Abstract
Background
Foot pain in patients with rheumatoid arthritis is common and can be associated with
excessive forefoot plantar pressure loading. Running and off-the-shelf orthopaedic
footwear are commonly recommended to manage foot pain and discomfort in these patients.
The aim of this study was to evaluate the effect of running footwear as an alternative
to off-the-shelf orthopaedic footwear on plantar pressure loading characteristics
in people with forefoot pain associated with rheumatoid arthritis.
Methods
Twenty participants diagnosed with rheumatoid arthritis reporting chronic forefoot
pain participated in this experimental, randomised, single-blind, cross-over trial
of three footwear conditions: control, running and off-the-shelf orthopaedic. Outcome
measures included measurement of peak pressure and pressure-time integral, with an
in-shoe plantar pressure measurement system, beneath the total foot, forefoot, midfoot
and rearfoot. Furthermore, perceived comfort and footwear acceptability were determined
for each footwear condition.
Findings
Compared to the control footwear, forefoot peak pressures were reduced by 36% in the
running footwear and by 20% in the orthopaedic footwear, compared to the control (P < 0.001). Forefoot pressure-time integrals were reduced by 33% in the running footwear
and by 23% in the orthopaedic footwear (P < 0.001). The largest reductions were achieved with the running footwear across the
whole plantar surface of the foot. Perceived comfort did not differ between running
and orthopaedic footwear, although both were significantly more comfortable than the
control footwear. Overall, more participants nominated the running footwear as the
most acceptable footwear condition.
Interpretation
The results of this preliminary study show that running footwear was most effective
at reducing plantar pressure loading and was regarded as a comfortable and acceptable
footwear alternative by participants with forefoot pain associated with rheumatoid
arthritis.
Keywords
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Article info
Publication history
Published online: June 20, 2007
Accepted:
April 17,
2007
Received:
October 30,
2006
Identification
Copyright
© 2007 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.