Modular Footwear Setup Validated for Biomechanical Testing in 10 Healthy Adults

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medRxiv Published April 3, 2026 Medically reviewed April 27, 2026 Study authors: Sarlak, H.; Shakir, K.; Rogati, G.; Sartorato, G.; Leardini, A.; Berti, L.; Caravaggi, P. DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider the Modular Footwear Setup as a validated research tool, not yet a clinical intervention.

This methodological validation study evaluated a Modular Footwear Setup (MFS) designed to test isolated biomechanical effects of footwear features. The study involved 10 healthy participants (5 male, 5 female) who wore both the MFS and a standard control shoe with the same upper and midsole. The primary outcome was the accuracy and repeatability of the MFS in replicating biomechanical outcomes of the control shoe.

For joint kinematics, Statistical Parametric Mapping analysis identified no significant differences between the MFS and control shoe. In-shoe plantar pressure measurements showed the MFS exhibited slightly lower peak pressure at the rearfoot, while pressure parameters in other foot regions were not statistically different. The inter-session repeatability of peak and mean pressure for the MFS was good-to-excellent, with intraclass correlation coefficients ranging from 0.84 to 0.97. Participant-reported comfort and stability were similar between the two footwear conditions.

Safety and tolerability data were not reported. The study's key limitations include the small sample size of healthy participants and the absence of testing for specific therapeutic outcomes or clinical efficacy. The findings are specific to validating a testing tool rather than demonstrating effects of specific footwear features on health outcomes. While the MFS shows potential as a reliable platform for footwear research, its direct relevance to clinical practice requires further investigation in patient populations and with specific therapeutic interventions.

Study Details

EvidenceLevel 5

PublishedMar 2026

View Original Abstract ↓

The effects of specific footwear features on biomechanical parameters are often confounded by simultaneous changes in other shoe conditions, making it difficult to identify the isolated effect of material and design properties on relevant biomechanical outcomes. This study aimed to propose a tool, namely the Modular Footwear Setup (MFS), to assess the effects of midsole modifications on lower limb joint kinematics and in-shoe plantar pressure. The MFS uses a micro-hook-and-loop fastening system and a custom alignment device to enable fast, strong, and reliable midsole attachment/detachment to/from the upper. Accuracy and repeatability of the MFS in replicating the biomechanical outcomes of a control shoe featuring the same upper and midsole were tested in 10 healthy participants (5M,5F; age=33.2{+/-}9.2 yrs; BMI=21.5{+/-}2.8 kg/m2). Participants were asked to walk wearing both the MFS and the standard control shoe in three sessions. Kinematics of lower limb joints were measured via inertial measurement units, while capacitive pressure insoles were used to measure in-shoe plantar pressure. Intraclass correlation coefficient (ICC) was used to assess the repeatability of kinematic and pressure measurements between sessions. Statistical Parametric Mapping analysis did not identify significant differences in joint kinematics between conditions. While the MFS exhibited slightly lower peak pressure at the rearfoot, pressure parameters were not statistically different in the other foot regions. The MFS demonstrated good-to-excellent inter-session repeatability (ICC 0.84-0.97) for peak and mean pressure. Participants reported similar levels of comfort and stability in both shoes. The findings of the present study suggest the MFS has the potential to be a reliable and accurate tool for evaluating the effect of midsole features on relevant biomechanical parameters. This modular approach may improve data-driven footwear design by providing a consistent platform for testing the effects of midsole designs and materials across various applications, including therapeutic, safety, and athletic shoes.