# Guidelines for Recommended Footwear for Healthy Children and Adolescents: A Rapid Scoping Review to Characterise the Nature and Extent of Footwear Research and Clinical Policy Guidelines

## TL;DR

This review finds that guidelines for children's footwear are inconsistent and often based on expert opinion rather than strong evidence, highlighting the need for standardized, research-based recommendations.

## Contribution

This is the first comprehensive review integrating governmental, professional, and clinical footwear guidelines for children.

## Key findings

- Footwear guidelines vary widely in definitions, recommendations, and supporting evidence.
- Most recommendations are based on expert opinion rather than empirical data.
- Commercial footwear sizing inconsistencies complicate proper fit assessment.

## Abstract

Background/Objectives: Clinical guidelines for children’s footwear vary widely across governmental and clinical sources, reflecting inconsistencies in best practices for paediatric foot health. These discrepancies arise from differing research interpretations, regional priorities, and clinical expertise. This scoping review evaluates existing guidelines and examines the evidence supporting them. The objective of this scoping review was to identify and map existing footwear guidelines for healthy children and adolescents across governmental, professional, and clinical sources, and to evaluate the type and strength of evidence underpinning these recommendations. Methods: A systematic search of PubMed, Google Scholar, ScienceDirect, and governmental databases was conducted. Studies on footwear recommendations for healthy children aged 18 months to 18 years were included. Articles published between 1970 and 2024 were considered, as 1970 marked the first mass marketing of running shoes/trainers. Results: Footwear guidelines lack standardisation, with variations in definitions, recommendations, and supporting evidence. Key inconsistencies exist in parameters such as fit, flexibility, and toe allowance, with most recommendations based on expert opinion rather than empirical data. Discrepancies in commercial footwear sizing further complicate proper fit assessment. Conclusions: This is the first comprehensive review of children’s footwear guidelines, integrating governmental, professional body, and clinical recommendations. While there is consensus on the importance of properly fitting shoes, the literature reveals inconsistencies and reliance on expert opinion rather than high-quality research. This review highlights the need for standardised, evidence-based criteria to guide footwear recommendations and serves as a foundation for future research aimed at bridging the gap between research and practice.