Abstract
BackgroundFootwear characteristics have been linked to falls in older adults and children, and the development of many musculoskeletal conditions. Due to the relationship between footwear and pathology, health professionals have a responsibility to consider footwear characteristics in the etiology and treatment of various patient presentations. In order for health professionals and researchers to accurately and efficiently critique an individual's footwear, a valid and reliable footwear assessment tool is required. The aim of this study was to develop a simple, efficient, and reliable footwear assessment tool potentially suitable for use in a range of patient populations.MethodsConsideration of previously published tools, other footwear related literature, and clinical considerations of three therapists were used to assist in the development of the tool. The tool was developed to cover fit, general features, general structure, motion control properties, cushioning, and wear patterns. A total of 15 participants (who provided two pairs of shoes each) were recruited, and assessment using the scale was completed on two separate occasions (separated by 1 – 3 weeks) by a physiotherapist and a podiatrist on each participant's dominant foot. Intra-rater and inter-rater reliability were evaluated using intra-class correlation coefficients (ICCs) (model 2, 1) and the 95% limits of agreement (95% LOAs) for continuous items, and percentage agreement and kappa (κ) statistics for categorical items.ResultsAll categorical items demonstrated high percentage agreement statistic for intra-rater (83 – 100%) and inter-rater (83 – 100%) comparisons. With the exception of last shape and objective measures used to categorise the adequacy of length, excellent intra-rater (ICC = 0.91 – 1.00) and inter-rater reliability (ICC = 0.90 – 1.00) was indicated for continuous items in the tool, including the motion control properties scale (0.91 – 0.95).ConclusionA comprehensive footwear assessment tool with good face validity has been developed to assist future research and clinical footwear assessment. Generally good reliability amongst all items indicates that the tool can be used with confidence in research and clinical settings. Further research is now required to determine the clinical validity of each item in various patient populations.
Highlights
Footwear characteristics have been linked to falls in older adults and children, and the development of many musculoskeletal conditions
Footwear characteristics considered to be important in the development and treatment of varying foot, lower limb, and low back conditions, as well as falls and diabetes-related issues were included in the tool
To allow a more objective measure of footwear quality in regard to motion control prior to consideration of foot orthoses prescription, a motion control properties scale was devised using items extracted from the tool
Summary
Footwear characteristics have been linked to falls in older adults and children, and the development of many musculoskeletal conditions. Due to the relationship between footwear and pathology, health professionals have a responsibility to consider footwear characteristics in the etiology and treatment of various patient presentations. Various footwear characteristics have been linked to falls in older people [2,3,4,5,6,7] and in children [8], and the development of multiple conditions including osteoarthritis of the foot [9,10] and knee [11], low back pain [12,13], foot ulcerations and amputations [14], and foot deformities such has hallux valgus and hammer toes [15]. In some cases, changing a patient's footwear may be the only intervention required [17]
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