Abstract
Introduction.
In rheumatoid arthritis, the forefoot is frequently affected. A variety of surgical procedures have been established in the treatment of rheumatic forefoot disorders. Postoperatively, patients are mobilized in specially designed footwear to reduce forefoot stress. Our study was conducted to investigate peak and mean plantar pressure occurring in two differently designed forefoot relief shoes by using the novel pedar ® system.
Materials and Methods.
Ten symptom-free volunteers were asked to walk on a treatmill, performing two trials at self-selected speed. The ”Barouk” (sole and heel supporting proximal fifty percent of the foot) and “Hannover” (Sole under whole foot, heel supporting proximal fifty percent of the foot) forefoot relief shoe (fior and gentz, Lueneburg, Germany) were compared. In a first trial, the shoe had to be used adequately, while in a second trial, the volunteers tried to put pressure on the forefoot, mimicking non-compliance. Peak and mean plantar pressure were obtained using the pedar® cable system (novel, Munich) and compared to the contralateral foot. Statistical t-test analysis was performed using SPSS 10. 0 for windows™.
Results.
When wearing the “Barouk” shoe with short sole, the forefoot was completely relieved in all trials. Non-compliant use of the shoe did not result in any forefoot stress. At the edge of the sole, peak pressure values were not higher than in conventional footwear. The shoework with complete sole reduced forefoot peak and mean pressure in contrast to normal gait by a mean of 34 percent. However, all volunteers were able to put stress on the forefoot when mimicking non-compliance, reaching peak values similar to normal gait.
Conclusion.
With regard to reconstructive forefoot surgery, the design of forefoot relief shoework affects the safety to non-compliance.
