Footwear Habits Research Articles

Prevalence, causes, and treatment of plantar fasciitis in young females of a medical college

BackgroundPlantar fasciitis, a common musculoskeletal disorder, is characterized by inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes. The plantar fascia plays a crucial role in supporting the arch of the foot and absorbing shock during movement. Factors such as excessive physical activity, improper footwear, and biomechanical abnormalities are recognized contributors to the development of plantar fasciitis. However, the prevalence and underlying causes may vary across different demographic groups, necessitating targeted investigations.ObjectiveThis study aims to investigate the prevalence, causes and treatment of plantar fasciitis in young female students (18–30) of a medical college in Pakistan and explore potential associations with high-heel footwear.MethodologyIn this study, a cross-sectional survey was carried out, engaging 100 young females from a medical college. Employing a structured questionnaire, we assessed a spectrum of parameters, including heel pain symptoms, footwear habits, and available treatment options. The diagnostic precision of the Windlass test, specific to plantar fasciitis, was incorporated. Rigorous data analysis, utilizing SPSS, centered on discerning associations between the nuances of high-heel wear (considering types and duration) and the reported symptoms. This methodological framework ensures a comprehensive and precise exploration of the prevalence, causes, and treatment of plantar fasciitis in our targeted demographic.ResultsAll the participants were female, and the total number was 100, of which 66% felt pain in the heel when they wore high heels. Out of this 66%, only 6% are diagnosed with plantar fasciitis. The rest of the 60% have pain in the heel due to different causes such as heel spurs, stress fractures, etc. 2% of people receive treatment with steroid injections, and 12% are treated with ice.ConclusionWe conclude that the prevalence of plantar fasciitis is high in females wearing high heels. This study reveals that an increase in the total duration of wearing high heels with hard soles increases the symptoms of plantar fasciitis. Plantar fasciitis can be prevented by education and applying ergonomics and could be treated by steroids and the ice method, according to medical practitioners.

Foot Complications and Footwear Habits: A Study of Diabetes Mellitus Patients in Bangladesh

Foot complications among diabetic mellitus patients are a major cause of morbidity and death across the world. A large number of Bangladeshis are also affected by this type of diabetes. This study aimed to explore the common foot complications and footwear selection of diabetes mellitus patients in Bangladesh. This study used a questionnaire to conduct empirical research and analyzed the data using statistics. In a survey of 304 diabetes mellitus patients, 36.84% reported peripheral neuropathy, 27.30% foot swelling, and 11.50% foot ulcers. Approximately 58.33% of patients reported at least one of the above complications. Only 14.5% of participants were aware of therapeutic footwear, and half were satisfied with their requirements. The remaining 85.5% of patients were careless about footwear safety. The findings of this study suggested increasing awareness of ergonomically fit footwear to reduce foot complications. Additionally, future studies should explore proper guidance and features for selecting and using them. Journal of Engineering Science 14(1), 2023, 77-83

What do male netball players want in their footwear? Design recommendations for netball-specific shoes for men

With the increasing professionalisation of men's netball and the high prevalence of foot-related problems and pain, manufacturers must develop shoes with the correct ergonomic design to meet the unique needs of male netball players. This study aimed to determine what factors men consider when selecting a netball-specific shoe and what design features they want in an ideal netball-specific shoe. 279 amateur, sub-elite and elite male netball players completed a 38-question online survey about their footwear habits and preferences. Support was the most influential factor when men selected a netball-specific shoe. A wider toe-box, more durable upper and outsole, and added cushioning and support in the midsole and insole were preferred fit, form and function features for an ideal netball-specific shoe. We recommend that manufacturers develop a range of netball-specific shoes based on the foot dimensions, playing demands and preferences of male netball players to meet men's fit and functionality requirements.

Are male netball players satisfied with the shoes that they wear for netball?

Despite the recent growth of men participating in netball, the footwear needs of male netball players have been largely neglected by researchers and shoe manufacturers. This study aimed to determine whether male netball players were satisfied with the shoes they currently wore for netball and explore the reasons why many men do not wear netball-specific shoes. 279 amateur, sub-elite and elite male netball players completed a 38-question online survey about their footwear habits and foot-related problems. A mixed-methods approach was used to analyse the quantitative and qualitative survey data. Irrespective of shoe type worn, men were dissatisfied with the width fit, durability and breathability of the shoes they currently wore for netball activity. The participants desired to modify the outsole, insole and toe box of the current shoes they wore for netball. Men also identified a diverse range of non-shoe design and shoe design factors related to fit and functionality that deterred them from wearing netball-specific footwear. It is recommended that the fit and functionality of shoes designed for male netball players are improved to better cater for the foot dimensions and netball performance demands of men.

