Abstract
Introduction
Various rehabilitation shoes are prescribed to protect the forefoot following surgery. Patients often complain of discomfort in other areas as a result of the postoperative shoe, including the knee, hip and lower back. This has never been quantified. This study aims to establish the effect on other joints using gait analysis. Methods: 11 healthy volunteers were investigated using various common types of postoperative shoe. They were studied with gait analysis equipment and the joint motion assessed with commercial software. The effect of commercial devices designed to minimise gait changes by lifting the contralateral foot were also evaluated.
Results
There was a reduction in knee flexion and extension compared to the contralateral leg in all phases of the gait cycle. This was the case with both heel wedge shoes and inflatable air boots. There was also an increase in pelvic tilt during gait with both shoes, which was more pronounced with the air boot. The foot raise device for the contralateral foot which is designed to decrease these changes was effective in decreasing gait changes.
Discussion
The use of rehabilitation shoes after forefoot surgery is almost universal. Patients are rarely counselled of the risk of joint pain or back pain as a result of the postoperative shoe. Patients with pre-existing back pain or hip pain may have fewer symptoms if they are supplied with an equalising device to raise the other foot.
Conclusions
Patients are at risk of initiation or exacerbation of low back pain or lower limb joint pain from the use of postoperative shoes. Patients with a history of back or limb symptoms should be provided with an equalising device for the contralateral limb to minimise their discomfort. Patients should be warned of this risk when giving consent.
