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Footwear Intervention Fails to Improve Gout Foot Pain
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The addition of athletic footwear to podiatric care and education failed to improve foot pain in patients with gout, despite short-term improvements in overall pain and impairment, according to recent findings in Arthritis Research & Therapy.
“Regular podiatric care is associated with a reduction in foot pain and disability in people with inflammatory arthritis, including those with gout,” Mike Frecklington, MPhil, BHSc, of the Auckland University of Technology, New Zealand, and colleagues wrote. “Prescribing footwear may be part of a foot care package for people with arthritis affecting the foot and ankle. For example, footwear interventions can improve foot pain and function in people with rheumatoid arthritis and foot osteoarthritis. In rheumatoid arthritis, footwear interventions can also improve plantar pressure measurements and walking speed.”
“Currently, the evidence supporting the long-term effect of a foot care package that includes footwear for people with gout is limited,” the researchers added.
To analyze the effectiveness of a footwear intervention on foot pain and disability in patients with gout, Frecklington and colleagues conducted a 6-month, two-arm, parallel randomized controlled trial. They recruited 94 patients with gout from public hospital rheumatology clinics, as well as through newspaper advertising between October 2014 and June 2016. Participants were randomly assigned to either the control group, where they received podiatric care and gout education, or the intervention group, which received podiatric care, gout intervention and a commercially available pair of athletic shoes.
Podiatric treatment received by participants in both groups included palliative nail and skin care, temporary padding, wound care and emollient use, as well as advice on foot care and footwear, given by an experienced podiatrist. Gout education included a pamphlet produced by the New Zealand Ministry of Health. The athletic shoe given to patients in the intervention group was the ASICS Cardio Zip 3, to be worn during daily activities. The shoe, chosen based on previous study findings, features heel and forefoot cushioning, a dual density midsole, a wide-fitting option and a zip for ease of fit. All fittings were performed by a podiatrist.
The researchers recorded measurements at baseline, 2 months, 4 months and 6 months. The primary outcome was foot pain severity, and secondary outcomes included overall pain, foot impairment and disability, footwear comfort, fit, ease and weight.
According to the researchers, no differences in foot pain scores were observed between the groups though 6 months (adjusted effect estimate = –6.7; 95% CI, –16.4 to 2.9). Improvements were noted among intervention patients in overall pain (–13.2; 95% CI, –22.2 to –4.3) and foot impairment and disability (–4.7; 95% CI, –9.1 to –0.3) at 2 months. However, these improvements disappeared at 4 and 6 months. Patients in the intervention group demonstrated improvements in footwear fit (–11.1; 95% CI, –21.1 to –1), ease (–13.2; 95% CI, –23.8 to –2.7) and weight (–10.3; 95% CI, –19.8 to –0.8) throughout 6 months.
“The footwear intervention did not significantly improve foot pain in people without high baseline levels of foot pain,” Frecklington and colleagues wrote. “However, 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.” – by Jason Laday
Disclosures: Frecklington reports no relevant financial disclosures. Please see the full study for additional authors’ disclosures.
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