Do the Footwear Profiles and Foot-Related Problems Reported by Netball Players Differ Between Males and Females?

IntroductionWe explored the footwear profiles and foot-related problems reported by netball players and whether these differed between males and females.MethodsTwo thousand nine hundred and twenty-five amateur, sub-elite and elite netball players (men n = 279; women n = 2646; age 26.4 ± 10.0 years) completed a custom-designed online survey with questions related to netball experience, current netball footwear habits and history of foot-related problems. Footwear profiles and foot-related problems were considered in logistic regressions against sex and competition level to ascertain significant relationships (p < 0.05) and predictive values (odds ratio).ResultsAlthough 80.4% of respondents reported wearing netball-specific shoes, females were 13.2 times more likely to wear netball-specific shoes than males. Foot-related problems and foot pain were reported by 84.3% and 56.8% of netball players, respectively; with blisters, ankle sprain/strains and calluses being most common. Although women were significantly more likely to suffer from foot-related problems than men, males were significantly more likely to believe their foot pain was caused by the footwear they wore for netball.ConclusionThe high prevalence of foot-related problems and pain reported by all netball players suggests that the shoes players are currently wearing for netball are not meeting the requirements of players, particularly regarding fit, comfort and functionality. As male netball players have significantly different footwear profiles to female players, men are likely to require netball-specific footwear that differs to the netball-specific shoes designed for female players.

Measurement of the Developing Foot in Shod and Barefoot Paediatric Populations: A Narrative Review.

The theory that footwear may change foot shape dates back 100 years. Since this period, research has revealed the anatomical and functional consequences that footwear can cause to the foot. Children’s feet remain malleable as they undergo developmental changes until adolescence, which is why childhood is arguably a crucial period to understand how footwear can affect natural foot development. This review explored the development of the foot in children and adolescents and the methods used to measure the different foot structures; it comments on the key issues with some of these methods and gives direction for future research. Various internal and external factors can affect foot development; the main factors are age, gender, ethnicity, body mass index (BMI) and footwear habits. Research on how footwear can affect foot development has increased over the years and the final section of this review aimed to unpick the findings. Studies investigating the influence of footwear habits on foot length and width have established inconsistent findings. Many of the studies in the review did not control for internal and external factors that can affect foot development. There was also a limited number of studies that investigated hallux valgus angle and muscle strength differences in those with different footwear habits. Moreover, multiple studies in the final section of this review did not successfully examine the footwear habits of the participants and instead used observations or self-assessments, which is a major limitation. Future research should examine footwear behaviors and other confounding factors when investigating the development of the foot in children and adolescents. Moreover, researchers should critically evaluate the methods used to quantify the different structures of the foot to ensure valid and reliable parameters are being used.

Density Flies and Helminth Infection at Child in Muara Angke

Context: Infection due to worms can lead to anemia, nutritional disorders, growth, and intelligence whichin the long run will reduce the quality of human resources. This study aims to determine relevant of densityof flies to helminthiasis and to know relevant between risk variables (gender, age, latrine availability,cleanliness of nails, footwear habits, parental education, socio-economic conditions, floor conditions, foodsanitation). This study was an observational analytic study with a cross sectional approach with a totalsample of 97 people taken from the age of 7-15 years. Stool examination results showed that students whotested positive for helminthiasis were 5 people (5.2%) and negative as many as 92 people (94.8%). Based onstatistical analysis was concluded that there was irrelevant between fly density, sex, age, latrine availability,hygiene of nails, footwear habits, mother’s education, and food sanitation.

