Abstract
BackgroundPlantar forefoot pain is commonly experienced by older people and it is often treated with forefoot pads to offload the painful area. However, studies have found inconsistent effects for different forefoot pads on plantar pressure reduction, and optimum forefoot pad placement is still not clear. The aim of this study was to compare the effects of different forefoot pads on plantar pressure under the forefoot in older people with forefoot pain.MethodsThirty-seven adults (31 females, 6 males) with a mean age of 73.5 (SD 4.8) participated. Forefoot plantar pressure data were recorded using the pedar®-X in-shoe system while participants walked along an 8 m walkway. Five conditions were tested in a standardised shoe: (i) no padding (the control), (ii) a metatarsal dome positioned 10 mm proximal to the metatarsal heads, (iii) a metatarsal dome positioned 5 mm distal to the metatarsal heads, (iv) a metatarsal bar, and (v) a plantar cover.ResultsCompared to the shoe-only control condition, each of the forefoot pads significantly reduced forefoot peak pressure and maximum force. The metatarsal dome positioned 5 mm distal to the metatarsal heads and the plantar cover were most effective for reducing peak pressure (17%, p < 0.001 and 19%, p < 0.001, respectively).ConclusionsThese findings indicate that forefoot pads are effective for reducing forefoot pressures in older people with forefoot pain, and that the position of the pad relative to the metatarsal heads may be more important than the shape of the pad.
Highlights
Foot pain in older people is associated with decreased mobility [1], self-reported disability [2], impaired balance [1], an increased risk of falling [3] and decreased healthrelated quality of life [2,4]
Plantar forefoot pain is often treated with forefoot pads [13,14,15,16], which are thought to be effective by reducing plantar pressure under the metatarsal heads [13,14,17]
The aim of this study was to compare the effects of different forefoot pads on plantar pressures under the forefoot in older people with forefoot pain
Summary
Foot pain in older people is associated with decreased mobility [1], self-reported disability [2], impaired balance [1], an increased risk of falling [3] and decreased healthrelated quality of life [2,4]. Forefoot pain is commonly associated with toe deformity and plantar hyperkeratosis [1,5,6] These conditions have been associated with increased plantar pressures [7,8,9], and higher plantar pressures have been associated with foot pain [3,10,11,12,13]. Plantar forefoot pain is often treated with forefoot pads [13,14,15,16], which are thought to be effective by reducing plantar pressure under the metatarsal heads [13,14,17] Such reductions are commonly thought to occur by redistributing plantar forces across a larger area of the foot [13,18,19,20]. The aim of this study was to compare the effects of different forefoot pads on plantar pressure under the forefoot in older people with forefoot pain
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