trigno System for muscle
electric signal and the Pedar-X system for plantar pressure distribution. A wide
range of parameters were investigated conducted for 4 study (1 in kinematic, 1
in electromyography and 2 in kinetics) which generated 4 scientific articles
contained in this manuscript. Significant differences in the knee kinematics were
observed across all the footwear conditions. The results also showed that
minimalist footwear and barefoot conditions were significantly different from
running with shoes, at least, in one of the three analyzed GRF components. It
was noticed also significant differences in the kinetics, kinematics and
electromyography of the lower limbs of the marathoners, especially knee, ankle
and foot in the acute transfer from shod to barefoot or minimalist shoes inducing
changes in their running patterns. Thus, the choice of the footwear influences
the biomechanic patterns of running in elite athletes.
xix
xx
Esta Tese foi realizada com base em quatro (4) artigos científicos
submetidos em publicações científicas internacionais indexadas e com fator de
impacto, especificamente:
xxi
Minimalist shoes do not acutely reduce biomechanical load during
running in experienced marathon athletes
Autores:
Tania Socorro Amorim Soares, (a,b) taniasos@yahoo.com
Denise Pascoal Soares, (a,b) denisesoares@hotmail.com
Michel Bertani, (a,b) mibertani@ibest.com.br
Leandro Machado, (a,b) lmachado@fade.up.pt
João Paulo Vilas-Boas, (a,b) jpvb@fade.up.pt
Mario Casimiro da Anunciação Paiva, (a,b) mario.paiva@fade.up.pt
xxii
CAPÍTULO 1
1 INTRODUÇÃO
O homem nasceu para correr e vem com esta prática desde a pré-
história. Passou milhares de anos correndo com pés descalços e nos dias de
hoje, com o desenvolvimento tecnológico de calçados esportivos, passou a
usá-los em corridas de lazer e competição (Lieberman, 2012).
Problema:
1
Corredor habitualmente calçado quando descalço e/ou com calçado
minimalista (FiveFingers), altera de forma aguda o padrão de passada? Qual o
padrão de impacto: retropé, mediopé ou antepé?
2
- Analisar a distribuição da pressão plantar em corrida em três situações:
calçado, descalço e com calçado minimalista.
3
utilizando-se as palavras- chaves: corrida calçada, corrida descalça,
maratonista, impacto solo, cinética, cinemática, EMG, palmilha de pressão
plantar.
4
CAPÍTULO 2
2.1.2 A Maratona
5
muito a terminar, com vitória de Atenas, o seu general Milcíades enviou seu
melhor soldado corredor – Filípides - para dar a notícia o mais rápido possível.
Ficava à distância oficial de 42km. Ao chegar ele apenas disse "vencemos" e
caiu morto por exaustão. Em 1896, nos primeiros Jogos Olímpicos da era
moderna, aquele grande feito foi homenageado com a criação da prova de
maratona com a mesma distância de Maratona para Atenas, os 42km. Porém,
em 1948, em Londres foi aferida a distância da prova pelo Comitê Olímpico
Internacional (COI) para 42,195km para que a família real britânica pudesse
assistir à largada da prova do jardim de seu palácio, acrescentando-se assim
195 metros. Anualmente tem crescido um pouco por todo o mundo o número
de maratonas e se popularizado além dos jogos olímpicos (Salgado & Chaco-
MIkahill 2006; Garcia, 2012).
6
todo, leva milhares de pessoas a tê-la como esporte preferido e a maratona é
uma das mais populares (Rothschild, 2012).
7
et al., 2007; Hall et al., 2013; Cooper et al., 2015).
8
força de reação do solo com alto impacto de colisões, que pode ter implicações
de saúde pública. O número de batidas no chão de um corredor é em média de
600 vezes por quilômetro, tornando os corredores propensos a lesões
decorrentes do contato sistemático com o solo (Bramble & Lieberman, 2004;
Cavanagh & Lafortune, 1980). No entanto, embora amortecidos, os sapatos de
calcanheira elevada são confortáveis, mas limitam a propriocepção e tornam
fácil o contato com o solo pela parte posterior do pé. Além disso, muitos
sapatos têm apoios em arco e solas endurecidas que podem contribuir para
enfraquecimento muscular dos pés particularmente a rigidez do arco plantar.
Essa fragilidade contribui para a pronação excessiva e provoca maiores
exigências sobre a fáscia plantar (Nigg, Hintzen & Ferber, 2006; Dinato et al.,
2015).
9
demonstrado, talvez implicações em circunstâncias competitivas, mas uma
menor economia de movimento é provável que não tenha grande importância
em circunstâncias de treinamento. Na verdade, alguns poderiam argumentar
que em condições de treinamento que reduzam a economia de corrida pode
até ser benéfico (Krabak, Hoffman & Millet, 2011). A corrida descalça obteve
grande popularidade sobretudo baseada em alegações infundadas de
prevenção de lesões (Robbins & Hanna, 1987), mas outras afirmativas surgem
e não consideram essa opinião (Nigg & Enders, 2013). Estudo recente sugeriu
que corredores que utilizam calçados tradicionais, quando da transição para
sapatos minimalistas têm maior probabilidade de lesão em comparação com
aqueles que só utilizaram calçado tradicional (Ryan et al., 2014; Dubois et al.,
2015).
Paiva (2002) relata que quanto maior a força de reação do solo, maior
será o custo energético. Isto é, quanto maiores forem as componentes de força
envolvidas, mais intenso será o contributo muscular necessário para controlar
os movimentos dos membros e estabilizar a posição do corpo durante a fase
de apoio. Tudo isto implica uma maior solicitação metabólica dos músculos
envolvidos.
10
No pico inicial do impacto no solo essas estruturas não absorvem de
todo o impacto; o corpo adapta-se transferindo parte da energia elástica que foi
acumulada para regiões próximas, como a estrutura ativa do músculo
quadríceps que contribui na propulsão. A componente vertical da FRS ao tocar
o solo na marcha é 1.0 a 1.5 vezes o peso corporal do sujeito e na corrida é
aumentado de 2.0 a 3.5 vezes (Cavanagh & Lafortune, 1980). Além disto, para
amenizar esse impacto do solo o corpo faz uma prono-supinação na
articulação subtalar coordenada com uma flexão e extensão dos joelhos, isto
provocado pela rotação da tíbia (Hintermann & Nigg. 1998). O primeiro pico de
força vertical no solo é produzido com uma taxa de 20% a 80% do peso
corporal por cada segundo de contacto (Figura 2), sendo importante a
interpretação desses dados para aferir a absorção do impacto no solo. Desta
maneira são visualizadas as mudanças das taxas de cargas plantares
estruturas do pé, como arco longitudinal medial e o alinhamento do retropé
importante informação no caso dos corredores (Lee & Hertel, 2012 ).
11
divididos pelo peso corporal, sendo o resultado em unidades de vezes o peso
corporal (normalização dos valores de FRS ao peso corporal dos sujeitos). Ou
ainda, as forças de reação do solo são divididas pela massa corporal, o
resultado é unidade de Newton por quilograma de massa corporal (N/kg). A
magnitude da FRS são maiores na corrida do que no caminhar porque varia de
acordo com a velocidade adotada (Nigg, 1997; Nigg, 2001). O componente
vertical (Fz) dos componentes da FRS é o de maior magnitude e o mais
importante no nosso estudo.
12
Figura 1 - Componentes da FRS durante o ciclo de marcha.
13
magnitude é de 0.15 do peso corporal e na corrida 0.5, sendo que na primeira
metade do apoio a componente é negativa e na segunda metade positiva
(Hamill & Knutzen, 2012; Hintermann & Nigg. 1998).
Autores como Lieberman et al. (2010); Williams, Davis & Manal (2000),
Cavanagh & Lafortune (1980), Altman & Davis (2009), relatam as diferenças
entre os padrões da mecânica do impacto inicial que precede o pico de
propulsão, o que faz ocasionar as altas taxas de impacto inicial. Porém, os
corredores que possuem o impacto inicial com o antepé são capazes de
eliminar esse impacto através da contração excêntrica da musculatura da
panturrilha, reduzindo significativamente o impacto típico do retropé, levando-o
para o antepé. Isto resulta num comprimento curto da passada com o pé de
apoio ficando menos avançado e mais próximo da projeção vertical do centro
de massa, reduzindo o braço de momento de força de reação do solo para o
quadril e o joelho, provavelmente reduzindo também os momentos de forças
14
registados habitualmente nestas articulações na corrida calçada (Altman &
Davis, 2009).
Hatala et al. (2013) afirmam que o padrão retropé pode ser mais
dependente de fatores como corrida de longa distância ou velocidade, nível de
treinamento e freqüência de corrida do que em relação ao uso de calçados
esportivos.
15
Correr descalço é associado a uma passada mais curta e com maior
frequência resultando em menor tempo em cada impacto no solo e, assim,
reduzindo os impulsos vertical e médio-lateral. Na região do quadril e joelho
também são reduzidas as cargas, assim como o risco de fraturas por estresse
(De Wit, De Clerck & Aerts, 2000; Bonacci et al., 2013. Cooper, Leissring &
Kernozek, 2015).
16
feitos principalmente de couro. Não existiam sapatos com sola de borracha até
o final de 1800 e os calçados esportivos não foram comercializados até o início
de 1900. Na década de 1960, houve uma explosão no mundo da corrida com
calçados específicos para esta modalidade esportiva e as várias empresas
criaram novas tecnologias para seus produtos. Nos últimos 30-40 anos, temos
visto a adição de vários componentes como diferentes tipos de gel, almofadas,
bolsas de ar, arco de suporte, listras de corrida, e assim por diante. No entanto,
apesar de todas essas mudanças, nenhuma pesquisa parece ter mostrado uma
diminuição na taxa de lesões nos corredores (Krabak, Hoffman & Millet. 2011).
17
movimento de forma complexa em respostas ao seus equilíbrios dinâmicos.
Lussiana, Hébert-Losier & Mourot (2015), analisaram corredores com
diferentes calçados, descalços em tapete rolante plano e em aclives. Eles
identificaram diferenças significativas não apenas relacionadas às diferentes
condições de calçados, mas às condições de contato.
Nigg & Segesser (1992) e Show et al. (2016) reiteraram que os calçados
possuem influência direta nos componentes de forças internas e externas que
atuam no aparelho locomotor. A maior ou menor incidência de lesões no
corredor resulta da magnitude do primeiro pico de força vertical após o contato
do pé com o solo, podendo o uso de calçado adequado diminuir a expressão
dessa força.
18
no que diz respeito a economia energética. Além disto, considera-se também
os diversos tipos de solo. O tipo de solo influência de forma direta na questão
do impacto do solo e no amortecimento. Outras variáveis importantes também
consideradas na confecção e escolha do amortecimento do calçado são a
velocidade da corrida, o padrão da passada, quilometragem de treinos e
competições (Nigg, Segesser,1992). Normalmente o amortecimento é feito de
material de borracha ou sintético, contribuindo na tração para acelerações,
desacelerações ou mudanças de direção comuns nos esportes.
19
PU separados e/ou combinados, juntos proporcionam a durabilidade (PU) e
maciez (EVA) no mesmo calçado. Existem ainda as câmaras de ar
encapsuladas entre o EVA e PU, deixando o calçado mais leve do que se
usasse só EVA ou só PU. Um outro material utilizado são cápsulas de silicone
em gel presa à uma base de EVA, ou ainda TPU (material termopoliuretano)
colocados no arco plantar em lâminas na sola do calçado (Melo, 1996; Bianco,
2005).
Avaliações dos calçados são realizadas não apenas para a sua criação
mediante as necessidades, mas para testar as propriedades mecânicas, como
funcionam em relação ao solo e o aparelho locomotor. Para isto, são feitos
testes mecânicos e biomecânicos (Bianco, 2005).
20
tentaram correr descalço, e 30% já tentaram correr com calçados minimalistas.
Esta pesquisa também descobriu que corredores que tentam uma transição
para descalço ou calçado minimalista o fizeram através do conselho de um
amigo ou de um livro e que fizeram a transição e a adaptação em menos de 2
semanas (Willson et al., 2014).
21
podem alterar as respostas de controle de carga no movimento, fato que indica
que a utilização do calçado esportivo, por diminuir a sensibilidade entre a
região plantar e o piso, atue negativamente na capacidade de adaptação
voltada à locomoção (Nigg, 2001). Após o bloqueio dos receptores plantares,
tanto o controle postural quanto a capacidade de responder à diferentes pisos
são prejudicados por conseqüência da diminuição do feedback plantar, além da
alteração do padrão de corrida e da distribuição da pressão plantar. Os
mecanoreceptores são encontrados em diversas estruturas do aparelho
locomotor (pele, articulações, músculos) e todos eles oferecem inputs para a
realização de ajustes corporais, o que torna os resultados determinados pela
relação entre controle de carga, flexão da articulação do joelho no contato
inicial da locomoção com os pés descalços (Nigg et al., 2006).
22
traumatismos (Krabak, Hoffman & Millet. 2011; Dubois et al., 2015).
23
enfraquecidos, diminuindo suas características funcionais e protetoras
aumentando a incidência de lesões. Existe razão para supor que os sapatos
podem contribuir para os pés fracos e inflexíveis, especialmente durante a
infância, quando o pé está crescendo. Os sapatos com amortecimentos,
especialmente aqueles com grandes estruturas amortecedoras, além de
alterarem a biomecânica da passada, inibem as reações reflexas e protetoras
do pé fragilizando-o e, consequentemente, favorecendo o aparecimento de
traumatismos. Corroborando com Lieberman et al. (2010), Saremi (2012),
McDougall (2010), Chen (2006) e Richards & Hallowel (2011) acrescentam que
a corrida descalça é biomecânicamente mais funcional e menos lesiva uma vez
que as reações proprioceptivas do pé são mais preservadas e estimuladas nos
corredores descalços do que nos corredores calçados.
Nos últimos 20 anos alguns estudos (Nigg & Wakeling, 2001; Squadrone
& Gallozzi, 2009; Lieberman et al., 2010; Hatala et al., 2013) referem que o uso
contínuo de calçados esportivos com grande proteção, amortecimento
sofisticado, proporcionam maior estabilidade na dinâmica da passada mas
diminuem a capacidade reflexa favorecendo a ocorrência de lesões.
24
corredores lidavam com o impacto causado pela colisão do pé com o solo
antes da invenção do sapato moderno. Habitualmente corredores descalços,
muitas vezes o contato inicial ocorre com o antepé no solo antes de tocar o
calcanhar no solo, mas às vezes pisavam com a parte mediana do pé, ou
menos frequentemente, sobre o calcanhar (contato com retropé). Em contraste,
habitualmente corredores calçados principalmente o contato inicial com retropé,
facilitada pelo calcanhar elevado e amortecimento do sapato de corrida
moderno. Dados cinemáticos e cinéticos mostram que mesmo em superfícies
duras, corredores descalços que contactam o solo inicialmente com a parte
dianteira do pé (antepé), geram menores forças de colisão do que corredores
calçados que contato é com o retropé. Pesquisas recentes de Saremi (2012),
confirmam a boa mecânica da corrida sem calçados, como também atestam as
contra indicações para correr descalço: diabetes, neuropatia, má circulação nas
extremidades inferiores, condição pobre da pele (rachaduras ou feridas), artrite,
sistema imunológico enfraquecido, deformidades nos pés, obesidade (a menos
que as pernas e os pés foram reforçados para suportar o peso), fraturas em
ossos dos membros inferiores, tendinite do tendão de Aquiles, fascite plantar
(Ryan et al., 2012; Dubois et al., 2015)
25
gastrocnêmios durante a corrida com apoio inicial pelo antepé, o que indica
uma carga maior no músculo e uma tendência de lesão (Ryan et al., 2012;
Dubois et al., 2015). No estudo de Squadrone & Gallozzi (2009), comparando
os corredores calçados, descalços e com minimalista, os autores reforçam a
hipótese de que mudanças na interface pé-terra levou a mudanças no padrão
de um grupo de experientes corredores descalços. O modelo minimalista,
parece ser eficaz em imitar a condição de descalço, proporcionando uma
pequena quantidade de proteção do impacto (Ryan et al., 2012; Dubois et al.,
2015).
26
ano de transição, surgiram lesões incluindo fraturas por estresse e ruptura da
fáscia plantar. Dubois et al (2015) afirmam, por seu lado, que corredores
calçados quando usam minimalistas tendem a ter mais lesões. Eles sugerem a
necessidade de mais pesquisas.