Foot problems, footwear habits and indoor footwear design preferences of the diabetic population in Thailand

Foot problems, footwear habits and indoor footwear design preferences of the diabetic population in Thailand

Factors associated with type of footwear worn inside the house: a cross-sectional study

BackgroundIn specific populations, including those at risk of falls or foot ulcers, indoor footwear is an important aspect of preventative care. This study aims to describe the indoor footwear worn most over the previous year in a sample representative of the Australian inpatient population, and to explore the sociodemographic, medical, foot condition and foot treatment history factors associated with the indoor footwear worn.MethodsThis was a secondary analysis of data collected from inpatients admitted to five hospitals across Queensland, Australia. Sociodemographic information, medical history, foot conditions and foot treatment history were collected as explanatory variables. Outcomes included the self-reported type of indoor footwear (from 16 standard footwear types) worn most in the year prior to hospitalisation, and the category in which the self-reported footwear type was defined according to its features: ‘protective’, ‘non-protective’ and ‘no footwear’. Multivariate analyses determined explanatory variables independently associated with each type and category.ResultsProtective footwear was worn by 11% of participants (including 4% walking shoes, 4% running shoes, 2% oxford shoes), and was independently associated with education above year 10 level (OR 1.78, p = 0.028) and having had foot treatment by a specialist physician (5.06, p = 0.003). Most participants (55%) wore non-protective footwear (including 21% slippers, 15% thongs/flip flops, 7% backless slippers), which was associated with older age (1.03, p < 0.001). No footwear was worn by 34% of participants (30% barefoot, 3% socks only). Those of older age (0.97, p < 0.001) and those in the most disadvantaged socioeconomic group (0.55, p = 0.019) were less likely to wear no footwear (socks or barefoot).ConclusionsOnly one in nine people in a large representative inpatient population wore a protective indoor footwear most of the time in the previous year. Whilst having education levels above year 10 and having received previous foot treatment by a specialist physician were associated with wearing protective footwear indoors, the presence of a range of other medical and foot conditions were not. These findings provide information to enable clinicians, researchers and policymakers to develop interventions aimed at improving indoor footwear habits that may help prevent significant health burdens such as falls and foot ulcers.

The influence of biological maturity on motor performance among habitually barefoot versus habitually shod adolescents

Biological maturation is associated with physiological changes which in turn affect motor performance. No study has assessed the association between growing up habitually shod versus habitually barefoot and motor performance in the context of maturation, so this approach is unique. The purpose of this study was to examine the influence of biological maturity on motor performance dependent on the participants’ footwear habits. Sixty-five German habitually shod (mean age 13.28 ± 0.83 years) and fifty-five South African habitually barefoot (mean age 13.38 ± 0.87 years) participants were included. Dynamic postural control was determined via backward balancing, explosive strength by standing long jump and sprinting performance based on a 20-m sprinting test. All tests were performed barefoot and shod. Biological maturation was calculated by using the maturity offset value. Linear mixed models were used to analyse interactions between the maturity offset value, footwear habits and motor performance. Throughout maturation, there was a significant difference between habitually barefoot and habitually shod balance performance (P = 0.001). Maturation led to balance improvements in habitually barefoot adolescents, but not in habitually shod adolescents. No such differences could be observed for standing long jump and 20-m sprint performance. Maturity offset was a significant predictor for jumping and sprinting performances (P < 0.001), independent of being habitually barefoot or habitually shod. Better performances could be observed in more mature subjects. Biological maturation seems to be a relevant predictor for motor performance characteristics for the jumping and sprinting performance in adolescents.

Motor Skills of Children and Adolescents Are Influenced by Growing up Barefoot or Shod.

Background: The objective of this study was to evaluate the association between growing up barefoot or shod and the development of motor performance during childhood and adolescence.Methods: Habitual barefoot and shod children and adolescents between 6 and 18 years were recruited in South Africa and Germany. Participants completed balance, standing long jump and 20 m sprint tests in barefoot and shod conditions. Outcomes were analyzed in separate mixed-effects linear regressions for three age groups according to stages of development (6–10, 11–14, and 15–18 years). All models were adjusted for confounders: sex, ethnicity, BMI, PAQ score and order of tests (barefoot vs. shod).Results: Three hundred and eight-five habitually barefoot and 425 habitually shod children participated. Significant age by footwear effects were found for the jump (p = 0.032) and sprint test (p = 0.041). Habitually barefoot children aged 6–10 years scored higher in the balance test (p = 0.015) and standing long jump (p = 0.005) whereas habitually shod children sprinted faster (p < 0.001). Faster sprint times were found for habitually shod participants between 11 and 14 years (p < 0.001). Habitually barefoot adolescents between 15 and 18 years of age showed a greater long jump distance (p < 0.001) but slower sprint times (p = 0.014) than shod adolescents.Conclusions: The results emphasize the importance of footwear habits for the development of motor skills during childhood and adolescence. Regular physical activities without footwear may be beneficial for the development of jumping and balance skills, especially in the age of 6 to 10 years.

Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution.

Few studies have focused on the relation between the use and characteristics of footwear and the presence of foot lesions in people with psychiatric disorders. This work analyzes the influence of different footwear habits on the presence of deformities and ungueal and dermal pathologies of the foot of institutionalized people with psychiatric disorders compared to people without these disorders. A transversal and observational study was conducted on 107 participants, divided into two groups who have used different types of shoes throughout their lives. The control group comprised 63 autonomous people who mainly use leather footwear and a study group of 44 institutionalized people with intellectual disabilities and psychiatric disorders who mainly use textile footwear. There were significant differences between populations. The group with psychiatric disorders presented more xerosis and hyperkeratosis. Footwear with inappropriate characteristics is a possible causal agent of skin alterations. Wearing footwear with quality textile uppers, e.g., fabric or felt, could influence the appearance of these alterations. Leather footwear is recommended for institutionalized people to reduce symptoms of xerosis and improve their quality of life.

Being barefoot. Prevalence at home, in school and during sport: a cross-sectional survey of 714 New Zealand secondary school boys

BackgroundIt may be assumed that a combination of culture, climate and economic resource are the major reasons that non-industrialised countries have a higher prevalence of barefoot activity. New Zealand is an industrialised country with comparable resources to that of many European countries; however, it seems to remain socially acceptable to carry out barefoot activities. A chance observation of students competing barefoot on a tartan track, prompted us to determine the prevalence of barefoot activity in an all-boys secondary school in Auckland New Zealand.MethodAn 11-question survey was administered at an Auckland boys secondary school, of high socioeconomic status, to determine the footwear habits of students (n = 714) during: a) daily life b) school life (c) physical education class and (d) sport. To classify students as habitually barefoot or shod, students were asked to select whether they were barefoot most of the time (2-points), half of the time (1-point) or none of the time (0-points) in three settings: around the house, during sport and during school. A score of ≥3 was required to be considered habitually barefoot. Participants were also asked to specify, when running at their most recent athletics event (100 m – 3000 m) on a track, whether they ran barefoot, in shoes, in spikes or another type of footwear. Finally, participants were asked to indicate if leg pain had interrupted running during the previous 12-months. Analysis was conducted using IBM SPSS.Results45% (95% CI: 41.5–49.5%) of the participants in our sample were classified as habitually barefoot. More than half of the sample reported being barefoot most of the time at home (n = 404, 56.6%) and during PE class (n = 420, 58.8%). Over 50% of the sample reported being barefoot half of the time or more during sport (n = 380, 53.2%). A smaller amount went to the supermarket (n = 140, 19.6%) or took the bus (n = 59, 8.3%) whilst barefoot around half of the time or more. The percentage of barefoot competitors declined with increasing distance: 100 m (46.5%), 200 m (41.8%), 400 m (38%), 800 m (31%), 1500 m (31%) and 3000 m (20%). The prevalence of leg pain interfering with running was 23.5%. There was no difference in the prevalence of leg pain between those classified as habitually barefoot and shod (Χ2(1, N = 603) = 0.005, p = 0.946).ConclusionThe results of this survey demonstrate that over 50% of students at an all-boys secondary school in Auckland, of high socioeconomic status, are barefoot at home, during physical education and sport half of the time or more. These results may point towards a cultural difference between New Zealand and other modern industrialised countries.

Are underground coal miners satisfied with their work boots?

