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Effectiveness of Shoe Stiffening Inserts for First Metatarsophalangeal Joint Osteoarthritis: A Proof-of-Concept Study

Jerilyn, Tan X. BHlthSc, MPodPrac(Hons); Menz, Hylton B. PhD; Murley, George S. PhD; Munteanu, Shannon E. PhD

American Journal of Physical Medicine & Rehabilitation: February 2016 - Volume 95 - Issue 2 - p 103–111
doi: 10.1097/PHM.0000000000000350
Original Research Articles

Objective The objective of this study was to determine the feasibility of shoe stiffening inserts to reduce pain in first metatarsophalangeal joint osteoarthritis.

Design Thirty-one participants with first metatarsophalangeal joint osteoarthritis were prescribed shoe stiffening inserts and were evaluated at baseline and at 1 and 3 mos. The primary outcome measure was foot pain, assessed using the foot pain domain of the Foot Health Status Questionnaire (possible score ranges from 0 to 100). Secondary outcome measures included foot-related disability (foot function domain of the Foot Health Status Questionnaire), self-reported treatment effectiveness, use of rescue medication and other co-interventions, and adverse events.

Results At 1 and 3 mos, statistically significant improvements in foot pain and foot-related disability were observed (mean difference at 3 mos: foot pain = 18.8, 95% confidence interval, 13.3–24.3; foot function = 11.8, 95% confidence interval, 4.3–17.3). Treatment was reported to be effective by 78% of participants. Few participants (4%) reported using pain-relieving medication. Minor adverse events were reported by 30% of participants.

Conclusions Full-length shoe stiffening inserts may be an effective intervention in first metatarsophalangeal joint osteoarthritis. However, further controlled studies are required.

From the Discipline of Podiatry, School of Allied Health (TXJ, HBM, GSM, SEM), and Lower Extremity and Gait Studies Program, School of Allied Health (HBM, GSM, SEM), La Trobe University, Bundoora, Victoria, Australia; and Department of Podiatry, Singapore General Hospital, Singapore (TXJ).

All correspondence and requests for reprints should be addressed to: Shannon E. Munteanu, PhD, Discipline of Podiatry, School of Allied Health, La Trobe University, Bundoora, Victoria 3086, Australia.

This study was funded by La Trobe University School of Allied Health. Prof Hylton Menz is currently a National Health and Medical Research Council Senior Research Fellow (ID: 1020925). The study sponsors had no involvement in the study design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.