Footwear Interventions for Foot and Ankle Arthritis
footwear ( d = 0.02 — 0.44 ; negligible-small effect ). Significant within group increases in walking velocity , step length and stride length in both the good and poor footwear characteristics groups compared to the participant ’ s own footwear ( d = 0.16 – 0.53 ; negligible-medium effect ), however , no between group differences were observed ( d = 0.29 ; small effect ).
1MTP OA
One cross-sectional study [ 24 ] reported significant within group reductions in PPP were observed at 1MTP ( d = 0.31 ; small effect ), 2 – 5MTP ( d = 0.91 ; large effect ) and heel ( d = 0.90 ; large effect ) in the rocker-sole footwear group compared to the participant ’ s own footwear . Significant reductions in PPP at lesser toes ( d = 0.35 ; small effect ), 2 – 5MTP ( d = 1.12 ; large effect ) and midfoot ( d = 0.72 ; medium effect ) was observed between the footwear intervention group compared to the own footwear with orthoses group . A significant reduction in stance phase percentage ( d = 0.51 ; medium effect ) in the rocker-sole footwear group compared to the own footwear with orthoses group . Significant within-group reductions for cadence ( d = 0.25 ; small effect ) and stance phase percentage ( d = 0.43 ; small effect ) were observed in the rocker-sole footwear group compared to the participant ’ s own footwear .
Discussion
The aim of this systematic review was to identify and evaluate the evidence for the clinical effectiveness of footwear interventions for foot pain , function , impairment and disability in people with arthritis . Despite the broad search strategy , the search only identified studies investigating RA , gout and 1MTP OA . The findings of the review support that footwear is associated with improvements to foot pain , function , impairment and disability in people with RA . There is evidence to suggest that footwear is associated with improvements to foot pain , function and disability in people with gout and improvements to foot pain and function in people with 1MTP OA . A greater body of evidence exists for RA compared to gout and OA , and there are no studies of footwear interventions for other forms of arthritis .
Within and between group effect sizes for foot pain indicate that footwear interventions are likely to result in improvements to foot pain in people with arthritis . However , for people with rheumatoid arthritis there was conflicting evidence between studies as to which type of intervention was preferable . Between group findings indicated the majority of studies in favor of therapeutic footwear with a semi-rigid insole compared to therapeutic footwear with a soft insole on foot pain , however , one study favored therapeutic footwear with a soft insole compared to a semi-rigid insole .
There was considerable variation in the methodology with respect to the footwear interventions and measures used to assess both primary and secondary outcomes . Of the included studies , footwear interventions included footwear only and footwear with orthoses conditions . It is difficult to isolate the individual treatment effect of footwear and foot orthoses when prescribed individually or as co-interventions . It is also difficult to ascertain if the observed changes are related to “ the footwear ” or specific characteristics of the footwear . There is currently no universally
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