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Shoe inserts alter plantar loading and function in patients with midfoot arthritis
Smita Rao1, Judith F Baumhauer, Laura Becica
1Center for Foot and Ankle Research, Department of Physical, Ithaca College-Rochester Center, Rhochester, NY, USA. smita.rao@nyu.edu
Summary
A 4-week intervention using a full-length (FL) insert improved functional outcomes and reduced plantar loading in patients with midfoot arthritis. This suggests the FL insert is a viable alternative for conservative management.
Area of Science:
- Orthopedics
- Biomechanics
- Podiatry
Background:
- Midfoot arthritis often presents with pain and low-arched foot alignment, leading to the recommendation of arch-restoring orthotics like the three-quarter-length (3Q) insert.
- Despite the use of 3Q inserts, many patients continue to experience foot pain.
- The efficacy of a full-length (FL) carbon graphite insert as an alternative has not been well-documented.
Purpose of the Study:
- To evaluate the impact of a 4-week full-length (FL) insert intervention on functional outcomes in patients with midfoot arthritis.
- To compare the effects of custom-molded three-quarter-length (3Q) and full-length (FL) carbon graphite inserts on plantar loading during walking in patients with midfoot arthritis.
Main Methods:
- An experimental laboratory study with a case series design involving 20 female patients diagnosed with midfoot arthritis.
- Functional outcomes were measured using the Foot Function Index-Revised (FFI-R).
- Plantar loading during walking was assessed with a shoe only, shoe with 3Q insert, and shoe with FL insert, analyzed using repeated-measures analyses of variance.
Main Results:
- A 4-week intervention with the FL insert led to a 12% improvement in the total FFI-R score (P = .03).
- Compared to the 3Q insert, the FL insert significantly reduced medial midfoot average pressure loading by 20% (P = .015) and decreased medial midfoot contact time by 8.5% (P < .01).
- No significant differences in plantar loading were observed between the shoe-only condition and the FL insert condition.
Conclusions:
- Symptomatic improvements in patients with midfoot arthritis treated with the FL insert were associated with reduced magnitude and duration of medial midfoot loading.
- These findings indicate that the FL insert may serve as a beneficial alternative for the conservative management of midfoot arthritis.
- Further research could explore long-term effects and patient adherence.
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