27
Tabela 1 - Metodologia dos autores citados
28
Chambon et al. 12 corredores recreacionais Descobrir se a ataque no solo do Calçados convencional, minimalista, No tapete rolante a adaptação
(2014) calçado tem o mesmo efeito descalço, plataforma de força em progressiva confortável, velocidade
independentemente corrida em pista tapete rolante e na pista, imagem 3D. preferida, recolha 20 passo. Depois
ou em esteira. correram 15 m na pista com 7 testes,
velocidade preferida
Cheung & Rainbow, 30 corredores recreacionais de 30km Investigar os efeitos iniciais de correr Calçado habitual, descalço, plataforma Velocidade 10km/h. Adaptação 4
(2014) semanal descalço em corredores habitualmente de força no tapete rolante, imagem 2D minutos, recolha 10 segundos
calçado em termos de modificação do
padrão de ataque e as taxas de cargas
da força vertical.
Cavanagh & Lafortune, 15 corredores Identificar as forças de reação do solo Calçado habitual Velocidade 4.5m/s
(1980) e centro de pressão (C de P) em
corredores calçados.
Cooper et al. 43 corredores (20 homens e 21 Examinar como as mudanças de carga Calçado habitual, plataforma de força, Velocidade: 2.8/3.2/3.8m/s. Adaptação
(2015) mulheres) recreacionais, Plataforma de plantares durante a corrida descalço pressão plantar 5 minutos, 1 minuto
força, pressão plantar em um grupo de corredores que
normalmente calçados e demonstrar
um padrão greve retropé alteraram o
seu padrão de ataque e de carga
plantar quando solicitado a correr
descalço em diferentes velocidades.
De Wit et al. 9 corredores experientes em Investigar variáveis espaço-temporais, Calçado habitual, descalço Velocidade: 3.5/4.5/5.5m/s. Adaptação
(2000) 30km/semanais as forças de reação do solo e Plataforma de força, video de alta preferida, 10 testes em pista 30 m
cinemática do plano sagital e frontal velocidade, tapete de pressão
durante a fase de apoio de nove
indivíduos treinados em execução com
os pés descalços e calçados em três
velocidades
Efeito agudo da condição
Dinato et al. 22 corredores recreacionais Investigar as relações entre a 4 calçado de diferentes Velocidade: 3.5m/s. Adaptação 10
(2015) 20km/semanal percepção de conforto e parâmetros amortecimentos minutos. Fase 1: corrida na pista de
biomecânicos (pressão plantar e força Plataforma de força, palmilha pressão 40m Fase 2 : tapete rolantes.
de reação do solo) durante a corrida plantar
com quatro tipos diferentes de
tecnologia de amortecimento em
calçados de corrida.
Divert et al. 35 corredores (31 homem e 4 Medir e discutir as diferenças Calçado habitual e descalço, tapete Velocidades de 4 a 3.33 m/s. 2 testes
(2005) mulheres) recreacionais. mecânicas e musculares que poderiam rolante e EMG. de 4 mim. 60 de recolha.
explicar as diferenças metabólicas
encontradas entre a corrida calçada e
descalça.
Divert et al. 12 corredores de longa distancia Identificar de forma clara e separar os Calçado convencional, calçado leve, Velocidade 3.6m/s. Aquecimento 10
(2008) efeitos do desgaste do sapato e a sua descalço com meia de neoprene, minutos. Recolha de 60 passos
massa sobre parâmetros metabólicos e plataforma de forma de força com
mecânicos de corrida calçado. tapete rolante,
Fredericks et al. 26 corredores recreacionais. Comparar os efeitos da corrida nas Calçado corrida padrão, minimalista, Velocidades entre 2.5 a 4m/s por 18 a
(2015) condições de calçado tradicional, descalço, imagem 3D. 27 minutos. Foram coletados 10
minimalistas e pés descalços no passos.
padrão de aterragem. Comprimento do
29
passo, ângulos do joelho e do
tornozelo.
Flaming et al. 10 corredores recreacionais Examinar os efeitos imediatos de pés Calçado habitual, descalço, tapete Velocidades: 3.13/3.80/4.47.
(2015) descalços em corrida no cinemática rolante com plataforma de força, 2D, Adaptação 10 minutos. Recolha 1
dos membros inferiores e atividade EMG minuto
muscular em um grupo de corredores
habitualmente calçadas
Hamner et al. 2010 1 corredor Determinar como os músculos Calçado habitual, imagem 3D, EMG, Velocidade 3.96m/s. 3 testes 60s
contribuem para a propulsão e apoio plataforma de força em tapete rolante
do centro de massa do corpo durante a
corrida em 3,96m/s, incluindo os
efeitos do tronco e braços.
Hryvniak et al. 509 corredores diversos Fazer um levantamento foi o de Calçado habitual, minimalista, Os autores desenvolveram a lista de
(2014) fornecer dados sobre os resultados descalço, questionário perguntas com base na importância
sobre os efeitos de correr descalço na dos corredores. Perguntou se os
eficiência, desempenho e lesões. corredores tinha tentado correr
descalço, se ele fez a diferença na sua
execução, e se instituiu como parte de
seu plano de treinamento normal. Se
assim for, os autores, em seguida,
perguntou se correr descalço
desempenharam um papel na lesão e
desempenho.
Goos et al. 60 corredores (37 homens, 23 Avaliar a precisão dos padrões de Calçado habitual, descalço, tapete Velocidades: preferida. Adaptação 5
(2014) mulheres) recreacionais ataque de retropé auto-relatados, rolante com plataforma de força, 3D, minutos. Recolha nos últimos 3
19.2km/semanal comparar tornozelo-negativo e trabalho EMG segundos de 5 testes.
angular do joelho entre os corredores
que usam diferentes padrões de
ataque do pé e usando sapatos
tradicionais ou minimalistas, e
descrever as taxas de cargas médias-
vertical.
Jones et al. 42 sujeitos (22 normais e 20 Procura superar estes obstáculos Calçado habitual, plataforma de força Foram coletadas na análise. rotações
(2008) osteroartrite) através da aplicação de uma do joelho, forças de reação do solo,
abordagem híbrida para a análise de parâmetros temporais distância e
dados de análise de movimento, medidas antropométricas.
usando análise de componentes
principais (PCA), o método é usado
para caracterizar as diferenças entre a
função normal do joelho e com
osteoartrite e para a produção de uma
hierarquia das variáveis que são mais
discriminatória no processo de
classificação.
Hamill et al. 10 corredores (5 homens e 5 Determinar as características de Calçados de várias espessuras de Velocidade 4.0m/s. 10 testes.
(2011) mulheres) recreacionais. impacto com várias espessuras de solado, minimalista e descalço. Escolhido o melhor de 60s.
entressola em calçado e em corrida PF em tapete rolante, imagem 3D.
descalço.
Hatala et al. 18 corredores (8 homens, 10 Investigar mais padrões de ataque do Descalço, tapete de pressão plantar, Velocidade preferida. Correram em
(2013) mulheres) pé entre um grupo corredores câmera de video de alta velocidade terreno plano 15 metros e tapete no
30
habitualmente descalços que correm meio, 3 testes.
com menos frequência do que o
Kalenjin e para testar uma relação
entre os padrões de ataque do pé e
velocidade de corrida.
Heiderscheit et al. 45 corredores recreacionais Caracterizar os efeitos biomecânicas Calçado habitual, plataforma de força, Velocidades: preferida. Adaptação 5
(2011) 24.1km/semanal da modificação da velocidade de passo 3D minutos. 1 minuto de recolha. 5 testes
durante a corrida nas articulações da
anca, do joelho e do tornozelo, a fim de
avaliar uma estratégia potencial para
reduzir a carga inferior extremidade e o
risco de lesão.
Hong et al. 10 experientes corredores retropé Comparar cargas plantares durante a Calçado habitual. Palmilha de pressão Velocidade 3.8m/s. Correram em
(2012) corrida em esteira e em superfícies de plantar concreto, grama e tapete rolante.
concreto e grama. Recolha de 5 passos.
Jenkins & David, Revisar se correr descalço promove Foram pesquisados PubMed (Medline),
(2011) muitos benefícios, como a melhoria do UpTo- Data e publicações da Web
desempenho e lesões reduzidas, usando as palavras-chave com corrida
enquanto detratores alertar para os descalça.
riscos iminentes envolvidos.
Karrigan et al. 68 corredores (31 homens, 37 Determinar o efeito de torque no Calçados habitual, descalço, Velocidade preferida, aquecimento 3-5
(2009) mulheres) recreacionais 24 calçado de corrida moderno nas plataforma de força em tapete rolante, minutos
milhas/semanal articulações dos membros inferiores 3D
Kernozek et al. 30 corredoras recreacionais. Transição Comparar cargas plantares entre Calçado corrida habitual, minimalista, Velocidade 2.9m/s por 60s em tapete
(2014) para minimalistas no período de 4 se- corredores com ou sem padrão retropé pressão plantar. rolante.
manas, aumentando gradualmente a após 4 semanas de corridas em
sua quilometragem com minimalista. calçados minimalista. Efeito adaptado
da condição.
Kyrölaäinen et al. 8 corredoras experientes Investigar a cinemática, cinética e Calçado padrão, lactado, plataforma de Velocidades 3.25-4.0-5.0m/s. Correram
(2001) atividade muscular para explicar a força, imagem 3D em pista, 3 testes de 3 minutos
economia de corrida em diferentes
velocidades de corrida.
Kyröläinen et al. 17 corredores (9 homens, 8 mulheres) Investigar a cinemática, cinética e Video de alta velocidade, imagem 3D, Velocidades 3.25 a 5.0m/s. Plataforma
(2014) treinados atividade muscular para explicar a plataforma de força, EMG de força em pista de 10m, aqueceram
economia de corrida em diferentes 10 minutos e recolha 1 minuto.
velocidades de corrida.
Lee et al. Avaliar o efeito das características do 25 sujeitos (8 homens, 17 mulheres) Calçados habitual, plataforma de força Velocidade preferida: preferida.
(2012) pé sobre medidas relativas à pressão recreacionais em tapete rolante, palmilha de pressão Aquecimento 3-5 minutos. Recolha 10
plantar, tais como pressão máxima, a plantar segundos
pressão do tempo máximo, e pressão
o tempo integral sob o aspecto medial
do pé durante a corrida.
Lieberman et al. 5 grupos de corredores de endurance Comparar preferências de cinemática e Corredores USA: calçado habitual, PF Ambos correram em PF ao longo de
(2010) EUA x África e habituais calçados x velocidades da corrida de endurance. em tapete rolante, imagem 3D. uma pista de 20-25m. Em velocidades
descalços. Efeito agudo da condição. Corredores África: pista terra, câmera preferenciais. 10 testes, registrados 5
de video 500hz testes.
Lieberman et al. 48 corredores da tribo Kalenjin do Explorar as variações intra e inter- Habituais calçados com calçado Velocidade preferida entre 3.0m/s e
Quênia individuais de modelos de efeitos padrão, habituais descalços, video de 4.0m/s. Correram em pista de 13
31
(2015) mistos lineares gerais no padrão de pé alta velocidade metros por 5 minutos. Recolha 4
de ataque do Kalenjin do Quênia passos ou 30 segundos
Lussiana et al. 14 sujeitos recreacionais Caracterizar e comparar o vertical e Calçados habitual, minimalista, Velocidade: 10km/h. Aquecimento 3-5
(2015) 45km/semanal rigidez da perna medidos durante a imagem 3D minutos. 5 testes. Recolha 2 minutos.
corrida em duas diferentes condições Adaptação à condição duas semanas
de Calçado em negativo, nível e pistas antes
positivas, utilizando apenas dados
cinemáticos.
McCallion et al. 14 corredores experientes, 30 a 50 Comparar mudanças agudas nas Calçado convencional, minimalista, Velocidade 85% do melhor tempo em
(2014) km/semanal variáveis espaço-temporais no descalço, imagem 3D, plataforma de 5km. Correram 4 a 6 minutos, recolha
comprimento da passada e a força em tapete rolante no minuto final
frequência, contato com o solo e em
tempo de vôo, quando correndo
descalço e em calçados de corrida
convencional e minimalista
McCarthy et al. 9 corredores recreacionais Investigar se um programa de Calçado habitual, descalço, imagem Velocidade: 3.33 m/s.Aquecimento
(2013) 15km/semana transição de 12 semana de corrida 3D preferido, recolha 5 segundos
descalça altera o padrão de ataque do Protocolo de adaptação à condição 12
pé no solo. semanas
Milner et al. 40 corredoras (20 retropé sem lesão e Determinar se existem diferenças na Calçado habitual, 3D, plataforma de Velocidade: 3.7m/s. Aquecimento
(2006) 20 retropé com lesão) experientes estrutura e mecânicos que funcionam força 5minutos. Recolha por uma única
32km/semanal entre corredores de longa distância passagem na plataforma. Pista 23m
treinado com uma história de fratura de com plataformas de força no meio. 5
estresse tibial anterior e aqueles que testes
nunca tenham sofrido uma fratura.
Murphy et al. Revisar a evidência clínica atualmente Revisão da literatura em baseada em
(2013) disponíveis em correr descalço e sua dados com 60 autores. Correr descalço
eficácia para prevenir lesões no não é uma medida preventiva
corredores lesões em execução, fundamentadas
requerendo tipicamente 6-8 semanas
para a recuperação.
Nigg Identificar possível associação entre as Revisão da literatura em baseada em
(2001) forças de impacto e pronação do pé e dados com 63 autores. Foi feita uma
do desenvolvimento de lesões tentativa de encontrar indícios nas
relacionadas com a corrida, e propõe várias publicações para apoiar ou
um novo paradigma para as forças de rejeitar o conceito atual de forças de
impacto e pronação do pé. impacto e controle de movimento.
Nigg and Wakeling, Resumir o conhecimento atual sobre A pesquisa baseada na analise de
(2001) os efeitos das forças de impacto autores sobre as forças de impacto
repetitivo e propor um novo paradigma durante atividades esportivas
para a compreensão das reacções do (principalmente para o calcanhar-
sistema locomotor a forças de impacto dedos na corrida), energia e atividades
repetitivo, com especial atenção em musculares. Novos paradigmas.
corrida.
Nigg et al. 93 corredores (47 masculino e 46 Testar a influência de três condições Calçado, 3D Velocidade: 3.33m/s. Aquecimento
(2012) feminino) recreacional mínimo 30 de dureza entressola diferentes, sexo e minutos. Recolha Pista de 30m
minutos/semanal idade sobre a cinemática dos membros
inferiores durante o calcanhar-dedo em
corrida
32
Novacheck Revisar a literatura atual sobre a Revisão da literatura em baseada em
(1998) análise comparativa da corrida e da dados de 83 autores. Características
marcha. do ciclo de marcha e a sua relação
com as interacções energia potencial e
cinética, momento da atividade
eletromiográfica, cinemática e dados
cinéticos (incluindo centro de medições
de pressão, os dados brutos vigor
placa, momentos articulares e poderes
conjuntos) e o impacto das mudanças
na velocidade.
Nielsen et al. Examinar a relação entre as Busca foram realizadas no PubMed,
(2012) características do treinamento (volume, Web of Science, embase, em
a duração, a frequência e intensidade) SPORTDiscus. Examinaram novato,
e as lesões relacionadas a corrida. recreativo, ou corredores de elite entre
18 e 65 anos. As variáveis estudadas
distância ou quilometragem, tempo ou
a duração, frequência, intensidade,
velocidade ou ritmo. O desfecho foi
corredores lesionados em geral ou
específica na extremidade dos
membros inferiores.
Nunns et al. 165 corredores recrutados Fornecer dados de referência para Calçado habitual, descalço Velocidade: preferida. 5 testes.
(2013) quatro tipos de modalidade ataque do 3D, tapete de pressão
pé entre habitualmente calçados
jovens do sexo masculino quando
correm descalço, e investigar se o
padrão de ataque influencia variáveis
associadas ao desempenho e risco de
lesão.
Olin & Gutierrez, 18 corredores (6 homens, 12 Examinar a ativação muscular e Descalço natural, descalço antepé, Velocidade preferida. Aquecimento 5
(2013) mulheres) recreacionais choque tibial durante a transição descalço retropé. plataforma de força minutos em bicicleta. Na recolha
20.9km/semanal imediata de calçado para corrida em tapete rolante, correram 7 minutos, gravados 2º, 4º 6º
descalço. minutos
Paquette et al. 14 corredores de longa distância. Examinar os efeitos agudos do calçado Calçado habitual, descalço, Velocidade 3.3m/s. 5 testes de 4
(2013) 35km/semanal minimalista, descalço e calçado minimalista, imagem 3D, plataforma de minutos.
habitual de corrida, padrões agudo de força em tapete rolante.
retro pé e antepé, FRS, o tornozelo e
joelho na cinética e cinemática durante
a corrida.
