Footwear characteristics in people with inflammatory arthritis in Singapore

Abstract

BackgroundFoot problems are common in people with inflammatory arthritis. Despite suitable footwear having the potential to alleviate pain, improve mobility and maintain independence, previous studies have found many people with inflammatory arthritis wearing poorly fitting and inappropriate footwear. Footwear styles and characteristics have not been reported in a Singapore inflammatory arthritis population. The objective of this study was to identify current footwear styles and characteristics of footwear worn by people with inflammatory arthritis in Singapore.MethodsOne-hundred-and-one participants with inflammatory arthritis were recruited from the rheumatology outpatient clinic of a large public hospital in Singapore. Disease and clinical characteristics were recorded. A patient-reported outcome included current foot pain. An objective footwear assessment of style, age of shoe, fit and construction was conducted.ResultsThe majority of participants were Chinese women with a mean (SD) age was 52.0 (15.0) years old and a mean (SD) disease duration of 9.3 (0.3) years. We found 50 % of participants (n = 51) reported footwear problems. Sandals (n = 27, 26 %), flip-flops (n = 19, 19 %) and moccasin type (n = 19, 19 %) was the most common footwear choice. Evaluation of footwear characteristics found that there was a lack of motion control features. Only 32 (32 %) participants had correctly fitting footwear with regard to length, width and depth. No participant was wearing therapeutic footwear.ConclusionThis study provides the first insight into footwear preferences of people with inflammatory arthritis in Singapore. Use of slip-on and poorly fitting footwear was found to be common in people with inflammatory arthritis. Further research on footwear preferences in Southeast-Asian communities needs to take into account cultural habit and preference, socio-economic status, footwear options and affordability.

Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature

“…Incorrect sized footwear defined as difference between foot and footwear greater than half a standard British shoe (7 mm) for length or one size for width. • 32 (49.2%) participants wore footwear that was too long • 3 (4.6%) were wearing footwear that was too short • 21 (32%) were wearing footwear that was too wide • 2 (3%) were wearing footwear that was too narrow • 47 (72%) of participants wore footwear that was incorrectly fitting based on either width or length • 42 (65%) of participants wore footwear that was too big (too long, too wide or both) • 4 (6%) or participants wore footwear that was too small (too short, too narrow or both) • Incorrect shoe length was significantly associated with increased ulceration • Foot pain was significantly associated with incorrect footwear length Carter et al [ 26 ] 101 participants, 51 men, 51 women, mean age: 52 ± 14.5 yrs. All participants diagnosed with inflammatory arthritis.…”

“…However, there were five studies that reported the number of participants that were wearing incorrectly fitted shoes based on more than one variable [ 15 , 18 , 26 , 27 , 29 ]. Four studies reported that between 63 and 72% of participants were wearing incorrectly fitted shoes based on length and width [ 18 , 29 ], while one study reported that 68% of participants wore incorrectly fitted shoes based on three measures (length, width and depth) [ 26 ]. One study compared total foot and shoe area to determine footwear fit, finding that the total area of the footwear was smaller than total area of the foot in 47% of participants [ 20 ].…”

“…In terms of width, between 30 [ 32 ] and 88% [ 23 ] (median 58% [ 27 ]) of participants wore footwear that were too narrow and one study found that only 1% of participants wore footwear that was too wide [ 28 ]. One study examined depth, finding that 31% of participants wore footwear that was too shallow [ 26 ].…”

Independent factors associated with wearing different types of outdoor footwear in a representative inpatient population: a cross‐sectional study

“…This was followed by thongs/flip flops, walking shoes, sandals and boots. Previous studies have also found running shoes, thongs/flip flops, walking shoes and sandals to be popular footwear amongst specific pathological populations including those with arthritis [ 17 – 19 , 36 ], diabetes [ 22 ], and those at risk of falls [ 37 ]. Although comparison with these condition-specific studies is challenging due to the differing conditions, geographical locations and methods used to categorise footwear type, taken together it does appear that running shoes, thongs/flip flops, walking shoes and sandals are popular outdoor footwear in diverse populations.…”

Special theme article: science and sociology of footwear

“…As such, this issue emphasises the complexities associated with the interrelationship between footwear, feet and the person wearing it. This themed issue provides the reader with information on footwear problems in people with inflammatory arthritis [ 5 ], lupus [ 6 ] diabetes [ 7 ] and neuromuscular conditions that include stroke and Parkinson [ 8 ]. The direct effect of pathological process and the resultant changes in the feet mean that people with long term foot conditions experience high levels of foot pain, impairment and disability.…”