FOOTWEAR CHOICES FOR PAINFUL FEET
favored by the older group over the younger
participants as they are easier to put on
and take off without the consideration for a
fastening. Similarly, the locality of this single
center sample of participants could limit the
generalizability of the observations made.
"The younger group, when
buying activity shoes,
reported comfort, fit and
support being the most
important factors."
Although the heel height of a shoe is often
suggested as a causative factor for HAV
formation, with increases observed in forefoot
plantar pressure and altered first ray function
[12, 17, 30, 31], the results of the current study
provide substantial evidence that age appears
to be more important than previously thought in
the forma-tion of this joint deformity. However,
it was not clear as to why participants with HAV
chose to wear shoes that were smaller than the
foot. There was a strong association between
purchasing shoes and feel good factor, yet
further exploration around the emotions around
wearing smaller shoes was not investigated.
Body image and a quest to hide deformity by
choosing to wear normal fashion shoes could
be responsible for this selection, as it is widely
reported that orthopaedic shoes are deemed as
ugly and often not worn [22].
A width difference of − 0.6 mm between the
width of the foot and the shoe is significant to
make a change in the comfort of the shoe. A
34
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comfortable good value shoe was considered
important to make participants feel good and
happy about themselves. Whilst it is commonly
argued that a shoe is most comfortable when
it mimics the shape of the wearers foot [32],
the geometry of the forefoot which matches
the shape of the toe box could be a critical
factor in this opinion of comfort. However,
often a shoe wide enough to fit the forefoot is
not found in 66% of people [33] leading to the
observed mismatch in foot-wear choice and foot
dimension. This constraint and drawback with
current footwear styling is stagnant and there
is a clear need for improved understanding
with possibilities for radical new last designs
or innovative manufacturing of accommodative
footwear uppers. With advances in technology
relating to foot assessment and manufacturing
techniques mass customization of footwear is
"This was not observed in the
older group who preferred
a slip-on shoe with more
fashionable factors of heel
shape color fit and comfort."
plausible. In addition, the development of 3D
printing techniques makes it easy to provide
patient specific footwear solution for effective
clinical management. There were observed
differences in the purchase decisions of these
footwear between the two age groups. The
younger group, when buying activity shoes,
reported comfort, fit and support being the most
important factors. This is similar to the previous
work that suggested comfort and activity were
the most significant factors that influence