Perl et al. 15 corredores (13 homens e 2 Avaliar economia de corrida com Calçados habituais, minimalista e Correram em velocidade 3.0 m/s.
(2012) mulheres) recreacionais experientes cinética e cinemática. Efeito agudo da descalço, imagem 3D, PF em tapete Aqueceram 5 minutos e 1 minuto de
em corrida minimalista e descalça. condição. rolante. recolha.
Ridge et al. 36 corredores (21 homens e 15 Avaliar alterações ósseas e de tecido Calçado tradicional, minimalista, Adaptação de 10 semanas com
(2013) mulheres) recreacionais experientes. mole em experiente corredores ressonância magnéticas minimalista. Analise de ressonâncias
24-48km/semanal recreacionais durante 10 semanas de magnéticas antes e depois.
período transitório de corredores de
calçado tradicional para minimalista
33
Salzier et al. 10 corredores treinados, Identificar as lesões músculo- Calçado habitual, minimalista, Transição de 1 ano na mudança de
(2012) 40km/semanal esqueléticas de transição do calçado ressonância magnética calçado habitual para minimalista
habitual para minimalista. através das imagens, exames clínicos
Shih et al. 12 corredores recreacionais habituais Provar que, para prevenção de lesões, Calçados habituais, descalços, câmera Correram em velocidade de 9.0 km/h.
(2013) calçados. o padrão marcante é mais importante de alta velocidade, plataforma de força 1 minuto de recolha em 4 testes, com 2
que a condição dos pés descalços ou em tapete rolante. minutos de descanso.
calçados. Efeito agudo da condição.
Sinclair, 30 corredores recreacionais Determinar se corrida descalça e com Calçado convencional, descalço, Velocidade 4m/s. 10 testes. Correram
(2014) calçado inspirados em descalço calçados de diferentes modelos em pista 22m no laboratório
causam diferentes níveis de força minimalista. Imagem 3D, plataforma de
patelofemoral e pressão no joelho, força
força no tendão de Aquiles no
tornozelo em comparação com calçado
convencional de corrida.
Squadrone et al. 8 corredores experiente em maratonas Avaliar como alterações das Calçado controle, minimalista, Velocidade 3.3m/s. 3 testes de 6
(2015) descalços características mecânicas da interface plataforma de força em tapeta rolante, minutos. 10 dias antes do testes
do solo pé/sapato afetam variáveis imagem 3 D, VO2, frequência adaptaram a corrida com calçado
espaço-temporais, distribuição de cardíaca, controle e minimalista.
pressões do solo, cinemática plano
sagital e economia da corrida em 8
corredores descalços experientes.
Squadrone et al. 14 corredores recreacionais, antes Investigar os efeitos agudos de Calçado corrida padrão, minimalista, Velocidade 3.33 m/s, correram 3
(2015) tiveram adaptação com minimalista. diferentes modelos de calçados pressão plantar, PF em tapete rolante, minutos e recolha nos últimos 30
minimalistas. Efeito crônico da imagem 3D. segundos.
condição.
Shorten et al. 20 corredores recreacionais Determinar se os efeitos anômalos de 4 calçados diferentes amortecimentos, Velocidade 4.0m/s/ Correram em pista
(2011) amortecimento sapato sobre a plataforma de força, palmilha de 3.84 metros no laboratório.
magnitude do Fz1 pode ser explicado pressão plantar
pelo posição de componentes de força
não relacionados com o impacto do
calcanhar.
Strauts et al. 6 corredores (4 homens e 2 mulheres) Observar alterações na cinemática e Calçado habitual, descalço, EMG, Velocidade preferida. Aquecimento 5
(2015) recreacionais 10.4km/semana atividades musculares quando imagem 3D minutos, recolha no ultimo minuto.
corredores calçados para descalço
Tam et al. 29 corredores experientes Determinar se os corredores podem Calçado habitual, descalço, imagem Velocidade 3.5m/s. Recolha antes e
(2016) 50km/semana atingir os propostos favoráveis 3D, plataforma de força em tapete depois do programa de adaptação de 8
mudanças cinemáticas e redução na rolante, EMG semanas
taxa de carregamento após um
programa de treinamento progressivo
que incluía correr descalço.
Thompson et al. 10 corredores (5 homens 5 mulheres) Determinar se a mecânica da corrida Calçado habitual, descalço, imagem Velocidade: preferida. Aquecimento 10
(2015) descalça pelos corredores de padrão 3D, plataforma de força minutos, pista 15m com placa de força
retropé calçados naturais diferia de no meio. Recolha de 10 passos em 10
corredores calçados naturais antepé testes.
Tillman et al. 11 corredores Determinar mudanças nos tempos de Calçado padrão, palmilha de pressão Correram em pista de 15m com
2002 contato do solo, impulsos e forças de plantar diferentes superfícies: asfalto,
reação do sapato durante a corrida em concreto, grama, e uma pista sintética.
34
diferentes superfícies. Uma passagem para cada superfície.
Van Gent et al. Apresentar visão sistemática de Uma busca na base de dados
(2007) relatórios publicados sobre a incidência eletrônica foi realizada utilizando o
e os fatores de risco potenciais banco de dados PubMed-Medline. Dois
associados de lesões execução das observadores avaliaram
extremidades inferiores em corredores independentemente a qualidade dos
de longa distância. estudos e uma melhor síntese
evidência foi usada para resumir os
resultados. A incidência de lesões do
membro inferior na corrida e local
predominante destas lesões.
Wiegerinck et al. Examinar a diferença de carga plantar Calçado padrão, calçado mais plano, Velocidade preferida. Aqueceram 3-5
2009 entre dois tipos de diferentes de palmilha de pressão plantar minutos. Correram em pista 10
calçados de corrida. metros. Recolha de 2 passos.
Willy & Davis 14 corredores, 16km/semana Determinar se a corrida minimalista Calçado, minimalista, imagem 3D, Velocidade: 3.35m/s. Aquecimento 10
(2014) resulta tem redução nas forças de plataforma de força em tapete rolante minutos. Recolha 1 minuto
reação do solo e altera a cinemática
com calçado de corrida padrão
Williams III et al. 20 corredores (10 homens e 10 Comparar a biomecânica dos membros Calçado habitual, imagem 3D Velocidade 3.35m/s. Correram em
(2012) mulheres), 9.6km/semana inferiores de corredores calçados pista de 20 m.
padrão retropé calçados que ocorrem
durante correm calçados em antepé e
em condição descalça.
Willson et al. 19 corredoras recreacionais, Examinar adaptações de curto prazo Calçado habitual e minimalista. Velocidade 3.5 e 3.8m/s. Adaptaram 2
(2014 16km/semanal na mecânica da corrida entre os Imagem 3D. Plataforma de força semanas antes. Recolha antes e
corredores que normalmente correm depois. Correram em pista de 23m no
em retropé quando fazem transição laboratório.
para calçados minimalista
Yan et al. Esclarecer o efeito de sapatos sobre Uma busca na base de dados
(2013) as variáveis mais comumente usadas eletrônica foi realizada utilizando o
acreditados para ser associado com banco de dados PubMed-Medline. Os
atenuação do impacto do pé e da termos de pesquisa foram: [choque ou
perna. impacto ou força ou pressão] e [(*
sapato ou calçado ou o pé ou os pés
ou calçado) e (descalço)] ou [visco-
elástico].
Yong, et al. 12 corredores retropé 12 corredores Identificar como as atividades Calçado habitual, imagem 3D, EMG, Velocidade 4.0m/s Aquecimento 5
(2014) antepé 25km/semana musculares diferem entre os tapete rolante com plataforma de força minutos, recolha 1 minuto
corredores com padrão natural retropé
com um padrão antepé natural.
35
36
CAPÍTULO 3
3 METODOLOGIA
3.1 Sujeitos
37
Figura 4 - Fluxograma de Seleção dos Atletas
3.2 Instrumentos
38
Figura 5 - Tapete rolante com Plataformas de
Força montadas em linha - AMTI.
39
total); (5) o pico ântero-posterior de desaceleração (% PC); (6) o pico ântero-
posterior de aceleração (% PC); (7) pico negativo médio-lateral (pronação) (%
PC); (8) o pico positivo médio-lateral (% PC) (supinação).
40
Figura 6 - Sistema de captura e análise de movimento 3D (Qualisys 3D
Motion Capture system)
41
Figura 7 - Atleta com marcadores reflexivos
e elétrodos
3.2.4 Podobarometria
42
da superfície plantar do pé (Figura 9). Uma vez que no calçado minimalista
FiveFingers não foi possível avaliar a pressão na área de dedos, decidimos não
considerar também os dados de pressão dos dedos para as situações calçados
e por isso a palmilha utilizada cobriu apenas a superfície plantar.
43
A força máxima foi normalizada para o peso corporal de cada sujeito
(kg), e a área de contacto foi normalizada em todas as palmilhas utilizadas na
recolha de dados, a fim de comparar estatisticamente sujeitos com diferentes
tamanhos de sapato (Kernozek, Meardon & Vannatta, 2014).
44
3.3 Procedimento Experimental
45
foram calculadas, na série temporal da força vertical, a força máxima
(normalizada pelo peso corporal) e a integral da força (peso corporal.ms) em
três áreas plantares (retropé - 30% do comprimento do pé, mediopé - 30% do
comprimento do pé, antepé e dedos - 40% do comprimento do pé) (R). Além
disso, também foram analisadas as áreas de contato (cm 2) nas mesmas áreas
plantares (Ribeiro, 2013).
46
CAPÍTULO 4
ARTIGOS
47
48
ABSTRACT
The growing number of runners in road racing has led to an increase of skeletal
muscle injury. The effects of running with or without shoes on injury prevention
have been extensively studied, and several investigations have assessed
biomechanical differences between them. However, findings are not consensual
and further insights on biomechanical load associated to differently shod or
barefoot conditions may be needed. This study has two main purposes: (1) to
observe if habitually shod marathon runners show acute alterations when
running barefoot or with minimalist shoes, and (2) to determine whether the
running kinematical adaptations of wearing minimalist shoes are similar to
barefoot running. 12 male elite marathon runners performed 15 minutes of
familiarization with treadmill running. Afterwards they were asked to run at their
average marathon pace in different footwear conditions: habitual running shoes,
wearing minimalist shoes, and barefoot. High-resolution infra-red cameras and
visual 3D software were used to assess kinematic data. The following
parameters were studied in the different phases of the running cycle, in initial
contact shoe/minimalist/barefoot: hip angle (39.96º/36.46º/36.92º) and range of
motion (51.02º/50.73º/52.06º), knee angle (12.97º/11.62º/10.73º) and range of
motion (32.6º/30.88º/30.88º), ankle angle (1.13º/-1.36/-1.23º) and range of
motion (35.93º/37.49º/29.56º), foot strike angle (15.25º/10.39º/11.44º),
normalized stride length (2.64cm/2.59cm/2.53cm), cycle time duration
(0.62seg/0.61seg/0.59seg) and stance time duration (46.14% /46.16% /
47.12%). Contrary to the expectations, it was found that highly trained habitually
shod elite marathon runners changed their lower limb kinematic pattern both
when running barefoot or wearing minimalist shoes. Minimalist shoes showed a
trend towards intermediate biomechanical effects between running with and
without shoes.
49
50
INTRODUCTION
Recently, some minimalist shoes, like Vibram FiveFingers TM, Nike FreeTM,
and New Balance MinimusTM, have emerged as an alternative to barefoot
running. The term minimalist shoes refers to a smaller cushioned heel, and
offers more flexible and less restrictive foot motion [12]. A recent survey in
minimalist shoes reveals the different types and characteristics available while
somehow offering more protection [13].
51
adaptation to new running footwear condition in elite marathon runners is
missing. Therefore, further research is needed to better understand the
mechanical effects of barefoot and minimalist shoes compared with the habitual
running shoes. It is important to understand the acute effects in the elite
marathon runners who change their use of the habitual running shoes for other
conditions. We had two purposes: (1) to observe if habitual running shoes high-
level marathon runners show acute kinematic changes when running with
minimalist shoes and barefoot, and (2) to determine whether the running
kinematic adaptations wearing minimalist shoes are similar to barefoot running
in this specific athlete: elite marathon runners.
METHODS
Subjects
12 male elite marathon runners ( age: mean 42.7 (SD 8.66)yr; height:
mean 172.6 (SD 7.08)cm; body mass: mean 64.6 (SD 7.65)kg ), using habitual
running shoes, with at least 3 years of competition experience and systematic
training, and running around 80 to 100 km/week (Table 1). The inclusion
criterion was that they had to have participated in the last two editions of the
Porto City Marathon. Subjects were screened for exclusion criteria by interview
and excluded when suffering from orthopaedic, cardiovascular or neurological
complaints, or having any previous experience running barefoot or with
minimalist shoes. Prior to participation, each subject read and signed a consent
form approved by the University’s Ethics Committee (FADEUP).
52
Table 1 Anthropometric data, training characteristics, and running
performance of the 12 high-level marathon runners studied.
Variables Mean (SD)
Procedures
The experiment was divided into two stages. In the first stage, the
participant’s health status and never used minimalist shoes were assessed. In
the second stage, a running assessment protocol was performed in the
biomechanics laboratory. The running protocol was adapted from previous
literature [17], and consisted of a period of familiarization with the treadmill
running at 3.33 m.s-1 for 15 minutes while wearing habitual running shoes. After
the familiarization, the velocity gave the average marathon pace of each runner,
calculated from their last marathon performance. Kinematic data were recorded
for 1minute at average marathon pace. Without resting between conditions,
they were made to change into minimalist shoes (Vibram FiveFingers© KSO;
Concord, MA, USA) and perform a 5-minute adaptation on the treadmill at their
average marathon pace and kinematic data were recorded for 1 minute. The
last step was to remove their minimalist shoes and perform barefoot for a 5-
minute adaptation on the treadmill and kinematic data was recorded for 1
minute. Twelve running trials were conducted on a split-belt AMTI Force-
53
Sensing Tandem Treadmill (AMTI Inc., MA).
Data Processing
54
Positive angular kinematics values denote hip flexion, knee flexion and ankle
dorsiflexion, whilst negative values correspond to hip extension, knee extension
and ankle plantarflexion. Foot strike angle was used to classify the foot strike
pattern, with midfoot/forefoot defined as a foot strike angle < 0° and rearfoot
defined as a foot strike angle > 0° [20].
Statistical Analysis
RESULTS
The mean velocity of the subjects in the running protocol was 4.44 (SD
0.48)m.s-1, and according to the protocol design, there was no within-subject (or
group) difference in the velocity between conditions (p=0.001). Kinematic
parameters for all running footwear conditions are shown in Table 2. The
different footwear conditions significantly influenced all the kinematic
parameters assessed (p<0.001). Indeed, values were significantly different
between the three conditions for all the studied kinematical variables, with the
exception of the knee range of motion (ROM) during the stance phase (between
minimalist shoes and barefoot), and for the stance time (between habitual
running shoes and minimalist shoes). In ten out of the sixteen variables studied,
the minimalist shoes condition showed a trend to imply intermediate values
regarding shod and barefoot running.
55
shod mean 1.13 (SD 6.56)º. Differences between minimalist shoes and barefoot
were also significant. This shows that, changing from wearing conventional
running shoes to running barefoot, and passing through minimalist shoes, the
foot strike also shifts from rearfoot strike to midfoot/ forefoot patterns. The
runners were midfoot striking in both shoes. Ankle angles of +5 degrees to -5
degrees dorsiflexion at initial contact have been used to describe a midfoot
strike. Ankle ROM was slightly higher in the minimalist shoes mean 37.49 (SD
10.7)º when compared to both remaining conditions, shod mean 35.93 (SD
7.13)º and barefoot running mean 29.56 (SD 8.5)º. Knee angle at initial contact
was getting lower across the conditions, from mean 12.97 (SD 7.44)º with
habitually running shoes to mean 11.62 (SD 7.05)º with the minimalist shoes
and mean 10.73 (SD 7.11)º when barefoot. Footstrike angles are all >0
regardless of footwear condition shoes mean 15.25 (SD 6.68)º, minimalist
shoes mean 10.39 (SD 8.27)º, barefoot mean 11.44 (SD 6.69)º so this suggests
that all runners were using a rearfoot strike. In the habitual running shoes, the ic
didn't have foot strike of the forefoot, however in minimalist shoes and barefoot
it had a little midfoot strike. Of the 12 runners, only 1 in the initial contact with
minimalist shoes was a forefoot strike, however, all runners’ patterns changed,
with a tendency to midfoot strike.
