BackgroundLower-limb running injuries are common. Running shoes have been proposed as one means of reducing injury risk. However, there is uncertainty as to how e ective running shoes are for the prevention of injury. It is also unclear how the e ects of di erent characteristics of running shoes prevent injury.
ObjectivesTo assess the e ects (benefits and harms) of running shoes for preventing lower-limb running injuries in adult runners.
Search methodsWe searched the following databases: CENTRAL, MEDLINE, Embase, AMED, CINAHL Plus and SPORTDiscus plus trial registers WHO ICTRP and ClinicalTrials.gov. We also searched additional sources for published and unpublished trials. The date of the search was June 2021.
Selection criteriaWe included randomised controlled trials (RCTs) and quasi-RCTs involving runners or military personnel in basic training that either compared a) a running shoe with a non-running shoe; b) di erent types of running shoes (minimalist, neutral/cushioned, motion control, stability, so midsole, hard midsole); or c) footwear recommended and selected on foot posture versus footwear not recommended and not selected on foot posture for preventing lower-limb running injuries. Our primary outcomes were number of people sustaining a lowerlimb running injury and number of lower-limb running injuries. Our secondary outcomes were number of runners who failed to return to running or their previous level of running, runner satisfaction with footwear, adverse events other than musculoskeletal injuries, and number of runners requiring hospital admission or surgery, or both, for musculoskeletal injury or adverse event.
Data collection and analysisTwo review authors independently assessed study eligibility and performed data extraction and risk of bias assessment. The certainty of the included evidence was assessed using GRADE methodology.
Main resultsWe included 12 trials in the analysis which included a total of 11,240 participants, in trials that lasted from 6 to 26 weeks and were carried out in North America, Europe, Australia and South Africa. Most of the evidence was low or very low certainty as it was not possible to blind runners to their allocated running shoe, there was variation in the definition of an injury and characteristics of footwear, and there were too few studies for most comparisons.
Do different types of running shoes change the risk of developing a lower-limb injury?
Key messagesNeutral / cushioned shoes may make little or no difference to the number of runners sustaining injuries or footwear satisfaction compared with minimalist shoes .It is uncertain if motion control shoes reduce the number of runners sustaining injuries compared with neutral/ cushioned shoes.Soft midsole shoes may make little or no difference to the number of runners sustaining injuries compared with hard midsole shoes.It is uncertain if stability shoes reduce the number of runners sustaining injuries compared with neutral/ cushioned shoes.It is uncertain whether or not motion control shoes reduce the number of runners sustaining a lower limb running injuries when compared with stability shoes.Prescribing running shoes and selecting on foot posture probably makes little or no difference to running injuries Future researchers should develop a consensus definition of running shoe design to help standardise classification. The definition of a running injury should be used consistently and confirmed via health practitioners. Researchers should consider a RCT design to increase the evidence in this area and explore the influence of different types or running shoes upon injury rates in specific subgroups.
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