Abstract
BackgroundIn clinical trials, good quality athletic shoes offer short-term improvements (two-months) in foot pain and disability in people with gout, but these improvements are not sustained over time. This may be due to wear and subsequent changes to the structural integrity of the shoe. The aim of this study was to examine the effects of wear on plantar pressures and footwear characteristics in shoes over six-months in people with gout.MethodsForty people with gout participated in a cross-sectional repeated measures study. Participants wore a pair of commercially available athletic footwear for six-months. Participants then attended a study visit where the worn footwear was compared with a new pair of the same model and size of footwear. Wear characteristics (upper, midsole, outsole) and plantar pressure were measured in the two footwear conditions. Wear characteristics were analysed using paired t-tests and Fisher’s exact tests. Plantar pressure data were analysed using linear mixed models.ResultsIncreases in medial midsole (P < 0.001), lateral midsole (P < 0.001) and heel midsole (P < 0.001) hardness were observed in the worn shoes. Normal upper wear patterns (P < 0.001) and outsole wear patterns (P < 0.001) were observed in most of the worn shoes. No differences in peak plantar pressures (P < 0.007) were observed between the two footwear conditions. Reduced pressure time integrals at the first metatarsophalangeal joint (P < 0.001), second metatarsophalangeal joint (P < 0.001) and hallux (P = 0.003) were seen in the worn shoes.ConclusionsThe study found signs of wear were observed at the upper, midsole and outsole in the worn footwear after six-months. These changes to the structural properties of the footwear may affect forefoot loading patterns in people with gout.
Highlights
In clinical trials, good quality athletic shoes offer short-term improvements in foot pain and disability in people with gout, but these improvements are not sustained over time
People with gout have altered loading patterns during walking when shod [4, 5] and barefoot [6]. When wearing their own footwear, people with gout display reduced peak plantar pressures and pressure time integrals at the hallux and increased pressure time integrals at the midfoot compared to controls [5]
Over the six-months, footwear diaries were completed in 2 month intervals, with 21 participants returning all completed diaries, 13 participants returning at least 1 completed diary and 6 participants did not complete any footwear diaries
Summary
Good quality athletic shoes offer short-term improvements (two-months) in foot pain and disability in people with gout, but these improvements are not sustained over time This may be due to wear and subsequent changes to the structural integrity of the shoe. People with gout have altered loading patterns during walking when shod [4, 5] and barefoot [6] When wearing their own footwear, people with gout display reduced peak plantar pressures and pressure time integrals at the hallux and increased pressure time integrals at the midfoot compared to controls [5]. Postulated factors contributing to first metatarsophalangeal joint involvement in gout include lower temperatures, trauma, biomechanical loading and the co-existence of osteoarthritis [7] These changes in pressure may reflect a pain avoidance strategy where people with gout offload painful regions of the feet [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