The knee ROM was getting decreased throughout the conditions when
compared to shod mean 32.60 (SD 6.85)º, but there was no difference between
minimalist shoes mean 30.88 (SD 6.58)º and barefoot conditions mean 30.88
(SD 6.62)º. The hip angle at initial contact decreased from mean 39.96º (SD
5.73)º when shod to mean 36.46º (SD 6.25)º in case of minimalist shoes and
got slightly higher with barefoot at mean 36.92º (SD 6.83)º. Hip ROM showed a
lower range in the minimalist shoes conditions mean 50.73 (SD 7.88)º with a
slightly higher range in barefoot condition mean 52.06 (SD 8.07)º when
compared to traditional running shoes mean 51.02 (SD 8.26)º.
The stride length was reduced when barefoot mean 3.01 (SD 0.45)m
was compared with all other conditions shod: mean 3.13 (SD 0.45)m;
FiveFingers: mean 3.08 (SD 0.44)m. Cycle time duration was reduced in the
barefoot condition mean 0.59 (SD 0.03)s in comparison with the minimalist
56
mean 0.61 (SD 0.03)s and habitual running shoes mean 0.62 (SD 0.03)s. In
contrast, stance time normalized to the cycle time (time normalized to % gait
cycle) increased in the barefoot condition mean 47.12 (SD 1.83)% while it
remained the same in minimalist shoes mean 46.16 (SD 1.78)% and habitual
running shoes mean 46.14 (SD 1.58)%.
Table 2 Kinematic group mean (SD), median values. Differences observed between
shoe, minimalist and barefoot running conditions are shown. ic = initial contact. ROM =
range of motion
ic Ankle Angle (º) mean 1.13 mean -1.36 mean -1.23 p < 0.00 p < 0.00 p < 0.00
(SD 6.56) (SD 13.52) (SD 9.03)
(2.1) (1.38) (-2.63)
Ankle ROM (º) mean 35.93 mean 37.49 mean 29.56 p < 0.00 p < 0.00 p < 0.00
(SD 7.13) (SD 10.70) (SD 8.05)
(36.86) (36.53) (29.19)
Foot strike angle (°) mean 15.25 mean 10.39x mean 11.44 p < 0.00 p < 0.00 p < 0.00
(SD 6.68) (SD 8.27) (SD 6.69)
(13,86) (9,72) (10,89)
ic Knee angle (º) mean 12.97 mean 11.62 mean 10.73 p < 0.00 p < 0.00 p < 0.00
(SD 7.44) (SD 7.05) (SD 7.11)
(14.58) (12.79) (11.47)
Knee ROM (º) mean 32.6 mean 30.88 mean 30.88 p < 0.00 p = 0.55 p < 0.00
(SD 6.85) (SD 6.58) (SD 6.62)
(32.46) (31.58) (30.22)
ic Hip Angle (º) mean 39.96 mean 36.46 mean 36.92 p < 0.00 p = 0.02 p < 0.00
(SD 5.73) (SD 6.25) (SD 6.83)
(39.92) (36.02) (37.23)
Hip ROM (º) mean 51.02 mean 50.73 mean 52.06 p < 0.00 p < 0.00 p = 0.01
(SD 8.26) (SD 7.88) (SD 8.07)
(51.59) (51.61) (50.62)
Stride Length (m) mean 3.13 mean 3.08 Mean 3.01 p < 0.00 p < 0.00 p < 0.00
(SD 0,45) (SD 0.44) (SD 0.45)
(3.24) (3.15) (3.16)
Cycle time-duration (s) mean 0.62 mean 0.61 mean 0.59 p < 0.00 p < 0.00 p < 0.00
(SD 0.03) (SD 0.03) (SD 0.03)
(0.62) (0.61) (0.60)
Relative stance time (%) mean 46.14 mean 46.16 mean 47.12 p < 0.00 p < 0.00 p < 0.00
(SD 1.58) (SD 1.78) (SD 1.83)
(45.83) (46.01) (46.95)
DISCUSSION
57
pattern [21]. Despite previous works showing that running with minimalist shoes
were similar to habitual running shoes, and different from barefoot condition
[19;12;10], as it happened, in the present study, the minimalist shoes have
resulted in biomechanical intermediate effects between running with shoes and
barefoot. The difference between the results found in previous studies
compared to ours might probably be explained by the differences in the
experimental procedures, as in the study by [10], where the authors provided to
their participants a previous period for familiarization with the footwear, or
barefoot condition.
Regarding the changes in the foot strike pattern, we have observed that
all the participants had rearfoot strike pattern when running with shoes, and that
they have shown a trend to run with a more flat foot in minimalist shoes, and
even flatter in barefoot conditions,. Hence, this suggests that all runners were
using a rearfoot strike, as assessed by the initial contact ankle angle. Several
58
studies about foot strike differences between footwear conditions in endurance
runners have also shown this trend [10; 26;27]. A deep analysis of the initial
contact ankle angle distributions obtained for the three footwear conditions,
allow understanding that a large variability of values occurred, meaning that the
observed trend requires to be carefully analyzed. Indeed, the foot strike angle
showed that, despite reducing the rearfoot contact dominance when changing
from habitual running shoes to minimalist shoes and barefoot, the mean contact
pattern seems to be kept as a rearfoot contact, albeit flatter. This might have
been a consequence of the runner’s stabilized motor pattern, acquired over
years of training with traditional running shoes, influencing this tendency of
initially contacting the ground with the heel even when running in different
footwear conditions. Additionally, we have noticed that, particularly in the
minimalist shoes, the runners had more variability in the foot strike angle,
making it hard to recognize a predominant pattern at the foot strike. Hence, it is
possible to accept that a motor learning process in progress might be expected
as an acute effect for the new running condition, shifting the strike pattern
towards a flatter or even forefoot strike. To our knowledge, no previous
literature had observed this variability in foot strike pattern during the early
stage of adaptation to the minimalist shoes.
Our findings of a reduction in the knee angle at initial contact and lower
knee range of motion during stance phase, when running barefoot or with the
minimalist shoes, are consistent with previous comparisons between the
different footwear conditions [5;14;27;28]. According to [10] a smaller knee
flexion angle during stance phase reduces the patellofemoral stress during
59
running. In addition, previous comparisons [18;29;28] of barefoot and shod
running have demonstrated that the knee flexion angle during the stance phase
is lower when running without shoes. These changes may happen due to the
reduction in stride length, which places the lower extremities more beneath the
body at the moment of the foot strike. Therefore, it reduces the impact loading
as well as the demand on the quadriceps muscle [10;24].
60
CONCLUSIONS
ACKNOWLEDGMENTS
DISCLOSURES
61
REFERENCES
[1] Chan-Roper M, Hunter I, Myrer JW, Egget DL, Seeley MK. Kinematic
changes during a marathon for fast and slow runners. Journal of Sports
Science and Medicine. 2012;11:77-82.
[2] Van Gent RN, Siem D, Van Middelkoop M, Van Os AG, Bierma-Zeinstra
SMA, Koes BW. Incidence and determinants of lower extremity running
injuries in long distance runners: a systematic review. Br J Sports Med.
2007;41:469-80.
[3] Altman, A.R. Davis, I.S. Barefoot Running: Biomechanics and Implications
for Running Injuries. American College of Sports Medicine. 2012;11:244-
50.
[4] History of Running Shoes [Internet]. Amazon; 2009 [Modified 2009 Mar 15].
Available from: http://edu.udym.com/history-of-running-shoes/
[5] De Wit, B., De Clercq, D., & Aerts, P. Biomechanical analysis of the stance
phase during barefoot and shod running. Journal of Biomechanics.
2000;33(3): 269-278. PMID: 10673110
[6] Divert, C., Baur, H., Mornieux, G., Mayer, F., & Belli, A. Stiffness Adaptations
in Shod Running. Journal of Applied Biomechanics. 2005;21 (4): 311-
321. PMID: 16498177
[7] Lieberman, D. E., Venkadesan, M., Werbel, W.A., Daoud, A.I., D’Andrea, S.,
Davis, I.S., Mang’Eni, R.O. & Pitsiladis, Y. Foot strike patterns and
collision forces in habitually barefoot versus shod runners. Nature.
2010;463; 531-536. Doi:10.1038/nature08723
[8] Daoud, A.I., Geissler, G.J., Wang, F., Saretsky, J., Daoud, Y.A., &
Lieberman, D.E. Foot Strike and Injury Rates in Endurance Runners. A
Retrospective Study. Med Sci Sports Exerc. 2012;44(7), 1325-1334. doi:
10.1249/MSS.0b013e3182465115.
[9] Fredericks, W., Swank, S., Teisberg, M., Hampton, B., Ridpath, L., & Hanna,
J. B. Lower Extremity Biomechanical Relationships with Different Speeds
in Traditional, Minimalist, and Barefoot Footwear. Journal of Sports
Science and Medicine. 2015;14(2): 276-283. PMID: 25983575
[10] Bonacci, J., Saunders, P.U., Hicks, A., Rantalainen, T., Vicenzino, B.G., &
Spratford, W. Running in a minimalist and lightweight shoe is not the
same as running barefoot: a biomechanical study. Br J Sports Med.
2013;47(6): 387–392. doi: 10.1136/bjsports-2012-091837
[11] Sinclair, J. Effects of barefoot and barefoot inspired footwear on knee and
ankle loading during running. Clinical Biomechanics. 2014;29(4): 395–9.
doi: 10.1016/j.clinbiomech.2014.02.004.
[12] Squadrone, R., Rodano, R., Hamill, J., & Preatoni, E. Acute effect of
different minimalist shoes on foot strike pattern and kinematics in rearfoot
62
strikers during running. Journal of Sports Sciences. 2015;33 (11):1196-
204. doi: 10.1080/02640414.2014.989534
[13] Esculier, J.F. Dubois, B. Dionne, C. Leblon, J. Roy, J.S. A consensus
definition and rating scale for minimalist shoes. Journal of Foot and Ankle
Research.2015;8:42. doi: 10.1186/s13047-015-0094-5
[14] Fleming, N., Walters, J., Grounds, J., Fife, L., & Finch, A. Acute response
to barefoot running in habitually shod males. Human Movement Science.
2015;42: 27-37. doi: 10.1016/j.humov.2015.04.008.
[15] Paquette, M.R., Zhang, S., & Baumgartner, L.D. Acute effects of barefoot,
minimal shoes and running shoes on lower limb mechanics in rear and
forefoot strike runners. Footwear Science. 2013;5(1): 9-18. doi:
10.1080/19424280.2012.692724
[16] Thompson, M.A., Lee, S.S., Seegmiller, J., & McGowan, C.P. Kinematic
and kinetic comparison of barefoot and shod running in mid/forefoot and
rearfoot strike runners. Gait Posture. 2015;41 (4):957-9. doi:
10.1016/j.gaitpost.2015.03.002.
[17] Shih, Y., Lin, K.L., & Shiang, T.Y. Is the foot striking pattern more important
than barefoot or shod conditions in running? Gait Posture. 2013;38(3):
490-4. doi: 10.1016/j.gaitpost.2013.01.030.
[18] Bonacci, J., Vicenzino, B., Spratford, W., & Collins, P. Take your shoes off
to reduce patellofemoral joint stress during running. Br J Sports Med.
2014;48(6): 425-8. doi: 10.1136/bjsports-2013-092160.
[19] McCallion, C., Donne, B., Fleming, N., & Blanksby, B. Acute Differences in
Foot Strike and Spatiotemporal Variables for Shod, Barefoot or
Minimalist Male Runners. Journal of Sports Science and Medicine.
2014;13(2): 280-6. PMID: 24790480
[20] Zeni J.A. Jr, Richards, J.G., & Higginson, J.S. Two simple methods for
determining gait events during treadmill and overground walking using
kinematic data. Gait Posture. 2008;27 (4): 710–714. PMID: 17723303
[21] McCarthy, C., Fleminng, N., Donne, B., & Blanksby, B. 12 Weeks of
Simulated Barefoot Running Changes Foot-Strike Patterns in Female
Runners. Int J Sports Med. 2014;35(5):443-50. doi: 10.1055/s-0033-
1353215.
[22] Divert, C., Mornieux, G., Freychat, P., Baly, L., Mayer, F., & Belli, A.
Barefoot-Shod Running Differences: Shoe or Mass Effect? Int J Sports
Med. 2008;29(6): 512-8. PMID: 18027308
[23] Cheung, R.T., & Davis, I.S. Landing Pattern Modification to Improve
Patellofemoral Pain in Runners: A Case Series. Journal of orthopaedic &
sports physical therapy. 2011;41(12): 914-9.
doi:10.2519/jospt.2011.3771
[24] Heiderscheit, B.C., Chumanov, E.S., Michalski, M.P., Wille, C.M., & Ryan,
M.B. Effects of Step Rate Manipulation on Joint Mechanics during
63
R u n n i n g . M e d S c i S p o r t s E x e r c . 2011;43(2), 296-302.
doi:10.1249/MSS.0b013e3181ebedf4
[25] Williams III, D.S.B., Green, D.H., & Wurzinger, B. Changes in lower
extremity movement and power absorption during forefoot striking and
barefoot running.The International Journal of Sports Physical Therapy.
2012;7(5): 525-32. PMID: 23091785
[26] Cheung, R.T. & Rainbow, M.J. Landing pattern and vertical loading rates
during first attempt of barefoot running in habitual shod runners. Human
Movement Science. 2014;34: 120-7. doi: 10.1016/j.humov.2014.01.006.
[27] Goss, D.L., Lewek, M., Yu, B., Ware, W.B., Teyhen, D.S., & Gross, M.T.
Lower Extremity Biomechanics and Self-Reported Foot-Strike Patterns
Among Runners in Traditional and Minimalist Shoes. Journal of Athletic
Training. 2015;49(6), 000–000. PMID: 25695854
[28] Perl, D.P., Daoud, A.I., & Lierberman, D.E. Effects of Footwear and Strike
Type on Running Economy. Med. Sci. Sports Exerc. 2012;44(7): 1335–
43. doi: 10.1249/MSS.0b013e318247989e.
[29] Kerrigan, D.C. Franz, J.R. Keenan, G.S. Dicharry, J. Croce, U.D. Wilder,
R.P. The Effect of Running Shoes on Lower Extremity Joint Torques.
The American Academy of Physical Medicine and Rehabilitation.
2009;1:1058-63.
[30] Squadrone, R., & Gallozzi, C. Biomechanical and physiological comparison
of barefoot and two shod conditions in experienced barefoot runners.The
Journal of Sports Medicine and Physical Fitness. 2009;49(1): 6-13.
PMID: 19188889
64
4.2 Kinematic and electromyographic effects of acute
transition from shod to barefoot or minimalist shoe
running
65
66
ABSTRACT
The purpose of this study was to investigate if acute changes in the muscle
activity in habitually shod rearfoot strike runners occur when running barefoot or
wearing minimalist shoes. Twelve high-level marathon runners were studied.
Firstly, the participants’ health status and previous use of minimalist shoes were
assessed. Afterwards, subjects were submitted to a treadmill (split-belt AMTI
Force-Sensing Tandem Treadmill) running protocol. Initially, they were asked to
run at their average marathon time wearing their habitual running shoes; then
they ran barefoot and wearing minimalist shoes at the same velocity.
Electromyography (EMG) and 3D kinematical data (Qualisys motion capture
system) were collected and compared. Significant differences in the knee
kinematics were observed across all the footwear conditions, with a less flexed
knee at initial contact when running barefoot, followed by the minimalist shoes
and habitual running shoes conditions. A significant change was also observed
in the increase in limb muscular recruitment pattern as a consequence of the
acute transition to minimalist shoes and barefoot running. It was concluded that
acute transfer from shod to barefoot or minimalist shoes induce changes into
kinematical and EMG running patterns.
67
68
INTRODUCTION
69
been examined in runners who intentionally shift their natural foot strike pattern
[7,13]. Bonacci et al. [14] tried to verify if running in minimalist shoes
biomechanically (kinematics and EMG patterns) replicates barefoot running in
highly trained athletes. No significant differences were observed between the
three running conditions. However, the authors didn’t assess acute effects once
they allowed 10 days familiarization with minimalist shoes and barefoot running.
Hence, it remains unclear if an acute change from the more cushioned shod
condition to barefoot condition, passing through minimalist shoes, will imply any
neuromuscular or kinematical specific response.
The purpose of this study was to describe the acute changes in the
muscle activity in habitually shod rearfoot strike runners when barefoot or
wearing minimalist shoes. A better understanding of how muscle activity
changes due to different footwear conditions may help runners and coaches to
safely transition to a barefoot condition or minimalist shoes’ frequent use in
training or competition.
METHODS
Participants
70
Table 1 Anthropometric data, training characteristics, and running
performance of the studied subjects.
Procedures
The experiment was divided into two stages. In the first stage, the
participants’ health status and previous use of minimalist shoes were assessed.
