FOOTWEAR CHOICES FOR PAINFUL FEET
the footwear chosen. This appears to be more
prevalent amongst women who wear longer
shoes than necessary to accommodate width or
depth changes [10, 12, 20].
Footwear advice and prescription shoes,
given as part of relevant rehabilitation related
treatments, are often disregarded by individuals
because of what the shoes look like [21]. The
restricted choice of therapeutic and functional
footwear has been linked to exclusion from
activities, self-consciousness and vulnerability as
well as lower self-esteem in individuals who are
advised to utilize them as part of rehabilitation
[22]. It has been proposed that women have
an emotional relationship with their shoes [23]
influenced initially by fashion and the need for
personal identity before any considerations
of pain and pathology. However, there are a
number of other factors that affect purchase
decisions and choices of foot-wear. Comfort and
fit were the most important factors in the choice
of shoes of an rheumatoid arthritis population
[24] and footwear choices made by young
women are often made related to the activity
being undertaken [16].
Given that the number of shoe characteristics
such as a narrow toe box [12] have previously
been associated with pathology, it is essential to
understand the reasoning behind the purchase
decisions of a population with foot pain to then
enable an effective rehabilitation intervention
to be agreed. Therefore, the primary aim of
this study was to establish which style of shoe
were chosen by a female population who have
independently sought podiatry treatment for
foot pain, additionally identifying what factors
influenced these footwear choices.
METHODS
Following Staffordshire University ethical
approval, a sample was drawn from female
patients who attend a private podiatric clinic
in Cambridge UK, for routine podiatry care.
Sixty-seven women were recruited during a
4-month summer time-period and informed
consent was gained form all the participants.
The inclusion of the women that were recruited
were participants over 40 with a history of
podiatric treatment for greater than 6 months.
An observational study design was implemented
to explore the choices made for footwear
purchases as well as wearing habits. In addition
to demographic and anthropometric data
around foot pain and pathology.
DATA COLLECTION
A 4-point demographic questionnaire was
used to gain foot shoe sizing measurements
for each participant. This consisted of defining
the shoe size of the dominant foot using a
Brannock® (Liverpool, NY, USA) measuring
device. Length was measured from the apex
of the longest toe to heel and width was taken
from the widest part of the forefoot at the
circumference of the 1st and 5th metatarsal
phalangeal joints. Measurements of the shoe
worn to clinic were taken at the longest and
widest part corresponding to the foot. Footwear
was then categorized to styling and type [25].
Finally, a clinic assessment of the participant’s
podiatric foot complaints related to ill-fitting
footwear was made, defining joint deformity,
hyperkeratoic skin lesions and participant’s
presenting soft tissue pain.
A footwear choice questionnaire was then
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