Current Pedorthics | March-April 2021 | Vol. 53, Issue 2 | Page 30

Footwear Interventions for Foot and Ankle Arthritis
Table 2 . Characteristics of included randomized clinical trials .
Author Nos . (% female )
Fransen and Edmonds [ 18 ]
15 RA ( 80 %) 15 Controls ( 67 %)
Sample characteristics , mean ( SD )
• Intervention group
• Age : 59 ( 14 )
• Disease duration : 16 ( 10 )
• Control group
• Age : 60 ( 9 )
• Disease duration : 15 ( 12 )
Followup ( wk )
Intervention
Control
Outcome measures
Findings
Quality
score
8 Extra-depth footwear ( P . W . Minor & Son Inc .)
Long inside counter ( rear stability and arch support ), foam padded heel counter ( leather lining ), soft leather upper , extra depth ( orthoses accommodation )
Own footwear
Primary outcome Not stated
Outcomes assessed :
• Lower limb walk pain , lower limb stair pain , lower limb NWB pain ( VAS )
• Function ( HAQ )
• Pain-free walk time ( min )
• Temporal-spatial ( normal and fast walking velocity , cadence , stride length )
Between group measures Not reported .
Within group measures :
• Significant reduction in lower limb ( p ¼ 0.001 ), lower limb stair pain ( p ¼ 0.001 ), HAQ scores ( p ¼ 0.04 ) with a significant increase in pain-free walk time ( p ¼ 0.001 ) for intervention group at follow-up . No significant differences found in the control group at followup .
54 %
• Primary outcome MTP pain ( VAS )
• Outcomes assessed
• Lower extremity function ( RB , TADL , 50 ft walk time )
• Significant improvement ( p o 0.05 ) in normal and fast walking velocity and stride length for intervention group at follow-up . No significant observed in control group at follow-up .
Chalmers et al . [ 19 ]
28 RA ( 75 %)
• Total sample
• Age : 60 ( 10 )
• Disease duration : 15 ( 9 )
12 • Extra-depth footwear
• ( P . W . Minor or Drew Co ) Firm heel counter , heel height1.5 – 2.0 cm , instep lacing , wide deep toe box , thick composite sole
• Extra-depth footwear + soft orthoses
• Firm heel counter , heel height1.5 – 2.0 cm , instep lacing , wide deep toe box , thick composite sole
• Soft orthoses ; 6mm Plastazote with medium density 6mm Plastazoe metatarsal lifts
• Extra-depth footwear + semi-rigid orthoses
• Semi-rigid orthoses ; NWB cast , 3mm
• Primary outcome
MTP pain ( VAS )
• Outcomes assessed
• Lower extremity function ( RB , TADL , 50 ft walk time )
Between group measures :
• Significant improvement in MTP pain scores ( p ¼ 0.006 ) for footwear and semi-rigid orthoses group , compared to footwear and soft orthoses group and footwear alone .
• No significant differences in RB , TADL and 50ft walk time between groups .
Within group measures :
• Significant improvement in MTP pain scores ( p ¼ 0.0004 ) for footwear with semi-rigid orthoses at follow-up . No significant differences in MTP pain with footwear and Plastazote and footwear only groups at follow-up .
79 %
Subortholen , RF and FF Nickleplast posting ,
FF 3mm PPT foam , full length leather top cover
• No significant differences in RB , TADL , and 50ft walk time and joint count within groups .
Williams et al . [ 13 ]
• 40 RA ( 73 %)
• 40 Controls ( 53 %)
• Total sample
• Age : not reported
• Disease duration : 17 ( 10 )
12 • New therapeutic footwear
• Front of shoe , heel and sole unit , leather and lining , ease of don / doff , heel height , sole thickness
• Firm contoured insole
• Traditional therapeutic footwear
• Soft , flat 6mm Plastazote , 3mm Poron insole
• Primary outcomes
• Foot pain , disability , activity limitation ( FFI )
• Foot pain , foot function , physical activity ( FHSQ )
Between group measures
• Significant improvement in FFI foot pain ( p ¼ 0.02 ), disability ( p ¼ 0.01 ), limitation ( p ¼ 0.02 ) and total scores ( p ¼ 0.01 ) for intervention group compared to control group at follow-up .
71 %
• Significant improvement
In FHSQ foot pain ( p ¼ 0.00 ) and foot function ( p ¼ 0.00 ) for intervention group compared to control group at followup .
28 Pedorthic Footcare Association | www . pedorthics . org