In the second stage, a running treadmill protocol was performed at a
biomechanics laboratory. The running protocol was adapted from Boyer and
Nigg [15], Shih et al. [7], and Hsiao et al. [16] and consisted of a period of
familiarization with the treadmill running at 3.33 m/s for 15 minutes while
wearing their habitual running shoes. After the familiarization period, they were
asked to run at their average marathon time, calculated from the last ran
marathon. Kinematic data were recorded for 1 minute after the adaptation
period at their marathon velocity. Participants then changed footwear conditions
and performed a 5-minute adaptation period with the minimalist shoes (Vibram
FiveFingers© KSO; Concord, MA) on the treadmill at marathon velocity before
kinematic data was also recorded for 1 minute. Again, the participants removed
their shoes and ran barefoot at marathon velocity for another 5 minutes before
kinematic data was recorded for 1 minute under this footwear condition. All the
71
running trials were conducted on a split-belt AMTI Force-Sensing Tandem
Treadmill (AMTI Inc., MA). In this study, the competition velocities of the
runners were of 4.44 m/s ± 0.48.
72
Figure 1 Runner instrumented for data collection wearing minimalist shoes.
Data processing
73
EMG data was processed using Visual 3D software (C-Motion,
Germantown, MD). The signals were bandpass filtered (Butterworth digital,
fourth order, 20-450 Hz) and rectified, and the RMS of the signal was obtained
using 100 ms moving continuous windows. EMG data was then normalized to
the maximal EMG activity found in the shod conditions within each subject for
each respective muscle. In the interpretation of EMG data, the conceptual
standardization was used that was established by ISEK (International Society of
Electrophysiology and Kinesiology) and followed by the Standards for Reporting
Date EMG.
Statistical Analysis
RESULTS
74
Table 2 EMG group mean ± standard deviation (median) for the studied
muscles activity. Data is presented as a percentage (%) of maximal stance phase
activity recorded during usual running shoes condition. Asterisk marks significant
differences (p < 0.05) between running conditions. * expresses differences between
usual and minimalist shoes. ** means significant differences between usual shoes and
barefoot. *** reflects barefoot to minimalist shoes differences.
Usual shoe Load acceptance Phase Propulsive Phase Pre-activation for LAP
(%) (LAP) 38.21 ± 12.81 (38.51) 9.27 ± 5.22 (7.27)
39.49 ± 11.42 (40.21)
Barefoot (%) Load acceptance Phase Propulsive Phase Pre-activation for LAP
(LAP) 43.45 ± 14.45 (40.63) 10.74 ± 5.15* (9.76)
43.47 ± 16.72 (39.65)
Biceps Higher muscle activity Intermediate Activity Lowest muscle activity phase
Femoris phase
Usual shoe Pre-activation for LAP Load acceptance Phase Propulsive Phase
(%) 51.42 ± 16.31*(53.68) (LAP) 37.37 ± 16.79 (35.23)
48.80 ± 17.36*(48.19)
Barefoot (%) Load acceptance Phase Propulsive Phase Pre-activation for LAP
(LAP) 44.20 ± 21.55 (44.30) 41.11 ± 21.78 (39.79)
51.27 ± 24.91 (49.17)
Ankle dorsiflexion
Tibialis Higher muscle activity Intermediate Activity Lowest muscle activity phase
Anterior phase
Usual shoe Load acceptance Phase Propulsive Phase Pre-activation for LAP
(%) (LAP) 33.45 ± 20.82 (33.45 ± 31.39 ± 21.91 (26.90)
41.98 ± 21.11 (41.46) 20.82)
Barefoot (%) Load acceptance Phase Propulsive Phase Pre-activation for LAP
(LAP) 67.29 ± 43.37* (60.49) 30.13 ± 17.2* (27.87)
70.60 ± 67.42 (47.49)
(To be continued)
75
Table 2 (Continuation)
Usual shoe Propulsive Phase Load acceptance Phase Pre-activation for LAP
(%) 57.16 ± 20.08 (60.42) (LAP) 24.24 ± 21.7 (16.01)
52.56 ± 22.65 (52.13)
Barefoot (%) Propulsive Phase Load acceptance Phase Pre-activation for LAP
45.26 ± 19.70 (45.29) (LAP) 13.58 ± 13.75 (9.35)
39.23 ± 19.62 (34.49)
Lateral Higher muscle activity Intermediate Activity Lowest muscle activity phase
Gastrocnemi phase
us
Usual shoe Propulsive Phase Load acceptance Phase Pre-activation for LAP
(%) 40.92 ± 11.88 (40.17) (LAP) 9.16 ± 4.16** (8.16)
38.16 ± 11 (37.87)
Barefoot (%) Propulsive Phase Load acceptance Phase Pre-activation for LAP
278.99 ± 258.78 (LAP) 19.74 ± 20.74** (11.9)
(202.53) 213.87 ± 186.79
(178.13)
Medial Higher muscle activity Intermediate Activity Lowest muscle activity phase
Gastrocnemi phase
us
Usual shoe Propulsive Phase Load acceptance Phase Pre-activation for LAP
(%) 45.55 ± 16.95 (48.73) (LAP) 12.11 ± 9.02* (8.94)
37.14 ± 14.18* (38.47)
Barefoot (%) Propulsive Phase Load acceptance Phase Pre-activation for LAP
44.05 ± 26.14* (41.06) (LAP) 11.88 ± 9.26* (9.50
37.87 ± 21.49*(34.51)
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significant differences between minimalist shoes and barefoot conditions (p <
0.200; p < 0.895), but when compared to traditional running shoes, both the
muscles had a higher root mean square (RMS) activity (p < 0.05). The biceps
femoris activity showed no difference between the habitual running shoes and
the minimalist shoes, displaying a lower activity in the barefoot condition.
Soleus had the higher RMS activity in the minimalist shoes, followed by the
habitual running shoes, with the barefoot condition exhibiting the lower muscle
activity. RMS activity of the medial gastrocnemius was not significantly different
across running conditions in the pre-activation phase.
77
activity during the minimalist shoe condition. The lowest activity was found
when running with habitual running shoes.
Rectus 9.27 ± 5.22 7.27 11.46 ± 10.06 10.74 ± 9.76 p < 0.00
Femoris 6.3* 5.15*
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* Table 3 (Continuation)
79
Significant alterations were observed in the knee kinematics across all
the footwear conditions, with a less flexed knee at initial contact when running
barefoot, followed by the minimalist shoes and habitual running shoes. The
knee range of motion for the absorptive phase was lower also when running
barefoot, with a higher excursion when shod (Table 4).
TO Ankle Angle (º) -19,89±7.21 -19,01 -21.62±11.65 -22.61 -16.95±13.13 -18.02 p < 0.00
IC Ankle Angle (º) 1.13±6.56 2.1 -1.36±13.52 1.38 -1.23±9.03 -2.63 p < 0.00
TO Knee Angle (º) 38.16± 5.23 38.44 36.86±6.18 35.71 37.33 ±5.96 36.42 p < 0.00
IC Knee Angle (º) 12.97±7.44 14.58 11.62±7.05 12.79 10.73±7.11 11.47 p < 0.00
TO Hip Angle (º) -8.03 ± 7.75 -10.09 -11.20 ± 9.96 -11.72 -12.84 ± 9.75 -11.37 p < 0.00
IC Hip Angle (º) 39.96±5.73 39.92 36.46±6.25 36.02 36.92±6.83 37.23 p < 0.00
LAP Ankle ROM (º) 12.33 ±4.14 11.24 14.35 ±5.80 14.14 10.78 ± 5.16 9.97 p < 0.00
LAP Knee ROM (º) 22.19 ± 7.10 22.53 21.74± 6.83 23.09 20.40 ± 6.46 20.95 p < 0.00
LAP Hip ROM (º) 14.12 ±5.41 13.01 15.14 ± 5.50 15.33 15.28 ± 4.97 15.48 p < 0.00
Discussion
The aim of this study was to measure the acute changes in muscle
activation pattern in runners in three conditions, with habitual running shoes,
with minimalist shoes, and barefoot. Our results showed an increase in muscle
activity when analyzed from habitual running shoes to barefoot condition. We
noticed that the significant neuromuscular adaptations can explain most of the
kinematic alterations.
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An especial feature was found in the load acceptance phase. The
minimalist shoes had increased activation of the triceps surae and the tibialis
anterior, whereas in the barefoot condition, only the lateral gastrocnemius and
the tibialis anterior exhibited higher activities. Fleming et al. [19] also reported
an increment in tibialis anterior activity for barefoot condition; however, during
the load acceptance phase, they have not detected significant differences in
lateral and medial gastrocnemius activities. Shih et al. [7] found the same
absorption mechanism, with eccentric control of the calf muscles for forefoot
striking runners. Similar to previous research [7, 19, 21], we also found high
muscular demanding in the propulsive phase.
In addition, we detected that the lower limb kinematics were altered due
to the changes in the footwear conditions. However, the most important
alteration observed among the kinematic parameters was the greater variability
in the ankle angle at initial contact, especially in the minimalist shoes.
Regarding the changes at the ankle joint, barefoot and minimalist shoe
conditions had a tendency to increase plantar flexion at the initial contact, as
previously reported by Fleming et al. [19], Lieberman et al. [3], and Perl et al.
[19].
Regardless of the variation of the ankle joint at the initial contact with the
ground, there is a tendency for landing in plantarflexed position followed by a
dorsiflexion movement. This acts as a damping spring and for the runners, it
acts as cushioning joint [9, 10].
81
increase in the rectus femoris in pre-activation and a decrease in the biceps
femoris when barefoot. The less flexed knee observed in the current study is
inconsistent with those previously reported in the literature [7, 21, 20].
Furthermore, regardless of the footstrike pattern, similar neuromuscular
adaptations were reported in Shih et al. [7] for barefoot running during the pre-
activation phase. Although barefoot and minimalist shoe conditions have shown
reduced knee excursion during the load acceptance phase, the neuromuscular
alterations during this phase were different between both the conditions.
The kinematic data showed that the patterns of running are immediately
changed after being exposed to a different footwear condition. Moreover, the
current data showed that being barefoot changes the shock absorption
mechanism. In the early stage of transition from habitual running shoes, the
initial impact is reduced by the more plantarflexed posture of the ankle and a
higher stiffness at the knee and hip joint levels. As proposed previously, high
stiffness during the absorptive phase enhances the mechanical efficiency and
power during the push-off phase [23], which is associated with a better running
economy [24]. Despite the potential benefits, the attempt of barefoot has to
consider the elevated demand on the plantarflexors muscles, as well as the risk
of injuries associated with a possible overloading of the musculoskeletal
system.
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CONCLUSION
The findings of the current study demonstrate that habitual running shoes
alter their running kinematics and lower limb muscular recruitment patterns at
the beginning of the transition to minimalist shoes and barefoot running. These
alterations might be brought about by the absence of the insole and the
immediate attempt to reduce the impact on the heel. The acute alterations at
the lower extremities suggest more compliance when running without the
conventional shoes. However, a high level of stiffness may increase the risk of
bone-related injuries. Therefore, habitual running shoes may need to reinforce
the calf muscles with appropriate training in order to adapt to a less cushioning
running condition.
ACKNOWLEDGMENTS
DISCLOSURES
83
REFERENCES
[1] Yong, J.R., Silder, A, Delp, S.L. Differences in muscle activity between
natural forefoot and rearfoot strikers during running. Journal of
Biomechanics. 2014; 47(15): 3 5 9 3 – 7 . doi:
10.1016/j.jbiomech.2014.10.015.
[2] Jenkins, D.W., Cauthon, D.J. Barefoot running claims and controversies: a
review of the literature. Journal of the American Podiatric Medical
Association. 2011;101(3): 231-46. PMID: 21622635
[3] Lieberman, D.E., Venkadesan, M., Werbel, W.A., Daoud, A.I., D’Andrea, S.,
Davis, I.S., Mang'eni, R.O., Pitsiladis, Y. Foot strike patterns and collision
forces in habitually barefoot versus shod runners. Nature.
2010;463(7280): 531-5. doi:10.1038/nature08723
[4] Williams III, D.S., McClay, I.S., Manal, K.T. Lower extremity mechanics in
runners with a converted forefoot strike pattern. Journal of Applied
Biomechanics. 2000;16: 210-8. doi:
http://fitnessforlife.org/AcuCustom/Sitename/Documents/DocumentItem/
2341.pdf
[5] Cavanagh, P.R., Lafortune, M.A. Ground reaction forces in distance running.
Journal of Biomechanics.1980;13(5): 397–406. doi:
http://dx.doi.org/10.1016/0021-9290(80)90033-0
[6] Altman, A.R., Davis, I.S. Is Midfoot Striking during Running Advantageous
over Rearfoot or Forefoot Striking? State College (PA): American Society
of Biomechanics. 2009. doi:
https://www.researchgate.net/publication/267768055
[7] Shih, Y., Lin, K., Shiang, T. Is the foot striking pattern more important than
barefoot or shod conditions in running? Gait & Posture. 2013;38(3): 490-
4. doi: 10.1016/j.gaitpost.2013.01.030.
[8] McCarthy, C., Fleminng, N., Donne, B., Blanksby, B. 12 Weeks of Simulated
Barefoot Running Changes Foot-Strike Patterns in Female Runners.
International Journal of Sports Medicine. 2014;35(5): 443-50. doi:
10.1055/s-0033-1353215.
[ 9 ] Divert, C., Mornieux, G., Baur, H., Mayer, F., Belli, A. Mechanical
comparison of barefoot and shod running. International Journal of Sports
Medicine. 2005;26(7): 593-8. doi: 10.1055/s-2004-821327
[10] Williams III, D.S., Green, D.H., Wurzinger, B. Changes in lower extremity
movement and power absorption during forefoot striking and barefoot
running. The International Journal of Sports Physical Therapy. 2012;7(5):
525-32. PMID: 23091785
[11] Hamner, S.R., Seth, A., Delp, S.L. Muscle contributions to propulsion and
support during running. Journal of Biomechanics. 2010;43(14): 2709–16.
doi: 10.1016/j.jbiomech.2010.06.025.
84
[12] Schmitz, A., Pohl, M.B., Woods, K,, Noehren, B. Variables during swing
associated with decreased impact peak and loading rate in running.
Journal of Biomechanics. 2014;47(1): 32-8. doi:
10.1016/j.jbiomech.2013.10.026.
[13] Olin, E.D., Gutierrez, G.M. EMG and tibial shock upon the first attempt at
barefoot running. Human Movement Science. 2013;32(2): 343–52.doi:
10.1016/j.humov.2012.11.005.
[14] Bonacci, J. Saunders, P.U. Hicks, A. Rantalainen, T. Vicenzino, B.G.T.
Spratford W. Running in a minimalist and lightweight shoe is not the
same as running barefoot: a biomechanical study. British Journal of
Sports Medicine. 2013;47:387–92.
[15] Boyer, K.A,. Nigg, B.M., Quantification of the input signal for soft tissue
vibration during running. Journal of Biomechanics. 2007;40(8): 1877–80.
doi: 10.1016/j.jbiomech.2006.08.008
[16] Hsiao, H., Guan, J., Weatherly, M. Accuracy and precision of two in-shoe
pressure measurement systems. Ergonomics. 2002;45(8): 537-55. doi:
http://dx.doi.org/10.1080/001401302101369
[17] Altman, A.R., Davis, I.S. Barefoot Running: Biomechanics and Implications
for Running Injuries. Current Sports Medicine Reports. 2012;11(5): 244-
50. doi: 10.1249/JSR.0b013e31826c9bb9
[ 1 8 ] Dunn, O.J. Multiple Comparisons Using Rank Sums. Technometrics.
1964;6(3): 241-52. doi: 10.2307/1266041
[19] Fleming, N. Walters, J. Grounds, J. Fife, L. Finch, A. Acute response to
barefoot running in habitually shod males. Human Movement Science.
2015;42: 27-37. doi: 10.1016/j.humov.2015.04.008.
[19] Perl, D.P. Daoud, A.I. Lierberman, D,E. Effects of Footwear and Strike
Type on Running Economy. Medicine And Science In Sports And
Exercise. 2012;44(7) : 1335–43. doi: 10.1249/MSS.0b013e318247989e.
[20] Strauts, J. Vanicek, N. Halaki, M. Acute changes in kinematic and muscle
activity patterns in habitually shod rearfoot strikers while running
barefoot. Journal of Sports Sciences. 2016;34(1): 75-78. doi:
10.1080/02640414.2015.1034756.
[21] Sinclair, J. Atkins, S. Richards, J. Vincent, H. Modelling of Muscle Force
Distributions During Barefoot and Shod Running. Journal of Human
Kinetics. 2015;47: 9-17. doi: 10.1515/hukin-2015-0057
[22] De Wit, B. De Clercq, D. Aerts, P. Biomechanical analysis of the stance
phase during barefoot and shod running. Journal of Biomechanics.
