What influences a patient's decision to use custom-made orthopaedic shoes?

NewsBot · Jun 13, 2012

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What influences a patient's decision to use custom-made orthopaedic shoes?
Jaap J van Netten, Pieter U Dijkstra, Jan H.B. Geertzen and Klaas Postema
BMC Musculoskeletal Disorders 2012, 13:92

Background
Despite potential benefits, some patients decide not to use their custom-made orthopaedic shoes (OS). Factors are known in the domains 'usability', 'communication and service', and 'opinion of others' that influence a patient's decision to use OS. However, the interplay between these factors has never been investigated. The aim of this study was to explore the interplay between factors concerning OS, and the influences thereof on a patient's decision to use OS.

Methods
A mixed-methods design was used, combining qualitative and quantitative data by means of sequential data analysis and triangulation. Priority was given to the qualitative part. Qualitative data was gathered with a semi-structured interview covering the three domains. Data was analysed using the framework approach. Quantitative data concerned the interplay between factors and determining a rank-order for the importance of factors of 'usability'.

Results
A patient's decision to use OS was influenced by various factors indicated as being important and by acceptance of their OS. Factors of 'usability' were more important than factors of 'communication'; the 'opinion of others' was of limited importance. An improvement of walking was indicated as the most important factor of 'usability'. The importance of other factors (cosmetic appearance and ease of use) was determined by reaching a compromise between these factors and an improvement of walking.

Conclusions
A patient's decision to use OS is influenced by various factors indicated as being important and by acceptance of their OS. An improvement of walking is the most important factor of 'usability', the importance of other factors (cosmetic appearance and ease of use) is determined by reaching compromises between these factors and an improvement of walking. Communication is essential to gain insight in a patient's acceptance and in the compromises they are willing to reach. This makes communication the key for clinicians to influence a patient's decision to use OS.
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NewsBot · Jan 18, 2014

The use of custom-made shoes in patients with foot deformities in foot clinic, Siriraj Hospital.
Paecharoen S, Chadchavalpanichaya N.
J Med Assoc Thai. 2013 Nov;96(11):1498-507.

OBJECTIVE:
To study the frequency, result, and concomitant factors of the use of custom-made shoes in Foot Clinic, Siriraj Hospital.
MATERIAL AND METHOD:
Studying from patient records and interviewing the patients who had foot deformities without numbness and received custom-made shoes from the Foot Clinic, Siriraj Hospital between January 2009 and December 2011 about the latest custom-made shoes after the first three months of use.
RESULTS:
Sixty-seven participants were reviewed and included eight males (11.9%) and 59 females (88.1%) with an average age of 57.1 years. The majority had congenital foot deformity (19.4%). Most of them received sandal-type shoes (34.3%) and total contact orthosis (52.2%). The use of custom-made shoes that the participants had to use for more than 3 days/week and for more than or equal to 50% of daily walking and standing duration was 47.8%. Using these shoes reduced foot pain and increased walking stability (p-value = 0.007 and 0.023). Factors associated with the use of custom-made shoes were no previous callus (odds ratio = 25.30, 95% CI 2.20-290.56), decreasing callus after using the shoes (odds ratio = 23.54, 95% CI 1.65-335.23), decreasing foot pain after using the shoes (odds ratio = 5.01, 95% CI 1.20-20.95), and overall satisfaction (odd ratio = 21.47, 95% CI 3.81-121.04).
CONCLUSION:
The use of custom-made shoes from the Foot Clinic, Siriraj Hospital was 47.8%. Using the shoes could reduce foot pain and increase walking stability. Factors associated with the use of custom-made shoes were no previous callus, decreasing callus, decreasing foot pain, and overall satisfaction.
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NewsBot · Aug 12, 2015

Users’perspective on custom-made orthopaedic shoes
Tomaž Štajer, Gaj Vidmar, Helena Burger
Prosthet Orthot Int June 2015 vol. 39 no. 1 suppl 2-608; abstract 323

