Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: A randomized controlled trial

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Abstract

Background:

Efforts have been made to retard the progressive debilitating pain and joint dysfunction in patients with knee osteoarthritis. We aimed to evaluate the therapeutic effect of a low-cost minimalist footwear on pain, function, clinical and gait-biomechanical aspects of elderly women with knee osteoarthritis.

Methods:

Throughout a randomized, parallel and controlled clinical trial, fifty-six patients with medial knee osteoarthritis were randomly allocated to an intervention (n = 28) or control group (n = 28), and assessed at baseline and after three and six months. The intervention involved wearing Moleca® footwear for at least 6 h/day, 7 days/week, over 6 months. The pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index was the primary outcome. The secondary outcomes were the other subscales, Lequesne score, distance walked in 6 min, knee oedema and effusion, knee adduction moment and paracetamol intake. Intention-to-treat analysis was performed using two-way casewise ANOVA (< .05) and Cohen's d coefficient.

Findings:

Intervention group showed improvement in pain (effect size: 1.41, p < .001), function (effect size: 1.22, p = .001), stiffness (effect size: 0.76, p = .001), Lequesne score (effect size: 1.07, p < .001), and reduction by 21.8% in the knee adduction moment impulse (p = .017) during gait wearing Moleca®. The analgesic intake was lower in the intervention group.

Interpretation:

The long-term use of Moleca® footwear relieves pain, improves self-reported function, reduces the knee loading while wearing Moleca®, refrains the increase of analgesic intake in elderly women with knee osteoarthritis and can be considered as a conservative mechanical treatment option. ClinicalTrials.gov (NCT01342458)

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