Design and development of an affordable customized EVA shoes for Individuals suffering from a non-flexible “Metatarsus Adductus”
DOI:
https://doi.org/10.48047/CU/54/01/270-280Keywords:
Bespoke shoes, Shoe customization , foot deformity , specialty Shoe manufacturing , Gait analysis , Markerless pose estimationAbstract
In this work, an affordable modified Ethylene-vinyl acetate (EVA) shoe was designed and developed for the persons suffering from “Metatarsus Adductus” foot deformity. The effects of developed shoes on the subjects gait parameters (i.e., speed, stride length, step length, double support time, and hip, knee, and ankle movement) were analyzed. The study involved measuring the subjects foot morphology, manufacturing custom EVA shoes, and presenting factors that helped reduce the cost of custom-made shoes while enhancing the subjects comfort. The stiffness of the lateral portion of the sole was modified to balance load distribution in the plantar region. Additionally, an inverted heel provision was incorporated to address excessive pronation moments. Gait analysis was conducted using a markerless pose estimation algorithm in different shod conditions (i.e., regular closed-toe shoes, open-toe slippers, and the modified/customized EVA shoes). The results were statistically analyzed using a two-sample t-test, and Bland-Altman analysis was performed to identify fixed and proportional biases in the dataset. To validate test reliability, the Intraclass Correlation Coefficient (ICC (3,1)) (Two-way mixed effects, single rater) was also calculated. The results confirmed that the modified EVA footwear positively impacted the subjects ambulatory movement (e.g., increased step length, stride length, and range of motion), which was further supported by the subjects feedback. This work provides valuable insights into low-cost manufacturing of both regular and customized footwear.
Downloads
References
BioRes Scientia LLC, Fernando V, M Maharaj M, et al (2023) The Use of Spatiotemporal Gait Analysis in Diagnosing Pathologies: A Review. Clinical Case Reports and Studies 3 (2), 1–14. https://doi.org/10.59657/2837-2565.brs.23.067.
Blake RL (1986) Inverted functional orthosis. Journal of the American Podiatric Medical Association 76 (5), 275–6. https://doi.org/10.7547/87507315-76-5-275.
Blake RL, Denton JA (1985) Functional foot orthoses for athletic injuries. A retrospective study. Journal of the American Podiatric Medical Association 75(7), 359–62. https://doi.org/10.7547/87507315-75-7-359.
Blake RL, Ferguson H (1991) Foot orthosis for the severe flatfoot in sports. Journal of the American Podiatric Medical Association 81(10), 549–55. https: //doi.org/10.7547/87507315-81-10-549.
Brauner T, Sterzing T, Gras N, et al (2009) Small changes in the varus alignment of running shoes allow gradual pronation control. Footwear Science 1(2), 103–110. https://doi.org/10.1080/19424280903133920.
Cramer K (1904) Metatarsus varus congenitus. Archives of Orthopaedic and Trauma Surgery 2, 370–374. https://doi.org/doi.org/10.1007/BF02662083.
Dapp U, Vinyard D, Golgert S, et al (2022) Reference values of gait characteristics in community-dwelling older persons with different physical functional levels. BMC Geriatrics 22(1), 713. https://doi.org/10.1186/s12877-022-03373-0.
Haley M, Price C, Nester C (2021) The effect of sole hardness on the metatarsophalangeal joint in children. Footwear Science 13(1), S93–S95. https://doi.org/ 10.1080/19424280.2021.1917699.
Hossain M, Davis N (2017) Evidence-Based Treatment for Metatarsus Adductus. In, Alshryda S, Huntley JS, Banaszkiewicz PA (eds) Paediatric Orthopaedics: An Evidence-Based Approach to Clinical Questions. Springer International Publishing, Cham, p 167–170, https://doi.org/10.1007/978-3-319-41142-218.
Jawish R, Rigault P, Padovani JP, et al (1990) [The Z-shaped or serpentine foot in children and adolescents]. Chirurgie Pediatrique 31(6), 314–321.
