Footwear Interventions for Foot and Ankle Arthritis
Menz et al . [ 24 ]
• 46 1MTPJOA ( 61 %)
• 52 Controls ( 44 %)
• Rocker-sole group
• Age : 57 ( 11 )
• Median Disease duration : 3
• Control
• Age : 57 ( 11 )
• Median Disease duration : 3
• Rocker-sole footwear
• ( MBT Mahuta / Matwa )
• Rounded sole , soft cushioned heel
Peak Plantar Pressure ; PTI , pressure time integral ; MTP , metatarsophalangeal joint .
• Between group
• Participant ’ s own footwear + orthoses
• Within group
• Participant ’ s own footwear
• Primary outcome Not stated
• Outcomes assessed
• Plantar pressure ( PPP )
• Temporal spatial ( walking velocity , stride length , cadence , stance phase %)
Between group measures :
• Significant reduction in PPP at lesser toes ( p = 0.008 ), 2 – 5MTP ( p < 0.001 ) and midfoot ( p = 0.003 ) in the footwear Intervention group compared to control group . Significant reduction ( p = 0.015 ) in stance phase percentage in footwear intervention group .
Within group measures :
• Significant reduction in PPP at 1MTP ( p = 0.002 ), 2-5 MTPs ( p < 0.001 ) and heel ( p < 0.001 ) in footwear intervention group . Significant reduction in cadence ( p = 0.015 ) and stance phase percentage ( p = 0.021 ).
71 % group ( d = 1.07 ; large effect ). The prospective observational study [ 22 ] reported significant within group improvements in foot pain with high-top , rocker-sole footwear after 4 weeks ( d = 1.45 ; large effect ), however , there was no comparator to this intervention .
Gout
One prospective observational study [ 11 ] measured foot pain in people with gout . One group with good footwear characteristics was compared to a group with poor footwear characteristics over an 8-week period . After eight weeks , significant within group improvement in foot pain was observed in the good footwear characteristics group only ( d = 0.75 ; medium effect ). There was no significant improvement in foot pain in the poor footwear characteristics group ( d = 0.19 ; negligible effect ).
1MTP OA
One RCT [ 12 ] measured foot pain in people with 1MTP OA . Rocker-sole footwear was compared to the participant ’ s own footwear with foot orthoses . After 12 weeks , improvements in foot pain were observed in the rocker-sole footwear group ( d = 1.25 ; large effect ) and own footwear with foot orthoses group ( d = 0.95 ; large effect ), however , no significant differences were observed between groups at follow-up ( d = 0.01 ; negligible effect ).
Patient-reported outcomes
Patient reported outcome measures assessing function , impairment and disability were reported for RA , gout and 1MTP OA .
Rheumatoid arthritis
One RCT [ 18 ] reported a significant within group improvement in function in the extradepth footwear group with no improvement in the control group at eight weeks . The control group of this sample were subsequently provided with extra-depth footwear in a repeated-measures design with significant within group improvements in function at eight weeks ( d = 0.30 ; small effect ). Another RCT [ 13 ] reported significant between group improvement in foot function , functional
Current Pedorthics | March-April 2021 33