Background
Seventeen to 42 percent of adults have foot pain [1] and half of them have activity limitations [2]. One possibility to decrease these limitations is to use custom-made orthopaedic shoes. However, shoes are only effective if worn. There are several aspects that may influence the use of orthopaedic shoes, such as effectiveness, efficiency and satisfaction [3]. All studies about these factors have been performed in the Netherlands and we do not know whether the same factors are equally important for patients in other countries.
Aim:
The aim of our study was to find out which factors (and in what ranking order) are important for users of custom-made orthopaedic shoes in Slovenia.
Method:
A questionnaire about the importance of various aspects of orthopaedic shoes for their users was devised. All patients using orthopaedic shoes for at least one year, visiting our outpatient clinic for foot problems in summer 2011, who were willing to participate were included in the study. The study was approved by our Institute’s ethics committee.
Results:
The participants were 62 women and 66 men, 63years old on average (range 12-92 years). Most of them had used orthopaedic shoes from 1 to 10 years, but some up to 70 years. There was a statistically significant difference between the ranked importance of different factors; the most important was comfort, followed by durability, weight, waterproofness, the way of tying up the shoes, shape, appearance and opinion of other people. Durability was especially important for men; the way of tying up the shoes became more important with increasing age. Orthopaedic shoes statistically significantly decreased foot pain (p<0.001) and improved walking ability (p<0.001).
Discussion & Conclusion (approx 70)
Similarly to other researcher, we also found out that orthopaedic shoes decrease foot pain and activity limitations [2]. Like in the Netherlands [3], comfort and good fit are the most important factors for users of orthopaedic shoes in Slovenia. Surprisingly, shape and appearance were not deemed very important, even though during their visits to our clinic several patients had complains about those aspects. It seems that decreased pain and better ability to walk overcome the aesthetic issues.
References:
[1] Hawke F, Burns J. J Foot Ankle Res 2009; 2: 1 – 11.
[2] Hawke F et al. Cochrane Database Syst Rev 2008; 83): CD00681.
[3] vanNettenJJ et al. J Rehabil Res Develop 2010; 47: 73 – 82.
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NewsBot · Oct 15, 2015

Orthopedic shoes : Still in touch with the times?
Greitemann B
Zeitschrift fur Rheumatologie [2015]

BACKGROUND: Deformities of the foot due to rheumatic disease, particularly rheumatoid arthritis, occur in 85-95 % of patients during the course of their disease.

OBJECTIVE: This study investigates whether treatment with orthopedic shoes still has a place in modern therapies.

RESULTS: Foot orthotics and technical orthopedic shoes can play an important role in purely conservative treatment as well as postoperative therapy.

CONCLUSION: Due to a lack of knowledge concerning modern orthopedic shoe techniques, this treatment option has slipped out of focus-in part because of its association with the old-fashioned unshapely black orthopedic shoes. Nevertheless, these shoes can contribute significantly to maintenance of patient mobility; a factor of extreme importance to the individuals who already suffer considerably from the disease per se.
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NewsBot · Apr 2, 2017

Communication techniques for improved acceptance and adherence with therapeutic footwear
Jaap J van Netten, Anthony Francis, Ashley Morphet, Lauren V Fortington, Klaas Postema, Anita Williams
Prosthetics and Orthotics International June 8, 2016

Background and aim:
Clients’ acceptance and adherence with orthoses can be influenced by a clinician’s communication skills. In this clinical note, we describe two communication techniques, in the context of therapeutic footwear.

Technique:
Person-centred communication involves engaging with and listening to the attitudes of the client towards their condition, as well as discussing acceptance and expectations, in a structured consultation. Building a relationship is crucial and requires clients to feel heard and understood. An important influence on the acceptance and adherence is that a client makes a conscious decision to receive their device. This active receipt can be facilitated through shared decision making, wherein clinicians give clear, relevant and meaningful examples, based on clinical evidence, and ensure this is understood.

Discussion:
Two communication techniques for clinicians providing therapeutic footwear are described. These can be adapted for use with provision of other assistive technologies to improve client acceptance and adherence.

Clinical relevance
Small changes in how clinicians communicate to their clients in daily practice can have a big influence on the subsequent acceptance and adherence with therapeutic footwear and indeed other prescribed assistive technologies.
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