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

Footwear characteristics and foot problems in community dwelling people with stroke: a cross-sectional observational study

PURPOSE

To explore footwear characteristics and foot problems in community dwelling people with stroke as most research to date focused on the general elderly population.

METHODS

Thirty people with mild to moderate stroke (nine men, mean age 68, mean time since onset 67 months) attended a single session to assess footwear and foot problems using established podiatry foot (wear) and ankle assessments.

RESULTS

Most participants wore slippers indoors (n = 17, 57%) and walking shoes outdoors (n = 11, 37%). Over half wore unsupportive ill-fitting shoes indoors and 47% of outdoor shoes fitted badly. All participants had foot problems (mean 6.5 (3.1), 95% CI: 5.4-7.7), including impaired single limb heel raise (93%), reduced range of movement (77%), sensation (47%), and muscle strength (43%). Many had foot-pain, hallux valgus (both 50%), or swollen feet (40%). Foot problems were associated with reduced balance confidence, activity, and community participation (all p < 0.05). A greater proportion of fallers (13/16) than non-fallers (4/14) reported foot problems (p = 0.029).

CONCLUSIONS

Many community-dwelling people with stroke wore poorly fitting shoes; all had foot problems. Foot problems were linked to reduced mobility. Finding more effective pathways to support people with stroke to select supportive, well-fitting indoor and outdoor footwear is indicated.Implications for rehabilitationPeople with stroke often wear unsupportive ill-fitting shoes and experience foot problems.Assessment of foot problems and footwear advice should be considered during stroke rehabilitation particularly when interventions target fall prevention or improvements in balance and mobility.Information on appropriate footwear and signposting that new shoe purchases should include measuring feet to ensure a good fit is recommended.

Repeatability and reliability of the footwear assessment tool in Spanish patients: A transcultural adaptation

BACKGROUND

The footwear assessment tool was designed to advise an appropriate footwear for each situation and patient. Footwear alterations structures can influence in musculoskeletal disorders, developing foot ulcers, increase the peak plantar pressure, bacterial growth, low back pain.

METHODS

To validate the study 101 subjects were recruited. The study was tested by two expert podiatrists using the tool for the assessment of footwear characteristics that is composed by five domains, fit, general features, general structure, motion control properties and cushioning system. Each domain analyzes different shoe items.

RESULTS

An excellent agreement between the test-retest. A suitable Cronbach's α was suggested for the five domains of fit (α = 0.952), general features (α = 0.953), general structure (α = 0.947), motion control properties (α = 0.951), and cushioning system (α = 0.951). Test-retest reliability was excellent for all domains. There were no significant differences between any domain (p > 0.05). There was only statistically significant difference in the item forefoot height (p = 0.011). For all the domains items there were no statistically significant difference (p > 0.05).

CONCLUSIONS

The tool for the assessment European footwear is a suitable repeatability and reliability footwear tool that can be used in Spanish language subjects.

Users' needs and expectations and the design of a new custom-made indoor footwear solution for people with diabetes at risk of foot ulceration

PURPOSE

To assess users' needs and expectations regarding custom-made indoor footwear, and to design such footwear with similar biomechanical efficacy and better usability compared to regular custom-made footwear in people with diabetes at risk for foot ulceration.

MATERIALS AND METHODS

Multidisciplinary systematic design approach. Needs and expectations regarding indoor footwear were evaluated via a questionnaire in 50 high foot ulcer risk people with diabetes using custom-made footwear. We systematically designed indoor footwear, and manufactured this for nine participants. Primary requirement was similar plantar pressure compared to participants' regular custom-made footwear.

RESULTS

Eighty-two percent of participants expressed a need for custom-made indoor footwear and 66% expected such footwear to increase their adherence. The custom-made indoor footwear had the same bottom construction as participants' regular custom-made footwear, but with softer and more light-weight upper materials. Peak pressures were similar or lower, while qualitative evaluation showed better usability and lower costs for indoor footwear.

CONCLUSIONS

People with diabetes at risk of foot ulceration expressed a clear need for custom-made indoor footwear, and expected such footwear to increase their adherence. Our indoor footwear design provides adequate pressure relief, with better usability, and can be produced at lower costs compared to regular custom-made footwear.Implications for rehabilitationPeople with diabetes at risk of foot ulceration express a need for special indoor footwear.We developed indoor footwear with similar offloading capacity as regular custom-made footwear.The indoor footwear is lighter in weight, easier to don/doff and lower in costs.At-risk people with diabetes expect this footwear to increase their footwear adherence.

Effects of Balance Shoes on Balance and Postural Stability in the Elderly: A Crossover, Controlled, Randomized Single-Blind Study

The risk of falling increases with age. Individuals wearing unadapted shoes present an aggravating risk factor. The objective of this study was to determine the effectiveness of specifically designed balance shoes on balance and postural stability in healthy elderly people compared to that of their usual shoes. In total, 21 healthy individuals aged 65–84 years (76.0 ± 8.0 years) performed balance tests (bipedal with open or closed eyes, unipedal with open eyes, limits of stability, and step cadence) while wearing their (i) personal shoes or (ii) balance shoes (Axis Comfort Development©). Three test sessions were conducted with personal and balance shoes. The first served as the baseline, and the other two were performed after a familiarization period of several days with the personal or balance shoes. The perception of balance shoe efficiency was documented using a questionnaire. The balance shoes significantly improved bipedal balance with closed eyes. Moreover, the familiarization period significantly improved unipedal balance with open eyes. Most subjects felt safer and stabler using balance shoes. The investigated specifically designed balance shoes were effective in elderly individuals in improving postural balance compared to personal shoes. The balance shoes could, therefore, reduce the falling risk in healthy elderly people.