Do Fitflops increase lower limb muscle activity?

NewsBot · Oct 2, 2012

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Do Fitflops™ increase lower limb muscle activity?
K.E. Burgess, P.A. Swinton
Clinical Biomechanics; 24 September 2012

Background
Fitness toning shoes are becoming increasingly popular, they aim to increase muscle activity, raise energy expenditure and improve overall health while wearing them. Yet there is a lack of consensus in the literature regarding their effectiveness. One such shoe on the market is the Fitflop™ designed to activate leg muscles through density shifts in the shoe's sole. The purpose of this study was to investigate the effect of wearing FitflopsTM on the muscle activity of the lower limb.

Methods
Twenty three females (age 20.8 (1.3)years, mass 62.9 (11.9)kg, height 165.4 (5.6)cm) participated in the study. Muscle activity of the medial gastrocnemius, biceps femoris, rectus femoris and gluteus maximus of the participants' right limb were recorded using surface electromyography during participation in three different tasks to simulate daily living activities. These were a) treadmill walking b) stair climbing and c) zigzag walking around cones. The participants completed the tasks barefoot, while wearing Fitflops™ and while wearing regular flip flops so that comparisons between muscle activity in the different shoe conditions could be made.

Findings
The results show that there was no significant difference in the activity of the medial gastrocnemius, biceps femoris, rectus femoris and gluteus maximus muscles across all shoe conditions and simulated daily activities (P > 0.05).

Interpretation
Based on these results, the use of Fitflops™ is not recommended as a means of increasing muscle activity of the medial gastrocnemius, biceps femoris, rectus femoris and gluteus maximus during activities of daily living in a healthy recreationally active female population.
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Admin2 · Oct 2, 2012

Re: Do Fitflops™ increase lower limb muscle activity?

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NewsBot · Nov 7, 2013

Re: Do Fitflops™ increase lower limb muscle activity?

A comparison of gait biomechanics of flip-flops, sandals, barefoot and shoes
Xiuli Zhang, Max R Paquette and Songning Zhang
Journal of Foot and Ankle Research 2013, 6:45 doi:10.1186/1757-1146-6-45

Background
Flip-flops and sandals are popular choices of footwear due to their convenience. However, the effects of these types of footwear on lower extremity biomechanics are still poorly understood. Therefore, the objective of this study was to investigate differences in ground reaction force (GRF), center of pressure (COP) and lower extremity joint kinematic and kinetic variables during level-walking in flip-flops, sandals and barefoot compared to running shoes.

Methods
Ten healthy males performed five walking trials in the four footwear conditions at 1.3 m/s. Three-dimensional GRF and kinematic data were simultaneously collected.

Results
A smaller loading rate of the 1st peak vertical GRF and peak propulsive GRF and greater peak dorsiflexion moment in early stance were found in shoes compared to barefoot, flip-flops and sandals. Barefoot walking yielded greater mediolateral COP displacement, flatter foot contact angle, increased ankle plantarflexion contact angle, and smaller knee flexion contact angle and range of motion compared to all other footwear.

Conclusions
The results from this study indicate that barefoot, flip-flops and sandals produced different peak GRF variables and ankle moment compared to shoes while all footwear yield different COP and ankle and knee kinematics compared to barefoot. The findings may be helpful to researchers and clinicians in understanding lower extremity mechanics of open-toe footwear.
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NewsBot · Dec 21, 2013

Re: Do Fitflops™ increase lower limb muscle activity?

Toning Shoe Maker Wins Nod For $5.3M False Ad Settlement

A California federal judge signed off Thursday on footwear manufacturer FitFlop USA LLP's $5.3 million settlement with a class of shoe purchasers accusing the company of advertising that its toning shoes strengthened leg muscles and had other health benefits they couldn't provide.

Judge Thomas J. Whelan preliminarily approved the deal calling for FitFlop to reimburse any purchaser of FitFlop shoes from 2007 until the date of the class notice for at least two pairs of shoes per customer.
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NewsBot · Dec 12, 2014

Re: Do Fitflops™ increase lower limb muscle activity?

