Key Takeaway
Both foot core exercises and minimalist footwear increase foot strength and induce biomechanical changes during walking and running, though evidence certainty remains low based on 28 randomized controlled trials.
Summary
This systematic review and meta-analysis of 28 randomized controlled trials (1,399 total participants) evaluated the effects of both foot core exercises and minimalist footwear on foot muscle sizes, foot strength, and biomechanics during dynamic tasks. The researchers performed 17 meta-analyses from studies identified across PubMed, Embase, Cochrane Library, and SPORTDiscus through March 2024.
For minimalist shoes, the meta-analysis found greater strength of toes 2 to 5 (SMD 0.02 to 0.76). Foot exercises produced lower medial longitudinal arch motion during running (CI 0.08 to 0.82). Both interventions occasionally modified walking and running biomechanical variables, suggesting meaningful functional changes from either approach.
However, evidence regarding muscle size changes was conflicting across studies, and overall evidence certainty was rated low to very low due to limited available studies and high risk of bias. The authors concluded that both foot exercises and minimalist shoes may be appropriate strategies for increasing foot strength and inducing beneficial biomechanical changes, but called for higher-quality research to strengthen confidence in these findings.
Methods
- Systematic review and meta-analysis of 28 randomized controlled trials
- 1,399 total participants across included studies
- 17 meta-analyses performed
- Databases searched: PubMed, Embase, Cochrane Library, SPORTDiscus through March 2024
- Included RCTs with interventions lasting 4 weeks or longer
- Calculated standardized mean differences with 95% confidence intervals
- Assessed both foot core exercises and minimalist footwear interventions
Key Results
- Minimalist shoes increased strength of toes 2-5 (SMD CI 0.02 to 0.76)
- Foot exercises reduced medial longitudinal arch motion during running (CI 0.08 to 0.82)
- Both interventions modified walking and running biomechanics
- Conflicting evidence regarding muscle size changes
- Overall evidence certainty rated low to very low
Limitations
- Low to very low evidence certainty across outcomes
- High risk of bias in many included studies
- Limited number of studies per meta-analysis
- Heterogeneous intervention protocols (exercise types, shoe types, durations)
- Conflicting findings for muscle size outcomes
- Most studies in healthy populations only