title: Computerized analysis of plantar pressure variation in flip-flops, athletic shoes, and bare feet.
abstract: BACKGROUND
  High peak plantar pressures predispose to foot problems and may exacerbate existing conditions. For podiatric physicians to make educated recommendations to their patients, it is important and necessary to begin to look at different shoes and how they affect peak plantar pressure.
  
  
  METHODS
  To determine how flip-flops change peak plantar pressure while walking, we compared peak plantar pressures in the same test subjects wearing flip-flops, wearing athletic shoes, and in bare feet. Ten women with size 7 feet and a body mass index less than 25 kg/m2 were tested with an in-shoe pressure-measurement system. These data were collected and analyzed by one-way analysis of variance and computer software.
  
  
  RESULTS
  Statistically significant results were obtained for nine of the 18 comparisons. In each of these comparisons, flip-flops always demonstrated higher peak plantar pressures than athletic shoes but lower pressures than bare feet.
  
  
  CONCLUSIONS
  Although these data demonstrate that flip-flops have a minor protective role as a shock absorber during the gait cycle compared with pressures measured while barefoot, compared with athletic shoes, they increase peak plantar pressures, placing the foot at greater risk for pathologic abnormalities.
authors.affiliation: Arizona Podiatric Medicine Program, College of Health Sciences, Midwestern University, Glendale, AZ 85308, USA.
authors.forename: Tanya J
authors.initials: TJ
authors.lastname: Carl
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Barrett
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005545:Forefoot, Human / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D010865:Pilot Projects; D011312:Pressure; D012775:Shoes; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology; D055815:Young Adult