Dalbeth, Nicola

Rome, Keith

Silvester, Renee N

Williams, Anita E

English

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Renee N Silvester

Anita E Williams

Nicola Dalbeth

Keith Rome

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Choosing shoes: a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid arthritis patients

Dalbeth Nicola

Williams Anita E

Silvester Renee N

Rome Keith

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Journal of Foot and Ankle Research

ORAL PRESENTATION Open Access
Choosing shoes: a preliminary study into the
challenges facing clinicians in assessing footwear
for rheumatoid arthritis patients
Renee N Silvester1*, Anita E Williams2, Nicola Dalbeth3,4, Keith Rome1
From Australasian Podiatry Council Conference 2011
Melbourne, Australia. 26-29 April 2011
Background
Footwear has been accepted as a therapeutic interven-
tion for the foot affected by rheumatoid arthritis (RA).
Evidence relating to the objective assessment of foot-
wear in patients with RA is limited. The aims of this
study were to identify current footwear styles, footwear
characteristics, and factors that influence footwear
choice experienced by patients with RA.
Methods
Eighty patients with RA were recruited from rheumatol-
ogy clinics during the summer months from clinics
based in Auckland, New Zealand. Clinical characteristics
of RA, global function, and foot impairment and disabil-
ity measures were recorded. Current footwear, footwear
characteristics and the factors associated with choice of
footwear were identified. Suitability of footwear was
recorded using pre-determined criteria for assessing
footwear type, based on a previous study of foot pain.
Results
The patients had longstanding RA with moderate-to
severe disability and impairment. The foot and ankle
assessment demonstrated a low-arch profile with both
forefoot and rearfoot structural deformities. Over 50% of
shoes worn by patients were open-type footwear. More
than 70% of patients’ footwear was defined as being
poor. Poor footwear characteristics such as heel rigidity
and sole hardness were observed. Patients reported
comfort (17%) and fit (14%) as important factors in
choosing their own footwear. Only five percent (5%) of
patients wore therapeutic footwear.
Conclusions
The study found that moderate impairment and limited
activity scores, consistent with significant foot disability.
Forefoot structural deformities were high, suggesting that
patients have problems in finding good footwear that
accommodates structural changes in the forefoot and les-
ser extent in the rearfoot. Difficulties in finding appropri-
ate footwear due to forefoot structural deformities and the
consequence wearing of inappropriate footwear can be a
major contributing factor to foot impairment. The study
also demonstrated that although fit and comfort were per-
ceived by patients to be important factors in choosing
footwear, current footwear choices are frequently inap-
propriate. Choices regarding footwear may reflect the diffi-
culties patients with RA experience when obtaining
footwear that meets their needs. This work has highlighted
the need for good footwear and the need to improve both
patient and practitioner knowledge of footwear.
Author details
1Health & Rehabilitation Research Institute, AUT University, Auckland, 0627,
New Zealand. 2Directorate of Prosthetics, Orthotics and Podiatry, University
of Salford, Salford, M6 6PU, UK. 3Auckland District Health Board, Auckland,
1051, New Zealand. 4University of Auckland, Auckland, 1010, New Zealand.
Published: 20 May 2011
doi:10.1186/1757-1146-4-S1-O43
Cite this article as: Silvester et al.: Choosing shoes: a preliminary study
into the challenges facing clinicians in assessing footwear for
rheumatoid arthritis patients. Journal of Foot and Ankle Research 2011
4(Suppl 1):O43.
* Correspondence: kww1832@aut.ac.nz
1Health & Rehabilitation Research Institute, AUT University, Auckland, 0627,
New Zealand
Full list of author information is available at the end of the article
Silvester et al. Journal of Foot and Ankle Research 2011, 4(Suppl 1):O43
http://www.jfootankleres.com/content/4/S1/O43
JOURNAL OF FOOT
AND ANKLE RESEARCH
© 2011 Silvester et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


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Choosing shoes: a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid arthritis patients

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