2000;33(3): 269-78. doi: S0021-9290(99)00192-X
[23] Kyröläinen, H. Belli, A. Komi, P. Biomechanical factors affecting running
economy . Medicine And Science In Sports And Exercise. 2001;33(8):
1330-7. doi: 10.1097/00005768-200108000-00014
85
[24] Slawinski, J. Heubert, R. Quievre, J. Billat, V. Hanon, C. Changes in spring-
mass model parameters and energy cost during track running to
exhaustion. The Journal of Strength & Conditioning Research.
2008;22(3): 930-6. doi: 10.1519/JSC.0b013e31816a4475
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4.3 Influence of different footwear on ground reaction force
during running analyzed through principal component
analysis
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88
ABSTRACT
The purpose of this study was to compare ground reaction force pattern
between customary running shoes, minimalist shoes and barefoot in
experienced marathon runners habitually shod using Principal Component
Analysis. Twelve high-level male marathon runners, habitually training mean
105.7 km/week, were examined. They were asked to run at their average
marathon pace, with habitual running shoes, then with minimalist shoes and
barefoot. Ground reaction forces were collected using two force platforms in a
treadmill (AMTI). The PCA model was generated based on the shoe running
data and then applied to the other two conditions. 3PCs were retained for each
component of GRF. The results showed that minimalist footwear and barefoot
conditions were significantly different from running with shoes, at least, in one of
the three analyzed GRF components. This results evidences that the choosing
footwear influences the kinetic pattern of running in elite athletes.
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90
INTRODUCTION
91
then, PCA has become a common method of reducing dimensionality and
analyzing waveforms in gait analysis (Muniz & Nadal, 2009; Soares, et al.,
2015). The study of the parameters obtained by the GRF curves allows the
evaluation of the mechanism that is associated with a particular movement and
the impact involved. From the analysis of the influence of the different footwear,
such as regular shoes, minimalist footwear and barefoot, it is possible to apply
these results to understand the differences between the footwear conditions,
and infer about the advantages and disadvantages for runners.
Thus, what happen with the foot pattern of usually shod runners when
they change to barefoot or minimalist footwear? So, the aim of this study is to
compare ground reaction force pattern between customary running shoes
(SHOE), minimalist shoes (MIN) and barefoot (BARE) in experienced marathon
runners habitually shod.
METHODS
Participants
Twelve male high-level marathon runners (age: 42.7 ± 8.66 years; height:
172.6 ± 7.08 cm; body mass: 64.6 ± 7.65 kg), habitually shod, with at least 3
years of competition experience and systematic training of 105.7 ± 50.45
km/week enrolled the study. The inclusion criterion was to had performed the
Porto City Marathon under 3h. Participants were screened for exclusion criteria
by interview and excluded when suffering from orthopaedic, cardiovascular or
neurological complaints, or having previous experience running barefoot or with
minimalist footwear. Everybody was formally informed about the objectives of
the study according the Helsinki declaration. Ethical approval was granted by
the local Ethics Committee (09/2014).
Protocol
The experiment was divided into two stages. In the first one, the suject’s
health status and previous use of minimalist footwear were assessed. In the
second stage, a running protocol was performed at a biomechanics laboratory.
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The running protocol was adapted from previous literature (Shih, Lin & Shiang,
2013), and consisted of a period of familiarization with the treadmill running at
3.33 m.s-1 for 15 minutes while wearing participant’s habitual running shoes.
After the familiarization period, they were asked to run at their average
marathon pace, calculated from his last marathon performance. Kinetic data
were recorded for one minute at their marathon velocity, after the adaptation
period. After this stage, the participants stopped running, changed the footwear
condition and performed a 5-minute adaptation period for the minimalist shoes
(Vibram FiveFingers© KSO; Concord, MA, USA) on the treadmill at marathon
pace before kinetic data were recorded again for one minute in this new
condition. For the last data collection, the participants stopped running and took
off the shoes and performed the same protocol running barefoot.
Ground reaction force (GRF) data were collected using a split-belt AMTI
Force-Sensing Tandem Treadmill (AMTI Inc., MA), composed by two
900x3x600mm force platforms (AMTI), sampling at 1200 Hz.
The GRF data was recorded using the treadmill software Netforce (AMTI
Inc., MA), and acquired with an amplifier G5 (AMTI Inc., MA). From the 60s
recorded, three consecutive steps from the right foot were taken to analysis.
GRF data was filtered using a 10th order Butterworth filter, with cutoff
frequency of 4Hz in. The signals were interpolated and resampled in order to
obtain 100 points (variables), providing one variable for each percent of stance
phase.
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linear combinations from those variables (Jolliffe, 2004). The PC models
defined by the equation Z= UtX, where U are the eigenvectors of the covariance
matrix of X (matrix S). Un is calculated by the equation SUn=λUn where λ are the
100 eigenvalues. PCs are arranged in decreasing order in such a way that the
first PC accounts for as much of the variability in the data, and each succeeding
component accounts for much of the remaining variability as possible
(Daffertshofer, Lamoth, Meijer, & Beek, 2004). In conclusion, each PC is a
representation of a transformation of the data x, into z uncorrelated variables.
Therefore, these uncorrelated variables are not redundant and explain different
aspects of data variance. Finally, the practical implications of each PC may be
drawn by analysis of the portion of the waveform in which it is relevant
(description below).
94
was used, and the PC score values (internal product from Matrix Z PC1, PC2
and PC3 to matrix A) for each participant in each condition were retained for
analysis (PC1, PC2 and PC3 scores for the three waveforms, totalizing 9 PC
score values per participant with each footwear). In the last phase, load vectors
were calculated by normalizing the PC models (matrix Z) between -1 and 1
according to Jones et al. (2008). After normalization, a threshold of ± 0.71 was
adopted to consider a load vector from one variable as relevant, and then to
attribute a meaning for this PC (Knapp & Comrey, 1973). It means that a
variable only with values above these loadings, have a biomechanical
interpretation in that portion of the curve (Jones et al., 2008). For more
information about PCA and its application previous studies are recommended
(Jones et al., 2008; Sadeghi, Allard, Barbier, Sadeghi, Hinse, Perrault, &
Labelle, 2002b).
Statistical Procedures
The normality of the distribution of the scores (PC1, PC2 and PC3 from
the GRFvt, GRFml and GRFap), were tested by Kolmogorov-Smirnov test and
the comparison between SHOE and the other footwear (MIN and BARE) was
performed by the nonparametric Wilcoxon test. Also, the scores generated for
each condition were ranked, and the 95% confidence interval (CI) was
calculated in order to evaluate the range of the data inside this interval. The
highest and lowest scores of these ranges were selected to highlight the main
differences between conditions. These statistical procedures were conducted
using SPSS (v.20; SPSS Inc, Chicago, IL) software with a significance level of
α=0.05.
RESULTS
The mean (±SD) velocity of the participants in the running protocol was
4.44±0.48 m.s-1 which represents a mean marathon duration of 2h38min
corroborating with our inclusion criteria.
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analyzed waveforms: (i) GRFvt PC1, (ii) GRFml PC2, (iii) GRFap PC1 (Table
2). Since differences between the variables GRFvt PC2, GRFml PC1, GRFap
PC2 and all the PC3 did not show any statistical significance between
conditions, they will not be discussed (Table 1). The explained variance
retaining 3PCs in each variable is 83%, 82% and 88%, respectively.
Table 1 PCA analysis: mean (SD) for PC1, PC2 and PC3 scores for the Fvt, Fml, Fap
and conditions habitual shoes, minimalist and barefoot
GRFvt: The grey area in Figures 1a-1c highlights the threshold area of
0.71, where the PCs have a meaningful interpretation (Knapp & Comrey, 1973).
The component loadings of GRFvt PC1 are relevant from 10% to 15%
representing the initial contact/first peak, from 25% to 42% (weight acceptance)
and from 60% to 90% (final propulsion) (Fig 1 a-b); GRFvt PC1 was significantly
different from shoe both in minimalist footwear and running barefoot (Table 1).
GRFvt PC3 is relevant from 45% to 65%, but no statistical differences between
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Figure 1 Vertical Ground Reaction Force: a) load vectors for PC1, PC2 and PC3; b)
highest and lowest scores in 95% confidence interval (CI) in PC1. PC: principal
component; SHOE: habitual running shoe; MIN: minimalist footwear; BARE: barefoot
condition. The grey area highlights the 0.71 threshold. NS: not significantly different.
50% to 75% (GRFvt highest peak) (Fig 2a). This variable was significantly
different between shoe and minimalist footwear. GRFml PC1 is relevant from
15% to 25% and GRFml PC3 is relevant from 50% to 75% %, but no statistical
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Figure 2 Medio-lateral Ground Reaction Force: a) load vectors for PC1, PC2 and PC3;
b) highest and lowest scores in 95% confidence interval (CI) in PC1. c) highest and
lowest scores in 95% confidence interval (CI) in PC2; PC: principal component; SHOE:
habitual running shoe; MIN: minimalist footwear. The grey area highlights the 0.71
threshold. NS: not significantly different.
GRFap: GRFap PC1 was relevant 25% to 28% and from 40% to 85%,
representing the deceleration peak and the increasing of the force, until
acceleration peak, respectively (Fig 3a). GRFap PC1 was significantly different
between shoe and both minimalist footwear and barefoot running. GRFap PC2
is relevant from 83% to 97% and GRFap PC3 is relevant from 2% to 10% , but
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Figure 3 Antero-posterior Ground Reaction Force: a) load vectors for PC1, PC2 and
PC3; b) highest and lowest scores in 95% confidence interval (CI) in PC1. PC: principal
component; SHOE: habitual running shoe; MIN: minimalist footwear; BARE: barefoot
condition. The grey area highlights the 0.71 threshold. NS: not significantly different.
the results obtained, PCA approach was able to differentiate the footwear in
different regions of the force-time series, determined by the 3 PCs retained for
each curve. All GRF waveforms were affected by the footwear, in at least one
PC. The results of the present study corroborates with a previous study (Soares
et al., 2014), which showed that PCA is a powerful method to analyze and to
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identify differences in GRF waveforms. Among the advantages observed with
characterize the whole curve; b) data from the entire gait cycle are considered;
the variance presented in the data (Soares et al., 2015). In specialized literature
there are references to other methods allowing to analyze the whole curve in
order to obtain a more detailed description of the data (Castro et al., 2015;
Jones et al., 2008). However, PCA seems to accomplish all the criteria and
The purpose of analyzing the force-time series in the light of PCs is first
meaning for the PCs (Sadeghi et al., 2002). The model presented here retained
3 PCs that accounted for at least 82% of explained variance in GRF variables.
In this way, some regions of the gait cycle may not be taken into account in this
model, namely the regions without any PC load vector above the 0.71 threshold
(Molenaar, 2013). Moreover, the analysis of PCs with higher index (PC4 to
PC10) showed that the variance accounted for each one of these PCs was
smaller than 5% and none of them reached the 0.71 threshold, which means
that they would not bring extra relevant information. Also Deluzio et al. (1997)
stated that PCs accounting for smaller variances are harder to explain.
time data recorded in SHOE condition, and then applied to MIN and BARE
conditions. In this sense, the variability induced by MIN and BARE conditions
could be in a region out of the ones retained for analysis (Molenaar, 2013).
However, it was accepted that the PCA model based in SHOE data provides
100
limits to which the other experimental conditions might be successfully
different results might be obtained if any of the remaining tested conditions was
and both other conditions, in the regions corresponding to the initial contact, the
weight acceptance and the propulsion phase. Analyzing the pattern of the
with habitual shoes, it might be observed that the slope of the curve is lower
than the one characteristic of the other two conditions, which implied the
difference observed on the initial contact phase (from 10 to 15% of the stance
phase). Cheung & Rainbow (2014) stated that running barefoot in individuals
habitually shod alters the landing pattern from a heel striking to a non-heel
striking one, which helps to explain the slower slope in SHOE GRFvt. Indeed,
the cushioning effect of both the soft tissues of the rear foot and the shoe sole
may explain this observation. The behavior of the MIN and BARE GRFvt curves
are very similar in this first phase (from 10% to 50 %), highlighting the similarity
between this two conditions, which is in accordance with previous studies that
stated that running with MIN is very similar to running barefoot (De Wit, De
Clercq & Aerts, 2000; Divert et al., 2008; Lieberman et al., 2010). GRFvt in MIN
and BARE, presents a higher first peak value, in comparison to SHOE condition
(Fig 1b), again this could be associated to the smaller cushioning properties of
running, that implies higher impact peaks in ground contact. The acceleration
sub-phase of the stance (from 60% to 90%) shows a different pattern between
101
conditions, where SHOE and BARE keeps the force at higher magnitudes for a
for the shape of the curves. Apparently the MIN condition imposes a constrain
the foot, not observed in BARE situation, and, to the best of our knowledge,
never before identified. This inability to, compared to SHOE and BARE, similarly
sustain the application of vertical force during the last stages of foot ground
contact in the MIN condition, may imply a performance constrain, once it seems
regions where PC2 is relevant correspond to the maximum peak of GRFvt and
propulsion phase (50% to 72% - Fig 2b). In the GRFml curve (Fig 2b), it is
evidenced the differences between SHOE and MIN, which also are in
accordance with previous studies (De Wit, De Clercq & Aerts, 2000; Divert et
al., 2008; Lieberman et al., 2010). The differences are more related to the
pronation pattern and MIN a supination one, which can also be an individual
characteristic, since the GRFml waveform is the one most adaptable among
limit the hallux application of force during the final foot contact, conversing to
suggesting that GRFml pattern from MIN and BARE are different Hryvniak,
Dicharry & Wilder, 2014). This also could be explained for the variability of the
102
data obtained in BARE condition, which is a common situation in individuals
habitually shod when run barefoot. Both MIN and BARE showed differences in
GRFap PC1 compared to SHOE. The relevant portions are from 23% to 27%
and from 40% to 83%. This portions amounts for 45% of the Stance Phase,
footwear or even running barefoot, alter almost half the pattern of GRFap. The
to MIN and BARE where, this peak is sharper and occur sooner. This pattern
could be, again, related to the highest cushioning properties of the shoe,
allowing a slower acceptance of the load by the foot (Altman & Davis, 2012;
Hryvniak, Dicharry & Wilder, 2014). Moreover, the evident inability of the MIN
condition to allow for sustaining the positive (forward) force and impulse, may
reinforce the previous considerations. Indeed, the observed lower pronation and
load migration to the hallux might have not only compromise the GRFvt
component, but also the time extension of the GRFap component due to a
lower use of the hallux tip to push backwards against the floor.
three components between running with shoes or both minimalist footwear and
shoes. Willy & Davis (2014) identified that running in a minimalist shoe appears
to, at least in the short term, increase loading of the lower extremity over
standard shoe running. Minimalist running was affirmed to reduce the risk of
injuries since it is a more natural running with lower impact forces (Lieberman et
al.,2010; De Wit, De Clercq & Aerts, 2000), but Salzler et al. (2012) warned of
103
the risks of runners that adopt this practice, analyzing the injuries associated
with the minimalist running as osseous edema, metatarsal stress fractures and
plantar fasciitis. In this way, the question whether minimalist running is better
than shoe is still unanswered. We have showed that the running pattern is
different, but the athletes and the coaches should evaluate individually the best
CONCLUSION
showing different pattern of the curves depending on the footwear used, or not
could be performed for each athlete individually, and help the coach and the
104
REFERENCES
105
Knapp, R.R. & Comrey, A.L. (1973). Further construct validation of a measure
of self-actualization. Educational and Psychological Measurement.
33;419–425.
Landry, S.C. McKean, K.A. Hubley-Kozey, C.L. Stanish, W.D. & Deluzio, K.J.
(2007). Knee biomechanics of moderate OA patients measured during
gait at a self-selected and fast walking speed. Journal of Biomechanics.
40;1754–1761.
Lieberman, D.E. Venkadesan, M. Werbel, W.A. Daoud, A.I. D’Andrea, S. Davis,
S. Mang’Eni, R.O. Pitsiladis, Y. (2010). Foot strike patterns and collision
forces in habitually barefoot versus shod runners. Nature. 463(28)531-6.
Lieberman, D.E. Castillo, E.R. Otarola-Castillo, E. Sang, M.K. Sigei, T.K.
Ojiambo, R. et al. (2015). Variation in Foot Strike Patterns among
Habitually Barefoot and Shod Runners in Kenya. PLoS ONE .
10(7)e0131354. doi:10.1371/journal.pone.0131354
Molenaar, P.C. Wang, Z. & Newell, K.M. (2013). Compressing movement
information via principal components analysis (PCA): Contrasting
outcomes from the time and frequency domains. Human Movement
Science. 32;1495–1511.
