Poster Presentation Australian Podiatry Conference 2019

Effects of a footwear intervention on foot pain and disability in people with gout a randomised controlled trial (#106)

Mike Frecklington 1 , Nicola Dalbeth 2 3 , Peter McNair 1 , Trish Morpeth 1 , Alain C Vandal 4 5 , Peter Gow 6 , Keith Rome 1
  1. Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand
  2. Department of Medicine, University of Auckland, Auckland, New Zealand
  3. Auckland District Health Board, Auckland, New Zealand
  4. Department of Biostatistics & Epidemiology, AUT University, Auckland, New Zealand
  5. Research & Evaluation Office, Ko Awatea, Counties Manukau Health, Auckland, New Zealand
  6. Counties Manukau District Health Board, Auckland, New Zealand

Background

The evidence supporting the long-term effect of a foot care package that includes footwear for people with gout is limited. The aim of this study was to investigate the effectiveness of a footwear intervention on foot pain and disability in people with gout.

Methods

Participants with gout (n=94) were randomly allocated to either a control group (podiatric care and gout education) or footwear intervention group (podiatric care and gout education plus a commercially available athletic shoe). Measurements were undertaken at baseline, two, four and six months. Primary outcome was foot pain. Secondary outcomes were overall pain, foot impairment/disability, footwear comfort, fit, ease and weight. Data were analysed using repeated measures models.

Results

Baseline foot pain scores were low, and no differences in foot pain scores were observed between groups. Improvements in overall pain scores (adjusted effect estimate: -13.2, 95% CI -22.2 to -4.3, P<0.01), and foot impairment/disability scores (-4.7, 95% CI -9.1 to -0.3, P=0.04) favouring the footwear intervention group were observed at two months, but not at four or six months. Improvements between groups in footwear fit (adjusted effect estimate: -11.1, 95% CI -21.1 to -1.0, P=0.03), ease (-13.2, 95% CI -23.8 to -2.7, P=0.01) and weight (-10.3, 95% CI -19.8 to -0.8, P=0.03) favouring the footwear intervention were observed over six months. Similar improvements were observed for footwear comfort at two and four months. 

Discussion and clinical relevance

Addition of footwear to a foot care package did not improve foot pain in people with gout. Short-term improvements in overall pain and foot impairment/disability, and more durable improvements in footwear comfort and fit were observed with the footwear intervention.