Dissatisfaction with work boot design is common in the mining industry. Many underground coal miners believe their work boots contribute to the high incidence of lower limb injuries they experience. Despite this, the most recent research to examine underground coal mining work boot satisfaction was conducted over a decade ago. This present study aimed to address this gap in the literature by assessing current mining work boot satisfaction in relation to the work-related requirements for underground coal mining. 358 underground coal miners (355 men; mean age = 39.1 ± 10.7 years) completed a 54-question survey regarding their job details, work footwear habits, foot problems, lower limb and lower back pain history, and work footwear fit and comfort. Results revealed that underground coal miners were not satisfied with their current mining work boots. This was evident in the high incidence of reported foot problems (55.3%), lower back pain (44.5%), knee pain (21.5%), ankle pain (24.9%) and foot pain (42.3%). Over half of the underground coal miners surveyed believed their work boots contributed to their lower limb pain and reported their work boots were uncomfortable. Different working roles and environments resulted in differences in the incidence of foot problems, lower limb pain and comfort scores, confirming that one boot design cannot meet all the work-related requirements of underground coal mining. Further research examining the interaction of a variety of boot designs across the different underground surfaces and the different tasks miners perform is paramount to identify key boot design features that affect the way underground coal miners perform. Enhanced work boot design could improve worker comfort and productivity by reducing the high rates of reported foot problems and pain amongst underground coal miners.

Effect of work boot type on work footwear habits, lower limb pain and perceptions of work boot fit and comfort in underground coal miners

Lower limb injuries are highly prevalent in underground coal mining. Wearing gumboots with inadequate ankle support was thought to contribute to these injuries. Despite the uptake of leather lace-up boots, which provide more ankle support, no recent research could be found investigating the effect of this alternative work boot in underground coal mining. Consequently, this study aimed to determine whether boot type (gumboot, leather lace-up boot) influenced work footwear habits, foot problems, lower limb pain, lower back pain, or perceptions of work boot fit and comfort in underground coal miners. Chi-squared tests were applied to 358 surveys completed by underground coal miners to determine whether responses differed significantly (p < 0.05) according to boot-type. There were no significant between-boot differences in regards to the presence of foot problems, lower limb pain or lower back pain. However, the types of foot problems and locations of foot pain differed according to boot type. Gumboot wearers were also more likely to state that their work boot comfort was either ‘uncomfortable’ or ‘indifferent’, their work boot fit was ‘poor’ and their current boot did not provide enough support. The introduction of more structured leather lace-up boots appears to have positively influenced the support and fit provided by mining work boots, although foot problems, lower limb pain and lower back pain continue to be reported. Further investigation is recommended to identify which specific boot design features caused these observed differences in work boot fit, comfort and locations of foot pain and how these design features can be manipulated to create an underground coal mining work boot that is comfortable and reduces the high incidence of foot problems and lower limb pain suffered by underground coal miners.

A survey exploring self-reported indoor and outdoor footwear habits, foot problems and fall status in people with stroke and Parkinson's.

BackgroundIll-fitting shoes have been implicated as a risk factor for falls but research to date has focused on people with arthritis, diabetes and the general older population; little is known about people with neurological conditions. This survey for people with stroke and Parkinson’s explored people’s choice of indoor and outdoor footwear, foot problems and fall history.MethodsFollowing ethical approval, 1000 anonymous postal questionnaires were distributed to health professionals, leads of Parkinson’s UK groups and stroke clubs in the wider Southampton area, UK. These collaborators handed out survey packs to people with a confirmed diagnosis of stroke or Parkinson’s.ResultsThree hundred and sixty three completed surveys were returned (218 from people with Parkinson’s and 145 from people with stroke). Most respondents wore slippers indoors and walking shoes outdoors and considered comfort and fit the most important factors when buying footwear. Foot problems were reported by 43 % (95 % confidence intervals 36 to 52 %; stroke) and 53 % (95 % confidence interval 46 to 59 %; Parkinson’s) of respondents; over 50 % had never accessed foot care support. Fifty percent of all respondents reported falls. In comparison to non-fallers, a greater proportion of fallers reported foot problems (57 %), with greater proportions reporting problems impacting on balance and influencing choice of footwear (p < 0.01) in comparison to non-fallers in each case. Forty-seven percent of fallers with foot problems had not accessed foot care support.ConclusionsMany people with stroke and Parkinson’s wear slippers indoors. A high percentage of these individuals reported both foot problems and falls impacting on footwear habits and choice of footwear; however many did not receive foot care support. These findings highlight that further exploration of footwear and foot problems in these populations is warranted to provide evidence based advice on safe and appropriate footwear to support rehabilitation and fall prevention.Electronic supplementary materialThe online version of this article (doi:10.1186/s13047-016-0170-5) contains supplementary material, which is available to authorized users.

