What does the current literature tell us about footwear comfort?
Systematic reviews are a vital source of information that appraises the literature and brings together the most recent evidence related to a particular subject. The Journal of Foot and Ankle Research (JFAR) has recently published three high quality review articles, which we are sharing as part of a three-part series each month.
Below is the final review summary in this three-part series. We recommend reading the entire article (which can be accessed for free here) to get a deeper understanding of the literature.
Footwear plays an essential role in protecting the foot from trauma and facilitating efficient and pain-free movement. An important consideration when selecting footwear is the degree of comfort. This includes factors like ease, support and contentment. Comfort is defined as the absence of pain and unpleasant sensation and the presence of highly subjective positive feelings.
The objective of this review by Professor Hylton Menz and Dr Daniel Bonanno was to synthesise the literature related to footwear comfort; including definitions, measurement scales, footwear design features, and physiological and psychological factors.
A systematic search of the literature from relevant databases and the journal Footwear Sciencewas conducted, identifying 101 relevant studies. Most studies were laboratory-based, repeated measures designs where comfort was measured under different footwear and/or insole conditions. The overall design of studies was fragmented, making it difficult to draw clinically relevant conclusions from the literature.
Among the included studies none specifically defined comfort, and a wide range of assessment scales were used. However, the findings do indicate that simple visual analog scales may provide a reliable (albeit unidimensional) assessment of comfort.
Despite the wide range of occupational and sporting groups assessed, there are some generic design principles that constitute comfortable shoes. These include appropriate fitting, the use of softer and more compliant materials, lower heel height among individuals that do not habitually wear high heeled shoes, lightweight shoes rather than heavier shoes, and a curved rocker-sole is considered more comfortable than a flat sole for a range of population groups.
Less consistent findings were observed for the influence of sole-flexibility, in-shoe temperature and insoles on comfort, most likely because these observations are specific to the population, setting and task.