‘Barefoot shoes’ may relieve knee arthritis
By Lynda Williams, Senior medwireNews Reporter
11 April 2013
Arthritis Rheum 2013; Advance online publication

medwireNews: Shoes designed to mimic barefoot movement of the feet may be able to adjust gait in patients with knee osteoarthritis and reduce pain, preliminary research suggests.

Six months of wearing the flexible lightweight shoes, designed with grooves in the major foot flexion points, led to a decrease in knee loading even when patients returned to using regular shoes.

This suggests that the "non-custom footwear functioned as a biomechanical training device to beneficially alter gait mechanics," say Najia Shakoor and co-authors, from Rush Medical College in Chicago, Illinois, USA.

The pilot study assessed the impact of mobility shoes on knee loading in 16 patients, aged an average of 57 years, with radiographic grade 2 or 3 medial compartment knee osteoarthritis. The patients underwent gait assessment in normal shoes, in bare feet, and in mobility shoes at baseline and again at 6 months after wearing mobility shoes for at least 6 hours a day for 6 days a week.

Four patients dropped out within 12 weeks of the study. Intent to treat analysis showed an 18% decrease in knee adduction moment (KAM) from baseline measurements taken in the patients' own shoes after 24 weeks of wearing the mobility shoes, but no significant difference in KAM between wearing mobility shoes and barefoot walking.

The patients also showed an 11% reduction in baseline KAM when wearing regular shoes at 24 weeks, and a 10% reduction when barefoot.

Furthermore, Western Ontario and McMaster Universities Arthritis Index scores showed a significant improvement over the study for the affected knee, from 225 mm at baseline to 175 mm at 6 weeks, 163 mm at 12 weeks, and 144 mm at 24 weeks, giving an overall significant 36% reduction.

The patients also reported improvements in pain in the opposite knee, hips, and ankles but these changes did not reach significance.

Shakoor et al say that the shoes were well tolerated, with patients wearing the shoes for an average of 7 hours per day and four patients were given arch or neutral inserts. Gait appeared to shorten and cadence increased in the patients while using mobility shoes compared with regular footwear.

Writing in Arthritis and Rheumatism, the team acknowledges the study is small and lacks a control group.

"This trial was not intended to provide definitive or generalizable treatment recommendations, but rather as a 'proof of principle' study to provide evidence that this noninvasive intervention could have beneficial biomechanical effects and to foster future studies," they emphasize.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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