The manipulation of midsole properties to alter impact characteristics in walking
Carina Price, Glen Cooper & Richard Jones
Footwear Science Volume 7, Issue 1, 2015

The midsole of footwear can provide an opportunity to attenuate the impact at the foot-ground interface. The present study was undertaken to quantify impact in walking in different footwear midsoles, comparing footwear thickness and hardness variations.

Methods: Footbed thickness (28–41 mm) and hardness (30–55 Shore A) were varied independently in seven flip-flops. Thirteen subjects walked in the footwear variations on a level walkway in the gait laboratory as lower limb kinematics, vertical ground reaction force and peak positive axial tibial acceleration were quantified. Peak magnitude and time of the acceleration were quantified and the heel-strike transient was characterised for comparison between conditions with a repeated-measures analysis of variance (ANOVA). Thickness and hardness variations were also compared using a drop-test protocol to replicate walking.

Results: Lower limb joint angles did not vary at heel-strike, however, a faster vertical heel-velocity was recorded in the softer midsoles (e.g. 55 Shore A = -0.294±0.055, 30 Shore A = -0.328±0.052, p<0.001). Varying the hardness of the midsoles also significantly altered tibial acceleration and force variables, however limited significant differences existed between the thickness variations in walking. Increasing the hardness of the heel section of the footwear increased the peak positive axial tibial acceleration values, for example increasing Shore A from 30 to 40 resulted in a 35% increase in this variable. Concurrently, the occurrence of heel-strike transients increased from 5.8% in the 30 Shore A condition to 22.5%, 46.7% and 71.7% of all trials in the 40, 47 and 55 Shore A conditions respectively. The drop-test protocol replicated the differences evident in the walking protocol despite magnitudes being elevated.

Conclusion: Modifying midsole properties of flip-flop footwear, particularly hardness, alters the gait kinematics and the shock experienced by the wearer in walking. This may pose benefits in terms of comfort and reduction in loading to the lower limb, however the influence on foot motion at initial contact and footwear longevity should be further quantified.
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NewsBot · Mar 11, 2015

Re: Do Fitflops™ increase lower limb muscle activity?

The biomechanical characteristics of wearing FitFlop™ sandals highlight significant alterations in gait pattern: A comparative study
Darren C. James, Laura J. Farmer, Jason B. Sayers, David P. Cook, Katya N. Mileva
Clinical Biomechanics'; Available online 4 March 2015

Highlights
Gait was investigated in people wearing FitFlop™ footwear.
An early change in centre of pressure location is the primary response.
The sagittal plane ankle moment and range of motion are reduced throughout stance.
These findings may have clinical relevance.
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Background
The net contribution of all muscles that act about a joint can be represented as an internal joint moment profile. This approach may be advantageous when studying footwear-induced perturbations during walking since the contribution of the smaller deeper muscles that cross the ankle joint cannot be evaluated with surface electromyography. Therefore, the present study aimed to advance the understanding of FitFlop™ footwear interaction by investigating lower extremity joint moment, and kinematic and centre of pressure profiles during gait.

Methods
28 healthy participants performed 5 walking trials in 3 conditions: a FitFlop™ sandal, a conventional sandal and an athletic trainer. Three-dimensional ankle joint, and sagittal plane knee and hip joint moments, as well as corresponding kinematics and centre of pressure trajectories were evaluated.

Findings
FitFlop™ differed significantly to both the conventional sandal and athletic trainer in: average anterior position of centre of pressure trajectory (P< 0.0001) and peak hip extensor moment (P= 0.001) during early stance; average medial position of centre of pressure trajectory during late stance; peak ankle dorsiflexion and corresponding range of motion; peak plantarflexor moment and total negative work performed at the ankle (all P< 0.0001).