Jin L (2022) The Influence of Different Footwear Insole Stiffness on Center of Pressure and Ankle Kinematics during Walking: A Case Report. Biomechanics 2(2), 205–212. https://doi.org/10.3390/biomechanics2020017.
Jin L, Xu X (2023) The effect of different insole stiffness on ankle joint moment during walking. Footwear Science 15(sup1), S47–S48. https://doi.org/10.1080/ 19424280.2023.2199278.
Kakavand M, Smith N (2022) The Effect of Non-prescription Orthotics on Walking Gait in Participants with Excessive Pronation. International Journal of Sport Studies for Health 5(2), 42–49. https://doi.org/10.61838/kman.intjssh.5.2.6
Kang HG, Dingwell JB (2008) Effects of walking speed, strength and range of motion on gait stability in healthy older adults. Journal of Biomechanics 41(14), 2899–2905. https://doi.org/10.1016/j.jbiomech.2008.08.002.
Lloyd-Roberts GC, Clark RC (1973) BALL AND SOCKET ANKLE JOINT IN METATARSUS ADDUCTUS VARUS : (S-shaped or serpentine foot). The Journal of Bone & Joint Surgery British Volume 55-B (1), 193–196. https://doi.org/ 10.1302/0301-620X.55B1.193.
Lockhart TE, Woldstad JC, Smith JL (2003) Effects of age-related gait changes on the biomechanics of slips and falls. Ergonomics 46(12), 1136. https://doi.org/ 10.1080/0014013031000139491.
Mittleman G (1971) Transverse plane abnormalities of the lower extremities: intoe and outtoe gait. Journal of the American Podiatric Medical Association 6(1), 1–7. https://doi.org/10.7547/87507315-61-1-1.
Na CH, Siebers HL, Reim J, et al (2024) Kinematic movement and balance parameter analysis in neurological gait disorders. Journal of Biological Engineering 18(1), 6. https://doi.org/10.1186/s13036-023-00398-w
Najdi H, Jawish R (2015) Management of metatarsus adductus, bean-shaped foot, residual clubfoot adduction and Z-shaped foot in children, with conservative treatment and double column osteotomy of the first cuneiform and the cuboid. International Journal of Orthopaedics 2(6), 438–444. https://doi.org/10.6051/ijo. v2i6.1453.
Pinto RZ, Souza TR, Maher CG (2012) External devices (including orthotics) to control excessive foot pronation. British Journal of Sports Medicine 46(2), 110–111. https://doi.org/10.1136/bjsports-2011-090804.
Reimann I, Werner HH (1983) The Pathology of Congenital Metatarsus Varus: A Post-mortem Study of a Newborn Infant. Acta Orthopaedica Scandinavica 54(6), 847–849. https://doi.org/10.3109/17453678308992920.
Rothbart BA (1972) Metatarsus adductus and its clinical significance. Journal of the American Podiatric Medical Association 62(5), 187–190. https://doi.org/10. 7547/87507315-62-5-187.
Rushforth GF (1978) The natural history of hooked forefoot. The Journal of Bone & Joint Surgery British Volume 60-B(4), 530–532. https://doi.org/10.1302/ 0301-620X.60B4.711803.
Shin KY, Rim YH, Kim YS, et al (2010) A joint normalcy index to evaluate patients with gait pathologies in the functional aspects of joint mobility. Journal of Mechanical Science and Technology 24(9), 1901–1909. https://doi.org/10.1007/ s12206-010-0608-9.
Taylor JB, Nguyen AD, Parry HA, et al (2019) MODIFYING MIDSOLE STIFFNESS of BASKETBALL FOOTWEAR AFFECTS FOOT and ANKLE BIOMECHANICS. International Journal of Sports Physical Therapy 14(3), 359. https://doi.org/10.26603/ijspt20190359
Williams CM, James AM, Tran T (2013) Metatarsus adductus: Development of a non-surgical treatment pathway. Journal of Paediatrics and Child Health 49(9), E428–E433. https://doi.org/10.1111/jpc.12219
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Atul Dayal, Devendra Kumar Chaturvedi (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.