Current Pedorthics | March-April 2021 | Vol. 53, Issue 2 | Page 31

Footwear Interventions for Foot and Ankle Arthritis
Cho et al . [ 21 ]
22 RA ( 100 %)
20 Controls ( 100 %)
Intervention group
Age : 49 ( 12 )
• Disease duration : 8 ( 6 )
• Control group
• Age : 49 ( 12 )
• Disease duration : 7 ( 7 )
24 Extra-depth shoes + custom orthoses
• Wide toe box , cushioned heel , forefoot rocker
• Custom orthoses : medial arch support , medial heelpost , metatarsal pad
Extra-depth shoes + prefabricated insoles
• Wide toe box , cushioned heel , forefoot rocker
• Prefabricated insole ; 6mm Plastazote
Primary outcomes
• Foot pain ( VAS )
• Foot pain , disability , activity limitation ( FFI )
Between group measures :
• No significant differences in foot pain and FFI total
Scores between intervention and control group at follow-up .
Within group measures
61 %
• Significant reduction in foot pain ( p o 0.05 ) in intervention and control groups at follow-up .
Menz et al . [ 12 ]
• 46 1MTPJ OA ( 61 %)
• 52 Controls ( 44 %)
• Intervention group
• Age : 57 ( 11 )
• Median disease duration : 2
• Control group
• Age : 57 ( 11 )
• Median Disease duration : 3
12 • Rocker-sole footwear
• ( Masai Barefoot Technology ( MBT ) Mahuta / Matwa )
• Rounded sole , soft cushioned heel
• Own footwear + orthoses
• VasyliCustoms
• Full length , cut out under1st metatarsal , varus wedge ( FPI > 7 )
Primary outcome
Foot pain ( FHSQ )
Outcomes assessed
Function ( FHSQ ) Foot pain , stiffness , difficulty , activity limitation , social issues ( FFI-RSF ) 1MTP walkpain , 1MTP restpain , 1MTP stiffness ( VAS )
Between group measures
• No significant differences in foot pain , function , stiffness , difficulty , activity limitation , social issues , MTP pain and MTP stiffness between group sat follow-up .
Within group measures
• Not reported
96 %
NWB , non-weight bearing ; VAS , visual analogue scale ; HAQ , health assessment questionnaire ; MTP , metatarsophalangeal joint ; RB , Robinson Bashall functional assessment ; TADL , Toronto activities of daily living measure ; FFI , foot function index ; FHSQ , foot health status questionnaire ; FFI-RSF , foot function index — revised ( short form ); SF , short form .
were not deemed appropriated based on the variation in disease type , interventions and tools used to measure primary outcomes . Negligible to large between group effect sizes were observed for foot pain , function impairment and disability .
Footwear interventions
Footwear interventions included off-the-shelf footwear [ 11 ], [ 12 ], [ 20 ], [ 23 ], [ 24 ] , therapeutic footwear
[ 13 ], [ 17 ], [ 18 ], [ 20 ], [ 22 ] and therapeutic footwear combined with foot orthoses [ 19 ], [ 21 ] .
Off-the-shelf footwear
The use of off-the-shelf footwear was reported in people with RA [ 20 ] , gout [ 11 ], [ 23 ] and 1MTP OA [ 12 ], [ 24 ] . In one study in people with RA , an athletic shoe was used with the footwear characteristic of this shoe being cushioning for forefoot pain [ 20 ] . For people with gout a range of walking shoes were used and divided into good footwear characteristics and poor footwear characteristics . Good footwear characteristics included a rockersole to facilitate a heel-to-toe gait , a dualdensity midsole to provide motion control , heel and forefoot cushioning to improve shock attenuation and a zip to allow for ease of entry and exit of footwear [ 11 ], [ 23 ] . Poor footwear characteristics included a single density midsole , no cushioning , minimal heel counter stiffness and midsole stability [ 11 ], [ 23 ] . For people with 1MTP OA , a rocker-sole shoe was used , allowing smoother progression of the body ’ s centre of mass over the stance foot , reducing the amount of 1MTP dorsiflexion required and loading at the forefoot joints [ 12 ], [ 24 ] .
Current Pedorthics | March-April 2021 29