Muniz, A.M.S. & Nadal, J. (2009). Application of principal component analysis in
vertical ground reaction force to discriminate normal and abnormal gait.
Gait & Posture. 29; 31–35.
Nielsen, R.O. Buist, I. Sorensen, H. Lind, M. Rasmussen, S. (2012).Training
errors and running related injuries: a systematic review. International
Journal of Sports Physical Therapy. 7: 58–75. PMC3290924
Olney, S.J. Griffin, M.P. & McBride, I.D. (1998). Multivariate examination of data
from gait analysis of persons with stroke. Physical Therapy. 78; 814–828.
Ryyan, M. Elashi, M. Newsham-West, R. & Tauton, J. (2014). Examining injury
risk and pain perception in runners using minimalist footwear. British
Journal of Sports Medicine. 48(16)1257-1262. doi: 10.1136/bjsports-
2012-092061.
Sadeghi, H. Allard, P. Barbier, F. Sadeghi, S. Hinse, S. Perrault, R. et al.
(2002a). Main functional roles of knee flexors/extensors in able-bodied
gait using principal component analysis (I). The Knee. 9;47–53.
Salzler, M.J. Bluman, E.M. Noonan, S. Chiodo, C.P. Asla, R.J. (2012). Injuries
Observed in Minimalist Runners. Foot & Ankle International. 33(4)262-6.
doi: 10.3113/FAI.2012.0262
Shih, Y. Lin, K. Shiang, T. (2013). Is the foot striking pattern more important
than barefoot or shod conditions in running? Gait & Posture. 38;490–494.
Soares, D.P. Castro, M.P.d Mendes, E. Machado, L. (2014). Influence of
wedges on lower limbs’ kinematics and net joint moments during healthy
elderly gait using principal component analysis. Human Movement
Science. 38:319–30.
106
Soares, D.P. Castro, M.P. Mendes, E.A. Machado, L. (2015) Principal
component analysis in ground reaction forces and center of pressure gait
waveforms of people with transfemoral amputation. Prosthet Orthot Int.
doi: 0309364615612634.
Squadrone, R. Gallozzi, C. (2009). Biomechanical and physiological
comparison of barefoot and two shod conditions in experienced barefoot
runners. Journal of Sports Medicine and Physical Fitness. 49(1)6–13.
Willy, R. Davis, I. (2014). Kinematic and Kinetic Comparison of Running in
Standard and Minimalist Shoes. Medicine And Science In Sports And
Exercise. 46;318-23. doi: 10.1249/MSS.0b013e3182a595d2
107
108
4.4 Minimalist shoes do not acutely reduce biomechanical
load during running in experienced marathon athletes
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110
ABSTRACT
Results: Significant differences were observed in: (i) contact time (greater in
shoes); (ii) foot contact area (larger in shoes); peak plantar pressures (higher in
shoes) and in the three components the Ground Reaction Force.
Conclusions: This study showed that acutely changing from the traditional
running shoe to minimalist footwear changes the kinetic pattern of running and
seems to overload the foot wearing minimalist footwear.
111
112
INTRODUCTION
113
As a consequence, running barefoot, or using minimalist shoes, started
to be part of the training habits of more and more runners.
The plantar pressure describes the forces' distribution in the sole of the
foot. High plantar pressure may be related to potential adverse effects on the
local tissues [19], allowing increase injuries’ incidence [20]. Understanding the
stride pattern (forefoot or rearfoot), allows knowing how the foot interacts with
the ground, but it is rather difficult to assess due to individual anatomical
variations and variability among performance tests. Plantar pressure evaluation
seems to be one of the best methods to provide this information more
accurately and in more detail [21].
So, the aim of this study is to biomechanically analyze the acute effect on
plantar pressure and ground reaction forces of wearing minimalist shoes by
usually shod high level marathon runners.
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METHODS
The experiment was divided into two stages. The first, the participant’s
health status, anthropometry, age and gender, as well as previous use of
minimalist footwear were assessed. In the second one, a running protocol was
performed at a biomechanics laboratory. The running protocol was adapted
from the literature [22], and consisted of a period of familiarization with the
treadmill running at 3.33 m.s-1 for 15 minutes while wearing the subject’s
habitual running shoes. After the familiarization period, subjects were asked to
run at their average marathon pace, calculated from their last marathon
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performance. Kinetic and baropodometric data were recorded for one minute at
their marathon velocity, after the adaptation period. After this stage, the
participants stopped running, changed the footwear condition and performed a
5-minute adaptation period for the minimalist shoes (Vibram FiveFinger© KSO;
Concord, MA, USA), on the treadmill, at marathon pace, before kinetics and
baropodometric data were recorded again for one minute in this new condition.
Ground reaction force (GRF) data were collected using a split-belt AMTI
Force-Sensing Tandem Treadmill (AMTI Inc., MA), composed by two
900x600mm force platforms (AMTI), sampling at 1200 Hz. The vertical (GRFvt),
antero-posterior (GRFap) and medio-lateral (GRFml) components of GRF were
recorded. In order to analyze the in-shoe pressure data, the foot was divided
into eight anatomic regions: rearfoot (medial, central, lateral) midfoot (medial,
lateral) forefoot (medial, central, lateral). The contact area was normalized to
the area of the entire insole used during data collection in order to statistically
compare subjects who were tested in different shoe sizes [23]. From each 60s
recorded, three consecutive steps from the right foot were taken, and the
following parameters were used to describe foot pressure characteristics: (1)
contact time (s); (2) total contact area (% total area); (3) maximum contact area
for each region (% total area); (4) contact area at GRFvt 1 st peak (% total area);
(5) contact area at GRFvt 2nd peak (% total area); (6) Peak pressure for each
region (kPa); (7) total peak pressure (kPa). The Pressure data was recorded
using the software Pedar Mobile Expert 8.2.
The GRF data was recorded using the treadmill software Netforce (AMTI
Inc., MA), and acquired with an amplifier G5 (AMTI Inc., MA). From the 60s
recorded, six consecutive steps from the right foot were taken to analysis. The
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parameters analyzed from the GRF are: (1) GRFvt initial peak (%BW); (2)
GRFvt intermediate minimum (%BW); (3) GRFvt 1st peak (%BW); (4) GRFvt
minimum between 1st and 2nd peak (%BW); (5) GRFvt 2nd vertical peak (%BW);
(6) GRFap deceleration peak (%BW); (7) GRFap acceleration peak (%BW); (8)
GRFml negative peak (%BW); (9) GRFml positive peak (%BW); (Figure 1); (10)
GRFvt impulse (N.s); (11) GRFap impulse (N.s); (12) GRFml impulse (N.s).
RESULTS
The mean (±SD) velocity of the subjects in the running protocol was
4.44(0.4) m.s-1 which represents a mean marathon duration of 143min,
corroborating with our inclusion criteria. The data showed good to excellent
between-trial reliability - for the GRF (ICC > 0.9), for the pressure parameters
(ICC > 0.8), and for the contact area distribution (ICC > 0.8).
The total foot contact area was higher during usual shoes running than
wearing the FiveFingers minimalist footwear (p<0.000). In relation to the regions
of the foot, the contact areas were always statistically higher wearing shoes,
considering both the maximum contact area during Stance Phase (p<0.000)
(Figure 1a) or the contact area at the 1 st GRF peak (Figure 1b) or the contact
area at the 2nd GRF peak (Figure 1c).
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Figure 1 Mean and SD from maximum contact area during Stance Phase (p<0.000)
(Figure 1a) or the contact area on the 1st GRF peak (Figure 1b) or the contact area on
the 2nd GRF peak (Figure 1c). Significant differences (P < 0.005) between groups are
indicated by *.
Figure 1a
Figure 1b
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Figure 1c
Figure 2 Mean and SD from total foot peak pressure. Significant differences (P <
0.005) between groups are indicated by *.
119
The comparison between the mean force curves in both conditions,
shows different patterns during the Stance Phase. The GRFvt initial peak is
anticipated in minimalist footwear, and the first minimum is higher in shoe
(Figure 3a). In relation to the GRFap, the acceleration peak is higher with
minimalist footwear (Figure 3b) a n d GRFml in negative and positive peak
(Figure 3c).
Figure 3 Mean and SD from Vertical Ground Reaction Force (a) and Antero-
posterior Force, (b) and (c) wearing shoes and minimalist footwear. Numbers indicate
the variables exemplified in the minimalist condition:: (1) vertical force on the 1st peak;
(2) intermediate minimum; (3) 1st vertical peak; (4) minimum between 1st and 2nd peak;
(5) 2nd vertical peak; (6) antero-posterior deceleration peak; (7) antero-posterior
acceleration peak; (8) medio-lateral negative peak; (9) medio-lateral positive peak.
Figure 3a
Figure 3b
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Figure 3c
Table 2 Mean (SD) for the GRF variables in shoes and minimalist footwear. P
value for the comparisons between conditions in all variables (p ≤0.05 significance
level).
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DISCUSSION
The aim of this study was to verify if acutely switching from normal
running to minimalist footwear imposes relevant changes on plantar pressure
distribution and GRF patterns on elite marathon runners. The absence of
studies evaluating minimalist shoes, mainly regarding baropodometric variables,
and the different masks created for the foot regions comparison in different
studies, makes difficult the comparison of our results with previous literature
[24,25]. Even running barefoot seems not to be the same as running with
minimalist footwear, although previous research on running have demonstrated
biomechanical similarities between these two conditions [1,11,12]. So,
comparing our findings with previous reports on barefoot running is also not
easy.
Six trials for each participant were taken into account to analyse the
pattern of running wearing the different shoes, value that is similar to previous
reports [26]. However, the subjects evaluated in the present study are elite
marathon runners, which present a more reliable pattern regarding previous
studies enrolling recreational runners, which is confirmed by the ICC values
obtained.
The foot total contact area was higher during in-shoes running than
wearing the minimalist footwear considering both the total contact area and the
contact area per foot region (Figure 1). This was expected since the shoe offers
a higher sole surface than the foot plantar area, which allows the foot to hit the
ground in a wider area. Also, traditional shoes runners have a rearfoot pattern,
because the running shoe has an additional support and cushioning and allows
a greater impact of the heel [1]. Cheung & Rainbow [27] stated that running
barefoot in individuals habitually shod alters the landing pattern from a heel
striking to a non-heel striking one, which helps to explain the smaller contact
area in minimalist footwear observed in the present study. The smaller area
even in the forefoot region wearing minimalist footwear could be explained by
the absence of data in the toes, where the highest support area must be
located, since the pattern is non-rearfoot [23, 16]. The contact area at the GRF
1st peak shows a distribution of the load along the plantar surface, while at the
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2nd peak the contact area seems more concentrated at the forefoot, as expected
since the toe-off phase is imminent, and the propulsion is generated with the
fingers.
123
fractures and plantar fasciitis.
The contact time was higher with usual shoes compared to the minimalist
condition. This can be related to the pattern of running; being non-rearfoot, the
foot stays less time in contact with the ground at the minimalist condition.
Contrary to our findings, different authors [1,12,23] sustain that no studies
identified differences between contact time in runners with different stride
patterns. Some authors stated that there was no evidence on footstrike different
types, raising the question that whether changes are a function of footstrike
modality or the changes of shoes [11,12,29]. However, differences in ground
contact time among footstrike characteristics may have performance
implications [26], what requires new dedicated studies.
This study has some limitations, the most relevant being the no
consideration of the toe region in what plantar pressures distribution study is
concerned. Wearing the Pedar system, it is not possible to measure pressure
with a device like minimalist footwear that has inter-toes physical divisions, so
we decide to evaluate only the metatarsal heads, the medial foot and the
calcaneous. However, we believe that the data we could provide helps to better
understand the pattern of running wearing different shoes. Even though, we
recognize the need for further research on the issue of adaptation of the plantar
loads as well as the rate of injuries arising as a consequence of the use of
different types of shoes, or without them, during running at marathon
competitive speeds.
CONCLUSIONS
Based upon the results of this study, the acute use of minimalist shoes
(Fivefingers) in elite marathon runners, compared to usual shod solutions, didn't
change forefoot strike pattern, despite a trend to run with a non-heel pattern
when wearing minimalist shoes cannot be excluded. Moreover, biomechanical
load is not reduced by the acute use of minimalist shoes; on the contrary: both
plantar pressure (total and regional), GRF and loading rate are increased in
most of the stance phase.
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There are still controversies and literature is scarce on these issues.
Further studies are requested to allow studying muscle adaptations of runners
changing from the traditional footwear to minimalists or barefoot. Arguments like
being “more natural” and “adaptations would be expected” will not replace
experimental controlled data, required to empower injuries prevention in long
distance elite and recreational runners.
ACKNOWLEDGMENTS
DISCLOSURES
125
REFERENCES
[1] Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D’Andrea S, Davis S,
et al. Foot strike patterns and collision forces in habitually barefoot
versus shod runners. NATURE. 2010;463:531-6.
DOI:10.1038/nature08723
[2] McDougall, C. Born To Run. Profile Books Ltd. London, United Kingdom.
2010; ISBN10: 1861978774
[3] Novacheck TF. The biomechanics of running. Gait & Posture. 1998;7:77-95.
DOI: 0966-6362/98/$19.00
[4] Nigg BM. The Role of Impact Forces and Foot Pronation: A New Paradigm.
Clinical Journal of Sport Medicine. 2001;11:2-9.
[5] Hatala KG, Dingwall HL, Wunderlich RE, Richmond BG. Variation in Foot
Strike Patterns during Running among Habitually Barefoot Populations.
PLoS ONE. 2013. DOI: 10.1371/journal.pone.0052548
[6] Milner CE, Ferber R, Pollard CD, Hamill J, Davis IS. Biomechanical Factors
Associated with Tibial Stress Fracture in Female Runners. Medicine And
Science In Sports And Exercise. 2006;38(2)323–328. DOI:
10.1249/01.mss.0000183477.75808.92
[7] Nigg BM, Wakeling JM. Impact forces and muscle tuning: a new paradigm.
Exercise and Sport Sciences Reviews. 2001;29(1)37-41.
[8] Altman AR, Davis IS. Barefoot Running: Biomechanics and Implications for
Running Injuries. American College of Sports Medicine. 2012;11:244-50.
DOI: 0091-6631/2901/37–41
[10] Ridge ST, Johnson AW, Mitchell UH, Hunter I, Robinson E, Rich BSE,
Brown SD. Foot Bone Marrow Edema after 10-Week Transition to
126
Minimalist Running Shoes. Medicine & Science in Sports & Exercise.
2013;45:1363-8. DOI: 10.1249/MSS.0b013e3182874769
[14] Wakeling JM, Nigg BM. Modification of soft tissue vibrations in the leg by
muscular activity. Journal of Applied Physiologyol. 2001;90: 412–420,
DOI: http://jap.physiology.org/content/90/2/412.full#ref-list-1
[15] Yan AF, Sinclair PJ, Hiller C, Wegene C, Smith RM. Impact attenuation
during weight bearing activities in barefoot vs. shod conditions: A
systematic review. Gait & Posture. 2013;38:175–86. DOI:
http://dx.doi.org/10.1016/j.gaitpost.2012.11.017
[16] Salzler MJ, Bluman EM, Noonan S,Chiodo CP, Asla RJ. Injuries Observed
in Minimalist Runners. Foot & Ankle International. 2012;33(4)262-6. DOI:
10.3113/FAI.2012.0262
[19] Shorten M, Mientjes M I V. The ‘heel impact’ force peak during running is
neither ‘heel’ nor ‘impact’ and does not quantify shoe cushioning effects.
127
Footwear Science. 20011:3(1)1-58.
DOI:10.1080/19424280.2010.542186
[20] Hong Y, Wang L, Li JX, Zhou JH. Comparison of plantar loads during
treadmill and overground running. Journal of Science and Medicine in
Sport. 2012;15:554–60. DOI:
http://dx.doi.org/10.1016/j.jsams.2012.01.004
[21] Tillman MD. Fiolkowski P. Bauer JA. Reisinger KD. In-shoe plantar
measurements during running on different surfaces: changes in temporal
and kinetic parameters. Sports Engineering. 2002:5(3)121–128. DOI:
10.1046/j.1460-2687.2002.00101.x
[22] Shih Y, Lin K, Shiang T. Is the foot striking pattern more important than
barefoot or shod conditions in running? Gait & Posture. 2013;38:490-
494. DOI: http://dx.doi.org/10.1016/j.gaitpost.2013.01.030
[23] Kernozek TW, Meardon S, Vannatta CN. In-Shoe Loading in Rearfoot and
Non-Rearfoot Strikers during Running Using Minimalist Footwear.
