Influence of unstable shoes on women with lumbopelvic postpartum pain: randomized clinical trial

Abstract

BACKGROUND: Back pain is a normal symptom during pregnancy and is expected to become worse beyond the first three months after childbirth. OBJECTIVES: To determine the effectiveness of wearing unstable shoes instead of conventional shoes, regarding pain intensity, low back mobility and stability, among women with lumbopelvic pain (LPP) during the postpartum period. DESIGN AND SETTING: Prospective, single-blinded, randomized clinical trial conducted at a podiatry and physiotherapy clinical center. METHODS: A nine-week program of wearing either unstable shoes (A) or conventional shoes (B) was implemented. The following outcomes were measured in three assessments: pain intensity, using a visual analogue scale (VAS); low-back mobility, using a modified Schober test; and stability, using a pressure platform. RESULTS: The lateral stability speed, anterior stability speed and anterior center of pressure (COP) showed significant (P < 0.05) decreases in the unstable shoes group after nine weeks, in relation to the conventional group. Intra-group measurements showed significant differences (P < 0.05) in VAS between the second and third assessments and between the first and third assessments in both groups. Intra-group evaluations also showed statistically significant differences (P < 0.05) in the lateral stability speed and anterior stability speed. CONCLUSIONS: Unstable shoes were effective in decreasing the pain intensity at five and nine weeks in women with postpartum LPP. In addition, their use produced decreases in lateral stability speed, anterior stability speed and anterior COP at nine weeks.

Assessing the Influence of Unstable Footwear on Lower Limb Lymphedema

“…This phenomenon aligns with the findings of Yamamoto et al,20 who reported enhanced venous return to the leg through the use of heel-less shoes during walking at 80 m/min. This enhancement was attributed to increased recruitment of slow muscle fibers like the soleus muscle, paralleling the findings of our study wherein the unstable sole shoe activation prompted similar muscle activation 10. Unstable footwear has also been investigated in other contexts, such as addressing back pain 21…”

“…This enhancement was attributed to increased recruitment of slow muscle fibers like the soleus muscle, paralleling the findings of our study wherein the unstable sole shoe activation prompted similar muscle activation. 10 Unstable footwear has also been investigated in other contexts, such as addressing back pain. 21 A systematic review in 2020 compared the influence of different footwear on the lower limb venous system, concluding that unstable shoes exhibited improved venous return parameters in contrast to regular footwear.…”

“…The instability activates muscles while standing, leading to increased muscle strength and a training effect in the lower limbs. 10,11 This muscle activation and strengthening may enhance lymph transport mechanisms, potentially reducing joint load during walking and alleviating associated lower limb pain. 12 Despite the potential advantages of these shoes for individuals with lower limb lymphedema, there is currently a lack of studies examining their specific impact on this patient population.…”

“…Unstable sole shoes, featuring an anteroposteriorly rounded sole that creates an unstable base, offer unique benefits. The instability activates muscles while standing, leading to increased muscle strength and a training effect in the lower limbs 10,11. This muscle activation and strengthening may enhance lymph transport mechanisms, potentially reducing joint load during walking and alleviating associated lower limb pain 12…”