Braam Carla, Kloprogge Sabine, Schiphof Dieuwke, van Meurs Joyce B J, Bierma-Zeinstra Sita M A, van Middelkoop Marienke
Department of General Practice, Erasmus MC, University of Medical Centre, Rotterdam, the Netherlands.
Department of Internal Medicine, Erasmus MC, University of Medical Centre, Rotterdam, the Netherlands.
J Foot Ankle Res. 2025 Jun;18(2):e70050. doi: 10.1002/jfa2.70050.
The effectiveness of footwear modifications for the first metatarsophalangeal (MTP) joint osteoarthritis (OA) compared to usual general practitioner (GP) care has never been studied. Understanding patients' perspectives is essential for assessing the feasibility of a randomized controlled trial (RCT) on this topic. Our objective is to explore experiences, expectations, beliefs, and opinions of patients with the first MTP joint OA regarding symptoms and limitations, healthcare management, footwear intervention, and research participation for designing a successful future effectiveness trial.
A qualitative research design was embedded within a feasibility pilot study for the recruitment of participants diagnosed with the first MTP joint OA. Qualitative data from semistructured interviews were categorized analyzed.
All participants (n = 10) experienced limitations on the activity and participation level due to pain symptoms in the first MTP joint. Patients experienced varying approaches and treatment outcomes in primary and secondary healthcare, leading to both positive and negative perspectives. Most participants highlighted the importance of the cosmetic appearance of modified footwear, indicating that this is crucial for compliance with the intervention. Participants showed willingness to participate in an RCT, with strong preference for randomization into an intervention group with a modified footwear alongside usual GP care rather than GP care alone.
Our study identified key considerations for designing a successful future trial, including recruiting incident cases, offering the deferred footwear intervention to the control group, providing clear information during recruitment and randomization phase, and the significance of the cosmetic appearance of modified footwear for patients with the first MTP joint OA.
与普通全科医生（GP）常规护理相比，鞋类改良对第一跖趾（MTP）关节骨关节炎（OA）的有效性尚未得到研究。了解患者的观点对于评估关于该主题的随机对照试验（RCT）的可行性至关重要。我们的目标是探索患有第一MTP关节OA的患者在症状和限制、医疗保健管理、鞋类干预以及参与研究方面的经历、期望、信念和意见，以设计一项成功的未来有效性试验。
在一项可行性预试验中采用定性研究设计，以招募被诊断患有第一MTP关节OA的参与者。对来自半结构化访谈的定性数据进行分类分析。
所有参与者（n = 10）由于第一MTP关节的疼痛症状而在活动和参与水平上受到限制。患者在初级和二级医疗保健中经历了不同的治疗方法和治疗结果，导致了积极和消极的看法。大多数参与者强调了改良鞋类外观的重要性，表明这对于干预的依从性至关重要。参与者表示愿意参加RCT，强烈倾向于被随机分配到接受改良鞋类与常规GP护理相结合的干预组，而不是仅接受GP护理。
我们的研究确定了设计未来成功试验的关键考虑因素，包括招募新发病例、为对照组提供延迟的鞋类干预、在招募和随机分组阶段提供清晰信息，以及改良鞋类外观对患有第一MTP关节OA患者的重要性。
