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Stick to supportive shoes if you have knee pain

Embargoed until: Publicly released:
Peer-reviewed: This work was reviewed and scrutinised by relevant independent experts.

Randomised controlled trial: Subjects are randomly assigned to a test group, which receives the treatment, or a control group, which commonly receives a placebo. In 'blind' trials, participants do not know which group they are in; in ‘double blind’ trials, the experimenters do not know either. Blinding trials helps removes bias.

People: This is a study based on research using people.

Though they may look daggier than flat-bottomed hipster shoes, a supportive shoe might help alleviate that niggling knee pain, say Aussie scientists. Recently, it has been argued that a flat and flexible shoe might allow more of a 'barefoot' experience, which could in turn help people with knee osteoarthritis. But, the team gave that theory the boot by finding that participants wearing supportive shoes ended up reporting improvements in their pain levels when walking, compared to the flexi-flat shoe wearers.

Journal/conference: Annals of Internal Medicine

Link to research (DOI): 10.7326/M20-6321

Organisation/s: The University of Melbourne

Funder: See paper for full list of funders

Media release

From: American College of Physicians

Sturdy supportive shoes better than flat flexible shoes for managing knee pain

A randomized controlled trial found that sturdy supportive shoes improve knee pain on walking and knee-related quality of life compared with flat flexible shoes. This evidence supports recommendations that previously had been based on expert opinion in the absence of data. Findings are published in Annals of Internal Medicine.

Knee osteoarthritis is a common problem that causes pain and can limit a person’s activities. People with knee osteoarthritis are often advised to wear stable supportive shoes. However, some experts believe that flat flexible shoes that allow more of a “barefoot” experience may provide more benefit.

Researchers from The University of Melbourne randomly assigned 164 patients with knee osteoarthritis to wear either sturdy supportive shoes or flat flexible shoes for at least 6 hours per day for 6 months to compare pain and the ability to participate in activities, such as walking. The participants were equally divided into the two groups and the researchers used standard surveys to measure patients’ pain, activity levels, and quality of life at the beginning and end of the study. At 6 months, the researchers found no evidence that flat flexible shoes were better than sturdy supportive shoes. Patients in the stable sturdy shoe group reported greater improvements in pain when walking and knee-related quality of life compared to the flat flexible shoe group. According to the researchers, these findings provide hard data to support clinical guidelines that recommend sturdy supportive shoes for patients with knee osteoarthritis.

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