Perceptions of people with multiple sclerosis on the effect and comfort of two different textured insoles: A qualitative study

Abstract

Background: People with multiple sclerosis (MS) suffer from progressive impairment of gait and balance. One of the causal factors is reduced plantar sensation. Pilot studies indicate that textured insoles may improve gait and balance by way of enhanced plantar tactile stimulation. However, no studies have reported subjective outcomes, which could provide significant information regarding the acceptance of textured insoles and their effect on psychological wellbeing. This study aimed to report the subjective experience of participants with MS when they wore insoles with two different textures. Methods: A within-subjects experimental design was used with two insole textures. Forty six participants were recruited (12 males, 34 females, mean age 49.1 years, SD=6.83). Participants were randomly allocated to one of the two textured insole types, which they wore for 2 weeks. They then took part in individual semi-structured interviews about their experience of wearing the insoles. Their answers were coded using thematic analysis to identify key themes. Results: The same themes emerged in both texture groups. Two key themes were identified: insole comfort and efficacy. Individual participants responded to the same texture in different ways; the perception of comfort was highly individual, as was insole acceptability. Perception of efficacy influenced acceptability, with participants more likely to wear the insoles if they thought they were beneficial. In several cases, confidence in mobility increased during insole use. Conclusions: Textured insoles have therapeutic potential in an MS population in regard to improving mobility confidence. However, their acceptability is highly individual so generalisations about their efficacy are difficult to make. Their acceptability and efficacy appear to be linked with a perception of benefit. The perception that they are beneficial encourages participants to wear the insoles and they are more likely to experience increased confidence. Implications: Textured insoles could provide a simple, inexpensive intervention to help people with MS maintain function and independence, thus enhancing quality of life. However, there is likely to be considerable individual variability regarding subjective outcomes.