Navigating Conservative Strategies for Ankle Osteoarthritis Treatment: Understanding Footwear Preference-Rocker Bottom Shoes and Ankle Foot Orthotics.

BACKGROUND

Ankle osteoarthritis (AOA) is a progressive condition that impairs mobility and reduces quality of life. Conservative treatments like rocker bottom (RB) shoes and ankle-foot orthoses (AFOs) are commonly prescribed, but their effectiveness in managing AOA is not well understood, and patient preferences are underexplored.

OBJECTIVES

This is a pilot study aimed to evaluate the effect of RB shoes and AFOs in managing AOA and to identify factors influencing patient preferences for these conservative treatments.

STUDY

DESIGN

This was a cross-over telehealth study involving 10 participants with doctor-diagnosed AOA. Each participant wore three footwear conditions: control shoes, RB shoes, and AFOs, each for 3 weeks.

METHODS

Participants completed baseline pain ratings and functional assessments using PROMIS and FAAM questionnaires. After each 3-week footwear session, participants reported pain levels and provided feedback on their preferred footwear.

RESULTS

Younger participants (aged 56-63) preferred AFOs for pain relief and improved mobility, while older (aged 66-75) and taller participants preferred RB shoes for their comfort. No significant differences were found in pain or function across footwear conditions, but AFO-preferred participants experienced significant reductions in maximum pain compared to the RB group.

CONCLUSIONS

Footwear preferences were influenced by age and activity level. Younger participants preferred AFOs for functional benefits, while older participants prioritized comfort and selected RB shoes. These findings emphasize the need for personalized conservative treatment strategies in managing AOA.

CLINICAL RELEVANCE STATEMENT: This pilot study highlights the importance of tailoring conservative treatments for AOA based on age and activity level. Understanding patient preferences can help guide clinical decisions and improve patient outcomes.