The effect of shoe toe box shape and volume on forefoot interdigital and plantar pressures in healthy females

Helen Branthwaite,Andrew Greenhalgh,Nachiappan Chockalingam

doi:10.1186/1757-1146-6-28

Helen Branthwaite, Andrew Greenhalgh + Show 1 more

Open Access

https://doi.org/10.1186/1757-1146-6-28

Copy DOI

Abstract

BackgroundIll-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort. Studies on footwear have primarily examined sports or orthopaedic prescription shoes and little is known about the effects that everyday flat shoes have on the forefoot. The aim of this study was to investigate the effect of toe box shape in a popular slip-on pump on dorsal and plantar pressures with particular interest around the forefoot in a healthy female population.MethodA convenience sample of 27 female participants with no known foot pathologies was recruited. After assessment of foot size, plantar foot pressure and interdigital pressures were recorded for each of the 3 different toe box styles; round, square and pointed. Participants walked at a self-selected speed over a 10 m walkway whilst wearing each of the 3 styles of shoe and also whilst barefoot. Processed and analysed data extracted included peak pressure, time to peak pressure, contact time and pressure time integral. ANOVA and Freidman analysis was used to test for statistical significance.ResultsShoes with a round toe showed least pressure around the medial aspect of the toes whilst the pointed shoe had least pressure on the lateral toes. Contact times for the plantar regions were not altered in any shoe condition yet contact around the medial aspect of the toes was highest in the pointed shoe.ConclusionThis study highlights that the shape of the toe box in footwear can significantly influence the amount of pressure applied to the forefoot. Furthermore, the contours of the shoe also have an impact on the contact time and pressure time integral around the forefoot and also the peak plantar pressure in the toe region. The changes observed could be significant in the development of pathology in certain footwear toe box shapes. Consideration should be given to footwear design around the toe box to improve fit and reduce pressure. Further work is required to investigate the effect of toe box shape and volume on a pathological population with pressure related lesions.

Highlights

Ill-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort
This study highlights that the shape of the toe box in footwear can significantly influence the amount of pressure applied to the forefoot
The contours of the shoe have an impact on the contact time and pressure time integral around the forefoot and the peak plantar pressure in the toe region

Summary

Introduction

Ill-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort. Studies investigating the effects of heel height have primarily focused on the influence of heel elevation on plantar pressure and triceps surae function rather than any other characteristics this shoe type imposes These reported changes in increased forefoot pressure and altered triceps surae function do not directly identify the impact high heeled shoes have on toe deformities. Increases in forefoot plantar pressure have been associated with the development of metatarsalgia, callus formation and increased risk of ulceration under the metatarsal heads [17,18,19,20] Treatment of these lesions should provide symptomatic relief and alleviate the underlying mechanical cause yet continuation of ill fitting footwear will ensure these painful conditions persist [21]

Objectives

Methods

Results

Discussion

Conclusion