Do commonly used postoperative orthopaedic shoes help off-load the forefoot?

Acta Bioeng Biomech. 2021;23(2):115-122.

Abstract

Purpose: The aim of the experiment presented in this study was to determine the pressure distribution within the forefoot depending on the type of orthopaedic footwear used.

Methods: The study included 27 women aged 20 to 25. The Zebris FDM-2 dynamographic platform was used in foot pressure measurements. The load distribution was measured in three types of orthopaedic footwear: MedSurg, MedSurgPro and OrthoWedge. The full gait cycle was recorded. The Cavanagh masks were applied to the load distribution results processed into a graphic form. The data were analysed using Statistica v.13.1.

Results: In the forefoot area, i.e. the metatarsal bones and toes 1-5, the lowest loads were reported in the shoes that off-load the forefoot (0.2 N/cm², p < 0.001). In the area of the first to fifth metatarsal bones and the hallux, the highest load was observed in the rocker shoe, accounting for 19.7 N/cm² ( p < 0.001). For comparison, high pressure in the flat shoe was found in the area of toes 2 to 5 ( p < 0.001).

Conclusions: In the area of the metatarsal and toe bones, the pressure exerted was highest in the commonly used rocker shoe. The flat shoe provides an even and uniform load in all areas of the forefoot, while this type of shoe does not significantly reduce the pressure forces on the forefoot. The shoe that was the most effective in off-loading was the forefoot off-loading shoe (OrthoWedge). Barefoot walking puts less load on the forefoot compared to the flat and rocker shoes used after orthopaedic procedures.

MeSH terms

  • Female
  • Foot
  • Hand
  • Humans
  • Orthopedics*
  • Shoes
  • Walking