Interpretation
The present findings demonstrate that FitFlop™ footwear significantly alters the gait pattern of wearers. An anterior displacement of the centre of pressure trajectory during early stance is the primary response to the destabilising effect of the mid-sole technology, and this leads to reductions in sagittal plane ankle joint range of motion and corresponding kinetics. Future investigations should consider the clinical implications of these findings.
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NewsBot · Feb 24, 2016

Effect of flip-flops on lower limb kinematics during walking: a cross-sectional study using three-dimensional gait analysis.
Sharpe T et al
Ir J Med Sci. 2016 Feb 22

BACKGROUND:
Flip-flops are a popular footwear choice in warm weather however their minimalist design offers little support to the foot.
AIM:
To investigate the effect of flip-flops on lower limb gait kinematics in healthy adults, to measure adherence between the flip-flop and foot, and to assess the effect on toe clearance in swing.
METHODS:
Fifteen healthy adults (8 male, mean age 27 years) completed a three-dimensional gait analysis assessment using Codamotion. Kinematic and lower limb temporal-spatial data were captured using the Modified Helen Hayes marker set with additional markers on the hallux and flip-flop sole.
RESULTS:
Compared to barefoot walking, there were no differences in temporal-spatial parameters walking with flip-flops. There was an increase in peak knee flexion in swing (mean difference 4.6?, 95 % confidence interval (CI) [-5.8?, -3.4?], p < 0.001) and peak ankle dorsiflexion at terminal swing (mean difference 2?, 95 % CI [-3?, -1?], p = 0.001). Other kinematic parameters were unchanged. Peak separation between foot and flip-flop was 8.8 cm (SD 1.48), occurring at pre-swing. Minimum toe clearance of the hallux in barefoot walking measured 4.2 cm (SD 0.8). Minimum clearance of the flip-flop was 1.6 cm (SD 0.56).
CONCLUSIONS:
Healthy adults adapted well to flip-flops. However, separation of the flip-flop from the foot led to increased knee flexion and ankle dorsiflexion in swing, probably to ensure that the flip-flop did not contact the ground and to maximise adherence to the foot. Minimum clearance of the flip-flop was low compared to barefoot clearance. This may increase the risk of tripping over uneven ground.
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NewsBot · Jan 15, 2020

Flip-flops do not alter the neuromechanical function of the gastrocnemius muscle and tendon during walking in children
Jayishni N.Maharaj et al
Gait & Posture 7 January 2020

Highlights
•Flip-flops do not increase the work performed by the ankle and MG muscle.
•Instead, flip-flops reduce the energy absorption requirements at the ankle.
•Flip-flops act as a compliant surface.
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Introduction/Aim: Flip-flops are a popular choice of footwear for children. However, their inherent design provides minimal support to the foot and ankle and has been suggested to increase the work performed by muscles and tendon structures, potentially predisposing them to injury. Therefore, the aim of this study was to compare the length change behaviour of the medial gastrocnemius (MG) muscle fascicles and muscle tendon unit (MTU) and their mechanical function at the ankle and subtalar joints in children during walking with and without flip-flop. Methods: Eight healthy children walked barefoot and with flip-flops whilst 3D gait analysis and simultaneous B-mode ultrasound images of the MG fascicles during level walking were collected. Joint kinematics, kinetics and muscle-tendon unit (MTU) lengths were analysed using musculoskeletal modelling and fascicle lengths using a semi-automated tracking algorithm. Results: The muscles and tendons across the ankle absorbed and generated greater amounts of power during barefoot walking compared to flip-flop walking. The muscle activations of the lateral gastrocnemius, soleus and tibialis anterior remained invariant across the conditions as did the activation, and fascicle length change behaviour of the medial gastrocnemius. In the barefoot condition, the MTU lengthened more to potentially absorb greater amounts of power, although no differences in shortening was observed during late stance. Conclusion: Walking with flip-flops does not increase the mechanical work performed by the MG muscle at the ankle and subtalar joints, suggesting that flip-flops do not increase the stresses and strains of the Achilles tendon and hence its predisposition to strain induced injury. Instead, our results suggest that flip-flops, act as a compliant surface and absorb energy during contact and hence the strain experienced by the Achilles tendon.
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