A recent study by Hurst et. al at Staffordshire University in the UK investigated the impact of fit and comfort with respect to medical grade footwear. Appropriate fitting footwear can greatly improve comfort as well as alleviating pressure hotspots, reducing the risk of ulceration. Constricting footwear can cause foot deformities including the development of joint pathologies and forefoot lesions. Compression from the footwear onto the digits can cause tissue breakdown, eventually leading to ulceration. Appropriately fitting footwear with stretchable uppers, such as the Dr. Comfort Brian X and the Annie X (both pictured above), can reduce these risk factors and prevent injury occurrences.
Medical-grade footwear: the impact of fit and comfort
To investigate the effect of an off-the-shelf, medical-grade shoe (Dr. Comfort Annie X and Brian X) on dorsal digital pressure and perceived comfort when compared to participant’s own preferred shoe.
Walkinsense® sensor placement 1–8 on digital landmarks, as well as experimental set up for data capture. Micropore was loosely applied to secure the sensors.
Thirty participants (18 females, 12 males) scored their perceived comfort whilst wearing each footwear style using a visual analog comfort scale. Dorsal digital and interdigital pressures were measured using the WalkinSense® in-shoe pressure system. Sensors were fixed to the following landmarks:
- Medial border of the 1st metatarsophalangeal joint
- Medial border of the first interphalangeal joint
- Interdigital (1/2, 2/3, 3/4, 4/5)
- Proximal interphalangeal joint
- 5th proximal interphalangeal joint
- Lateral border of the 5th metatarsal head
They found overall peak pressure, pressure time integral and contact time decreased, whilst the time taken to reach peak pressure increased across all anatomical landmarks whilst wearing the test shoe.
The Dr. Comfort Annie X-Deep & Brian X-Deep provided greater comfort and reduced the amount of pressure on the forefoot. They were ranked most comfortable in all of the defined nine footwear characteristics and were in agreement with previous studies which proposed that the design, construction and properties of footwear are important factors in footwear comfort. These are therefore a viable alternative to custom made prescription footwear and more suitable than a regular everyday shoe when treating digital lesions associated with pressure.