International Journal of Sports Medicine 2014;35:1-6. DOI:
http://dx.doi.org/ 10.1055/s-0034-1372627
[24] Putti, A.B. Arnold, G.P. Cochrane, L. Abboud. R.J. The Pedar in-shoe
system: Repeatability and normal pressure values. Gait & Posture.
2007;25:401–5. doi: 10.1016/j.gaitpost.2006.05.010
[25] Wiegerinck JI, Boyd J, Yoder JC, Abbey AN, Nunley JA, Queen RM.
Differences in plantar loading between training shoes and racing flats at
a self-selected running speed. Gait & Posture. 2009;29:514–9.
[27] Cheung RTH, Rainbow MJ. Landing pattern and vertical loading rates
during first attempt of barefoot running in habitual shod runners. Human
Movement Science. 2014;34,120–127.
DOI:10.1016/j.humov.2014.01.006
128
[28] Murphy DF, Beynnon BD, Michelson JD, Vacek PM. Efficacy of Plantar
Loading Parameters During Gait in Terms of Reliability, Variability, Effect
of Gender and Relationship Between Contact Area and Plantar Pressure.
Foot & Ankle International. 2005;26(2)171-179. DOI:
10.1177/107110070502600210
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CAPÍTULO 5
5.1 DISCUSSÃO
131
contacto inicial o pé ficou mais plano com o solo, apesar do padrão retropé
continuar a manter-se. Isto é, o angulo de ataque diminuiu.
132
Cooper, Leissring & Kernozek (2015).
133
Observamos também que os valores da distribuição da pressão plantar tiveram
diferenças significativas entre as condições calçada e minimalista (artigo 4). Na
condição minimalista o pico de pressão total foi maior, bem como a pressão na
região do antepé. Em relação à FRS vertical no 1º pico, esta foi mais baixa e
teve uma subida mais suave na condição calçada.
134
mais ainda na descalça. De fato obtivemos um aumento da atividade no recto
femoral na pré-ativação e uma diminuição no bíceps femoral com os pés
descalços, o que é coerente com uma mais pronunciada manutenção da
extensão do joelho. Além disso, o bíceps femoral não mostrou diferenças entre
a condição minimalista e calçado habitual, no entanto tivemos maior actividade
muscular na condição descalça. A diminuição da excursão do joelho na fase de
apoio representou um aumento da sua rigidez. Além disso, foi observado um
menor ângulo de flexão do quadril quando correndo com minimalista ou
descalço, o que reflecte um efeito pequeno de amortecimento à nível do
quadril.
135
primeiras adaptações humanas para correr sem os calçados habituais de
corrida não demonstraram mudanças para o padrão antepé, embora os
maratonistas de alto nível demonstraram uma tendência a correr com um pé
mais plano quando as suas condições de calçados foram alteradas. Na
condição minimalista mostrou resultados independentes, confirmando ser um
calçado intermediário entre calçado habitual e a condição descalça.
136
de pressões, não é reduzida pelo uso agudo de calçados minimalistas; pelo
contrário: tanto a pressão plantar (total e regional), como a FRS e a taxa de
carga são aumentados na maioria das fases de apoio.
5.3 PERSPECTIVAS
137
fisiologistas, médicos, etc) sejam favorecidos com novas descobertas e termos
não apenas atletas com melhores performance, mas com menores riscos de
lesões.
138
energético e a economia de corrida na corrida descalça ou quando se
utiliza calçado habitual e minimalista utilizando diferentes tipos de piso,
como areia, relva, alcatrão ou terra batida.
139
140
REFERÊNCIAS BIBLIOGRÁFICAS
Bonacci, J., Saunders, P. U., Hicks, A., Rantalainen, T., Vicenzino, B. G. T., &
Spratford, W. (2013). Running in a minimalist and lightweight shoe is not
141
the same as running barefoot: a biomechanical study. British Journal of
Sports Medicine. 47:387–392.
Boyer, K. A. Nigg, B.M. (2007). Quantification of the input signal for soft tissue
vibration during running. Journal of Biomechanics, 40:1877–1880
Bramble, D.M. Lieberman, D.E. (2004). Endurance running and the evolution of
Homo. Nature, 432(7015)345-52.
Cheung, R.T.H. & Davis, I.S. (2011). Landing Pattern Modification to Improve
Patellofemoral Pain in Runners: A Case Series. Journal of orthopaedic &
sports physical therapy, 41(12)914-919. DOI:10.2519/jospt.2011.3771
Clark, T. Frederick, E.C. Hammill, C.L. (1983). The effects of Shoes desing
parameters on rearfoot control in running. Medicine and Science in
Sports and Exercise. 15: 376-81.
142
Cook, S.D. Brinker, M.R. Poche, M. (1990). Running shoes their relationchip to
running injuries. Sport medicine. 10(1)1-8.
Cooper, D.M. Leissring, S.K. Kernozek. T.W. (2015.) Plantar loading and foot-
strike pattern changes with speed during barefoot running in those with a
natural rearfoot strike pattern while shod. The Foot. 1-8.
Davies, D.S. Burns, H. Jewell, T. McBride, M. (2011). Start Active, Stay Active:
A report on physical activity from the four home countries’ Chief Medical
Officers. Department of Health, Physical Activity, Health Improvement
and Protection-IM&T. London.
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/docume
nts/digitalasset/dh_128210.pdf (Accessed 22 Feb 2014).
Dinato, R.C. Ribeiro, A.P. Butugan, M,K. Pereira, I.L.R. Onodera, A.N. Sacco,
I.C.N. (2015). Biomechanical variables and perception of comfort in
running shoes with different cushioning technologies. Journal of Science
and Medicine in Sport. 18:93–7.
143
randomised controlled trial. Footwear Science.7(3)159-64. doi:
10.1080/19424280.2015.1049300
Goss, D.L. Lewek, M. Yu, B. Ware, W.B. Teyhen, D.S. & Gross, M.T. (2014).
Lower Extremity Biomechanics and Self-Reported Foot-Strike Patterns
Among Runners in Traditional and Minimalist Shoes. Journal of Athletic
Training. 49(6)000–000.
Groner, C. (2010). The truth about barefoot running: It’s complicated. LER-
Lower extremity review. http://lowerextremityreview.com/cover_story/the-
truth-about-barefoot-running-its-complicated (Accessed 19 bar 2014).
Hatala, K.G. Dingwall, H.L. Wunderlich, R.E. Richmond, B.G. (2013). Variation
in foot strike patterns during running among habitually barefoot
populations. PLos ONE. 8:1.
Heiderscheit, B.C. Chumanov, E.S. Michalski, M.P. Wille, C.M. & Ryan, M.B.
(2011). Effects of Step Rate Manipulation on Joint Mechanics during
144
Running. Medicine And Science In Sports And Exercise. 43(2) 296-302.
DOI:10.1249/MSS.0b013e3181ebedf4
Hsiao, H. Guan, J. And Weatherl, M. (2002). Accuracy and precision of two in-
shoe pressure measurement systems. Ergonomics. 45(8)537-555
Kerrigan, D.C. Franz, J.R. Keenan, G.S., Dicharry, J. Croce, U.D. & Wilder,
R.P. (2009). The Effect of Running Shoes on Lower Extremity Joint
Torques. the American Academy of Physical Medicine and
Rehabilitation. 1(12)1058-1063.
Krabak, B.J. Hoffman, M. D. & Millet, G.Y. (2011). Barefoot Running. Physical
Medicine and Rehabilitation. 3(12)1142-1149.
Lee, S.Y. & Hertel, J. (2012). Effect of static foot alignment on plantar-pressure
measures during running. The Journal of Sport Rehabilitation. 21(2):137-
43.
Lieberman, D.E. (2012) What we can learn about running from barefoot
running: an evolutionary medical perspective. Exercise and Sport
Sciences Reviews. 40(2):63-72.
145
Lussiana, T. Hébert-Losier, K. Mourot, L. (2015). Effect of minimal shoes and
slope on vertical and leg stiffness during running. Journal of Sport and
Health Science. 4:195-202.
Milner, C.E.F.R. Pollard, C.D. Hamill, J. & Davis, I.S. (2006.) Biomechanical
Factors Associated with Tibial Stress Fracture in Female Runners.
Medicine And Science In Sports And Exercise. 38(2):323-8.
Nachbauer, W. Nigg, B.M. (1992). Effects of arch height of the foot on ground
reaction forces in running. Medicine And Science In Sports And Exercise.
24:1264–1269.
Nigg, B.M. (2001).The Role of Impact Forces and Foot Pronation: A New
Paradigm. Clinical Journal of Sport Medicine.11:2-9.
146
Nigg, B.M. Hintzen, S. Ferber, R. (2006). Effect of an unstable shoe
construction on lower extremity gait characteristics. Clinical
Biomechanics. 21:82-8.
Nigg, B.M. & Wakeling, J.M. (2001). Impact forces and muscle tuning: a new
paradigm. Exercise and Sports Sciences Reviews. 29(1)37-41.
Ogon, M. Alekiev, A.R. Spratt, K.F. Pope, M.H. Saltzan, C.L. (2001). Footwear
affects the behavior of low back muscles when jogging. International
Journal of Sports Medicine. 22(6)414-23.
Olin, E.D. Gutierrez, G.M. (2013). EMG and tibial shock upon the first attempt at
barefoot running. Human Movement Science 2013. 32:343–52.
Perl, D.P. Daoud, A.I. & Lieberman, D.E. (2012). Effects of Footwear and Strike
Type on Running Economy. Medicine And Science In Sports And
Exercise. 44(7)1335–1343.
147
Pate, R.R. Pratt, M. Blair, S.N. Haskell, W.L. Macera, C.A. Bouchard, C.
Buchner, D. Ettinger, W. Heath, GW, King A.C. Et al. (1995). Physical
activity and public health: a recommendation from the Centers for
Disease Control and Prevention and the American College of Sports
Medicine. Journal of the American Medical Association. 273:402-9.
Razak, A.H.A. Zayegh, A. Begg, R.K. & Wahab, Y. (2012). Foot Plantar
Pressure Measurement System: A Review. Sensors. 12:9884-9912.
Ribeiro, A.P. (2013). Padrão de apoio e impacto dos pés com o solo durante a
corrida de corredores com historia e sintoma de fascite plantar e sua
relação com o arco longitudinal medial e angulo do
retropé.Tese(doutorado).Faculdade de Medicina da Universidade de São
Paulo. Programa de Fisiopatologia Experimental. USP.
148
Sacco, I.C.N. Melo, M.C.S. Rojas, G.B. Naki, I.K. Burgi, K. Silveira, L. (2003).
Análise biomecânica e cinesiológica de posturas mediante fotografi a
digital: estudo de casos. Revista Brasileira de Ciência e Movimento.
11:25-33.
Sacco, I.C.N. Tessutti, V.D. Aliberti, S. Hamamoto, A.N. Gomes, D.R. Costa, M.
de S.X. 2007. Força de reação do solo durante a marcha com uso do
tênis e sandália plataforma. Revista Fisioterapia em Movimento. Curitiba.
20(3)55-62.
Salzler, M.J. Bluman, E.M. Noonan, S. Chiodo, C.P. Asla, RJ. (2012) Injuries
Observed in Minimalist Runners. Foot & Ankle International. 33(4)262-
266. DOI: 10.3113/FAI.2012.0262
Sinclair, J. Atkins, S. Taylor, P.J. (2015). The Effects of Barefoot and Shod
Running on Limb and Joint Stiffness Characteristics in Recreational
Runners. Journal of Motor Behavior. 1-7.
Shih, Y. Lin, K. Shiang, T. (2013). Is the foot striking pattern more important
than barefoot or shod conditions in running? Gait & Posture. 38:490–494.
Snow, N.J. Basset, F.A. Byrne, J. (2016).An Acute Bout of Barefoot Running
Alters Lower-limb Muscle Activation for Minimalist Shoe Users. Int
International Journal of Sports Medicine. DOi: 10.1055/s-0035-1565140
149
Sporting Goods Manufacturers Association (2011). Sports, Fitness and
Recreational Activities Topline Participation Report-The Sports and
Fitness Products Industry Rebounds.Available from:
https://www.sfia.org/reports/sample.php?id=277. (Accessed 22 Feb
2014).
Squadrone, R., Rodano, R., Hamill, J., & Preatoni, E. (2014). Acute effect of
different minimalist shoes on foot strike pattern and kinematics in rearfoot
strikers during running. Journal of Sports Sciences. 1-9.
Taunton, J.E. Ryan, M.B. Clement, D.B. McKenzie, D.C. Lloyd-Smith, D.R.
Zumbo, B.D. (2003). A prospective study of running injuries: the
Vancouver Sun Run “In Training” clinics. British Journal of Sports
Medicine. 37:239–44.
Van Gent, R.N. Siem, D. van Middelkoop, M. van Os, A.G. Bierma-Zeinstra,
S.M.A. Koes, B.W. et al. (2007). Incidence and determinants of lower
extremity running injuries in long distance runners: a systematic review.
British Journal of Sports Medicine. 41(8)469–80.
150
Williams, D.S. Davis, I.S. Manal, K.T. (2000). Lower extremity mechanics in
runners with a converted forefoot strike pattern. Journal of Applied
Biomechanics. 16:210-8.
Williams III, D. S. B., Green, D. H., & Wurzinger, B. (2012). Changes in lower
extremity movement and power absorption during forefoot striking and
barefoot running. The International Journal of Sports Physical Therapy.
7(5). 525-532. DOI:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474309/
Willson, Bjorhus, Williams III, Butler, Porcari & Kernozek. (2014). Short-Term
Changes in Running Mechanics and Foot Strike Pattern After
Introduction to Minimalistic Footwear. the American Academy of Physical
Medicine and Rehabilitation. 6:34-43.
Yong, J.R. Silder, A. Delp, S.L. (2014). Differences in muscle activity between
natural forefoot and rearfoot strikers during running. Journal of
Biomechanics. 47:3593–7.
Zammit, G.V. Menzi, H.B. and Munteanu, S.E. (2010). Reliability of the
TekScan MatScan system for the measurement of plantar forces and
pressures during barefoot level walking in healthy adults. Journal of Foot
and Ankle Research. 3:11.
151
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ANEXO A – Termo de Consentimento Livre e Esclarecido
Projeto
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num ritmo confortável por 15 minutos para aquecimento, antes da
recolho propriamente dita.
6. Cada sujeito correrá no tapete rolante por aproximadamente 30 minutos,
sob as condições calçado habitual, FiveFingers e descalço onde serão
submetidos à avaliação dinâmica da corrida, através de força de reações
do solo, eletromiografia, análise de imagens e análise de pressões
plantares, ou seja análise biomecânica da corrida.
7. Terminada a recolha de dados, será entregue a cada sujeito um
certificado de participação, com os agradecimentos da equipa de
projeto. No prazo de duas semanas após o teste será disponibilizado um
relatório detalhado.
Eu,
_______________________________________________________________,
nascido a ___/___/___, aceito participar como voluntário do projeto de
pesquisa.
______________________________________________________________
O Participante Convidado
______________________________________________________________
O Investigador Responsável
xxv
ANEXO B – Parecer da Comissão de Ética
xxvi
xxvii
ANEXO C - Questionário de Seleção da Amostra - Recolha
1 Dados de Identfcação do Atleta Data:
Nome:
Email:
Telemóvel:
Data Nascimento: Idade:
Altura: Peso:
2 Perguntas
Corre a quanto tempo:
Média de Km semanal:
Pratca outra modalidade esportva ?
Qual ? Quantas vezes por semana:
Rotna de treino semanal de corrida (dias de treino, descanso):
Já teve alguma lesão músculo esquelétca ?
Há quanto tempo?
Quantas maratonas fez?
Data da últma maratona: Tempo da últma maratona:
Está treinamento para maratona? Quando será ?
Marca usual de calçado esportvo: Nº:
Já correu descalço ? Gostou ?
Já uso FiveFingers ? Gostou ?
Costuma treinar onde:
Asfalto ( ) Grama ( ) Cimento ( ) Calçamento ( ) Areia ( )
3 Números Calçados e Palmilhas PEDAR
Sapatlha: Palmilha Pedar®:
FiveFingers: Palmilha Pedar®:
4 Cálculo de velocidade média de maratona Tempo de Maratona:
Exemplo de Tempo de Maratona: 3h15min
3 x 60 + 15 = 195 min ___ __x +___ = _ min_
60 x 195 = 11700 seg x _ _____ = __ seg__
42195 / 11700 = 3,60 m/seg / __ __ = ______
3600 x 3,60 = 12,96/km x __ __ = ____
Logo velocidade recolha 13km/h Velocidade recolha=_ km/h_
xxviii