The Effects of Commercially Available Footwear On Foot Pain and Disability in People With Gout: A Feasibility Study

Keith Rome¹, Sarah Stewart², Alain Vandal^3,4, Peter J. Gow⁵, Peter J. McNair² and Nicola Dalbeth⁶, ¹Health & Rehabilitation Research Institute, Auckland, New Zealand, AUT University, Auckland, New Zealand, ²Health & Rehabilitation Research Institute, AUT University, Auckland, New Zealand, ³Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand, ⁴Counties Manukau District Health Board, Auckland, New Zealand, ⁵Rheumatology Dept, Middlemore Hospital, Auckland, New Zealand, ⁶Medicine, University of Auckland, Auckland, New Zealand

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Disability, foot care, foot wear, gout and pain

Session Information

Title: ARHP Orthopedics, Low Back Pain and Rehabilitation: Rehabilitation Sciences

Session Type: Abstract Submissions (ARHP)

Background/Purpose: The non-pharmacological management goals for people with foot-related rheumatic diseases are pain management, preservation of foot function and patient mobility. One of the therapeutic components that may achieve these goals is footwear. To date, no clinical trials have examined the impact of footwear as an intervention for people with gout. The aim of this study was, first, to determine the factors that are important to people with gout in their choice of walking shoes, and thereafter to determine whether those chosen shoes could reduce foot pain and musculoskeletal disability in people with gout over 8 weeks.

Methods: Thirty-six people with gout participated in a randomised, single-blind, crossover trial, followed by an 8-week prospective observational study. Four walking shoes were included into the trial based upon cost and footwear characteristics (Helix Viper, Dunlop Apollo, Dunlop Asteroid, ASICS Cardio Zip). Perceived comfort and footwear acceptability were determined for each shoe; participants selected a shoe for the observational study. The primary outcome of the crossover trial was perceived comfort of the footwear. The primary endpoint of the observational study was foot pain visual analogue scale.

Results: The Cardio Zip shoe was selected by 21/36 (58%) participants. The Cardio Zip was reported as comfortable by 81% and well-fitting by 62% participants (p=0.004 and 0.03 compared with other shoes respectively). Compared with baseline, scores at 8-weeks decreased in foot pain (p=0.03), general pain (p=0.012), Health Assessment Questionnaire (HAQ)-II (p=0.016) and Leeds Foot Impact Scale (LFIS) impairment subscale (p=0.03). No significant differences were observed in other patient reported outcomes including patient global assessment , LFIS activity subscale, and Lower Limb Task Questionnaire subscales (all p>0.10). We observed significant differences between participants’ own shoes and the Cardio Zip for foot pain (p=0.002), general pain (p=0.001), HAQ-II (p=0.002) and LFIS impairment subscale (p=0.004) after 8 weeks. The other three shoes did not improve pain or disability.

Conclusion: Footwear with good cushioning, motion control and adequate width may reduce foot pain and disability in people with gout.

Disclosure:

K. Rome,
None;

S. Stewart,
None;

A. Vandal,
None;

P. J. Gow,
None;

P. J. McNair,
None;

N. Dalbeth,
None.

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