In-shoe pressure distribution in “unstable” (MBT) shoes and flat-bottomed training shoes: A comparative study

Background Footwear comfort in many clinical situations is dependent on the ability of the ‘shoe’ to redistribute plantar pressure. Offloading the metatarsal heads may be achieved by fitting an insole, but recently a new design of shoe with a curved under sole (Masai Barefoot Technology® or “MBT shoe”) has been advocated. The aim of this study was to directly assess the effect of such shoes on gait pattern. Methods Normal subjects were recruited and asked to walk sequentially in (a) flat-soled training shoes and (b) midfoot bearing shoes (MBT shoe). Mean and peak pressures in four anatomically defined areas of the foot, and the total area of sole contact were measured electronically by an in-shoe system (Pedar Ltd., UK). Principal results Standing in the Masai shoes resulted in a 21% lesser peak pressure under the midfoot and an 11% lesser peak pressure under the heel in comparison to the figures found when patients wore their training shoes. There was a 76% compensatory increase in pressure under the toes. In essence there was a significant shift in pressure towards the front of the foot.