Effects of footwear interventions on foot pain
A new article published in Seminars in Arthritis and Rheumatism has reviewed the existing evidence looking at footwear interventions for foot pain, function, impairment and disability for people with foot and ankle arthritis.
1440 studies were identified, 11 of which were included in this review. 7 of the studies focussed on rheumatoid arthritis while the other 4 addressed 1st MPTJ arthritis and gout. Footwear types included off-the-shelf footwear, therapeutic footwear and therapeutic footwear with foot orthoses with characteristics including “cushioning and a wide toe box for rheumatoid arthritis; cushioning, midsole stability and a rocker-sole for gout; and a rocker-sole for 1st metatarsophalangeal joint osteoarthritis”/
Findings suggest that intervening with the appropriate footwear can alter plantar pressures in people with rheumatoid arthritis, gout and 1st MPJT osteoarthritis and walking velocity in patients with rheumatoid arthritis and gout.
Best cast for the job? Thoughts for diabetics
A study due to be published in Gait & Posture has addressed different types of casting technique for offloading the diabetic foot.
16 diabetic patients with peripheral neuropathy and a healed or active plantar forefoot ulcer had peak plantar pressures, force-time integrals, and perceived walking comfort measured while walking in different casts. These included a non-removable knee-high total contact cast (TCC), a removable knee high TCC (BTCC), “the same device made below-ankle (cast shoe), the cast shoe worn with a different walking sole and in a newly made cast shoe without a custom-moulded foot-device interface”.
Findings suggested that the TCC gave superior offloading because it is knee-high and non-removable. However, these are less comfortable for the patient to walk in.
1st MPTJ head morphology: a quantitative approach
Research published recently in Foot and Ankle Surgery has analysed 1st MPTJ morphology for hallux rigidus and hallux limitus.
This study used a quantitative measurement of 1st metatarsal radius of curvature to assess if hallux rigidus metatarsal heads were flatter than hallux valgus heads.
Results showed that hallux rigidus metatarsal heads are quantitatively flatter and less circular than hallux valgus metatarsal heads and the less circular hallux rigidus heads have a chevron shape. The authors concluded that “quantitative measurements are consistent with qualitative observations, validating the use of subjective metatarsal head morphology assessments”.