Effects of minimalist footwear on postural stability, plantar footprint, and safety in healthy adults: a single-blind randomized clinical trial

Abstract

This study evaluated the long-term changes induced by wearing minimalist footwear (MF) during activities of daily living (ADLs) on the plantar footprint and postural stability in healthy adults. In this randomized clinical trial, a total of 95 healthy adults were recruited; 90 participants completed the protocol and were analyzed in either an experimental group (EG, n = 45), which wore MF for at least 5 h per day over a 6-month period, or a passive control group (CG, n = 45). Plantar pressure distribution (forefoot, rearfoot, and total contact areas), static stability (center of pressure (CoP) displacement under open-eyes and closed-eyes conditions), and dynamic stability (forward reach test) were assessed using a force platform at baseline and post-intervention. A self-reported questionnaire and an adverse event record were also completed by the EG. Statistical analysis was carried out using a repeated-measures analysis of variance (ANOVA) and a paired Student’s t-test; statistical significance level was set at p < 0.05. The Group × Time interaction analysis revealed no statistically significant between-group differences across the evaluated parameters. However, within-group analysis showed a significant increase in CoP displacement under the open-eye condition in the CG (𝑝=0.037), indicating a decline in baseline postural efficiency, whereas the EG maintained structural and posturographic stability. Regarding user feedback, comfort (44.4%) was highlighted as the primary advantage, aesthetics (77.8%) was the main drawback, and 70% of the participants intended to continue using MF. Only two minor, transient adverse events were recorded. In conclusion, a 6-month program of MF use during ADLs did not produce any statistically significant changes in plantar footprint or stability in healthy adults.