title: The effect of the kindergarten barefoot policy on preschool children's toes.
abstract: BACKGROUND
  This study compared the effects of barefoot policy, a policy instructing preschool children to go without shoes, on untouched-toes, which do not touch the ground while standing normally, of preschool children attending kindergartens that follow this rule, to preschooler in kindergartens where they must wear shoes, i.e., no-barefoot policy.
  
  
  METHODS
  The study used longitudinal data from measurements taken 2 years apart of the amount of times. The subjects were 59 children (34 boys and 25 girls) who went to a kindergarten that followed barefoot policy and 179 children (103 boys and 76 girls) who went to a kindergarten that did not follow barefoot policy. Images were taken of the contact surface area of the soles of the children's feet by having them stand on the measurement device with their bare feet.
  
  
  RESULTS
  The number of untouched-toes in children participating in the study was determined from the pictures. In boys who attended kindergartens following barefoot policy, the ratio of the children without untouched-toes significantly increased for 2 years of childhood (35.3-64.7 %). The number of untouched-toes were significantly fewer in boys from kindergartens following barefoot policy than in boys from kindergartens not following the policy, and the magnitude of the difference grew for the two study years (ES: 0.41-0.63). In girls, there were no significant differences between the two groups in the ratio of girls without untouched-toes and the number of untouched-toes.
  
  
  CONCLUSIONS
  In conclusion, the ground contact of the toes becomes better for boys in kindergarten with a barefoot policy. The results were inconclusive with regard to girls, and other factors may need to be examined. In the future, it will be necessary to increase the number of the subjects and perform detailed examinations.
authors.affiliation: Shiga University, 2-5-1, Hiratsu, Otsu, Shiga, 520-0862, Japan. matsuda@edu.shiga-u.ac.jp.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Matsuda
authors.affiliation: Gifu University, 1-1, Yanagido, Gifu, Gifu, 501-1193, Japan.
authors.forename: Kosho
authors.initials: K
authors.lastname: Kasuga
authors.affiliation: Chubu University, 1200, Matsumoto-cho, Kasugai, Aichi, 487-8501, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Hanai
authors.affiliation: Jin-ai University, 3-1-1, Ohde-cho, Echizen-city, Fukui, 915-8586, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Demura
authors.affiliation: Kyoto Bunkyo Junior College, 80, Senzoku, Makishima-Cho, Uji-City, Kyoto, 611-0041, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Komura
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D016134:Organizational Policy; D012574:Schools; D012775:Shoes; D014034:Toes / Q000033:anatomy & histology*
keywords: Barefoot; Foot shape; Infant; Toe; Untouched-toe