Clinical profile and management outcome of diabetic foot ulcers in a tertiary care hospital in Haryana

Background: Diabetic foot ulcers are predisposing factor in 85% of lower limb amputations. This study was done to evaluate risk factors for the development of diabetes and associated foot problems in the rural area of Khanpur Kalan and adjoining villages of Haryana to educate the rural population for the promotion of healthy foot care and footwear habits. Objective: The aim of this study was to determine major risk factors and management outcome of diabetic foot ulcers to prevent amputation. Methods: This study was conducted in the Department of Plastic Surgery, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonepat, from December 2013 to November 2015 in 64 patients who reported in our outpatient department and emergency. Results: Sixty-four patients with type 2 diabetes mellitus were enrolled in the current study with different stages of diabetic foot presentations. They underwent different methods of surgical management: debridement, amputations, and skin grafting giving good and fast results. Eight patients underwent below-knee amputations, and six were subjected to forefoot amputation. Ten great toe amputations were performed. Two finger amputations were performed. Conclusion: Early diagnosis and management of diabetic foot ulcers can improve patient outcomes and reduce health-care costs.

The effects of being habitually barefoot on foot mechanics and motor performance in children and adolescents aged 6-18 years: study protocol for a multicenter cross-sectional study (Barefoot LIFE project).

BackgroundBarefoot locomotion has evoked an increasing scientific interest with a controversial debate about benefits and limitations of barefoot and simulated barefoot walking and running. While most current knowledge comes from cross sectional laboratory studies, the evolutionary perspective suggests the importance of investigating the long-term effects. Observing habitually barefoot populations could fill the current gap of missing high quality longitudinal studies. Therefore, the study described in this design paper aims to investigate the effects of being habitually barefoot on foot mechanics and motor performance of children and adolescents.MethodsThis study has a cross-sectional, binational design and is part of the “Barefoot Locomotion for Individual Foot- and health Enhancement (Barefoot LIFE)” project. Two large cohorts (n(total) = 520) of healthy children and adolescents between 6 and 18 years of age will be included respectively in Germany and South Africa. A barefoot questionnaire will be used to determine habitually barefoot individuals. The testing will be school-based and include foot mechanical (static arch height index, dynamic arch index, foot pliability) and motor performance (coordination, speed, leg power) outcomes. Gender, BMI and level of physical activity will be considered for confounding.DiscussionThe strength of this study is the comparison of two large cohorts with different footwear habits to determine long-term effects of being habitually barefoot on foot mechanics and motor performance.Electronic supplementary materialThe online version of this article (doi:10.1186/s13047-016-0166-1) contains supplementary material, which is available to authorized users.

Pathological variations in mummified feet between two near-distance/long-time populations in Ancient Egypt.

BackgroundIn ancient populations, a significant quantity of foot pathology was related either to the type of footwear they used or the underlying terrain they walked on. Our study was carried out to analyze these parameters with the foot pathologies the mummies presented.MethodsBetween 2006 and 2012, more than 650 individuals were recovered from the Sharuna and Qarara necropolis (Middle Egypt) dating from the VIth Dynasty of the first Ptolemaic Period to the second Coptic Period. From among them, a total of 73 mummified feet (41 from Sharuna and 32 from Qarara) were studied. We took into account the differences existing between both sites in location (15 km apart) and in time (2500 years apart).ResultsAlmost all feet from Sharuna were wrapped and impregnated with a preservative substance (anthropological mummification), while the mummification process in Qarara was quite natural. Pathologies were found in 36 of the 73 ft (20 from Sharuna and 16 from Qarara). The differences in foot pathologies between the two sites were analysed.ConclusionsThe foot pathologies we found in both necropolises have led us to hypothesise that the majority of the diachronic differences could be related more to progressive changes in the type of the terrain brought out through droughts, than the changes in footwear habits.

Footwear habits and general health in middle‐aged women: a retrospective ten year study

Background Success of footwear as a modifiable intervention is complex and various qualitative studies have revealed that for women in particular shoes form an important part of clothing, self-identity and self-esteem. Whilst it is accepted that heel height may be an important differentiating characteristic of shoes that affect biomechanical function there is very little epidemiological longitudinal data that investigates other factors such as health and well-being. The objective of this study was to describe the footwear habits and relationship of this to general health in middle-aged women over a 10-year period.