Franettovich Smith Melinda M, van den Hoorn Wolbert, van den Hoek Adele, Kerr Graham, Hurn Sheree E
School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
J Foot Ankle Res. 2025 Jun;18(2):e70055. doi: 10.1002/jfa2.70055.
Footwear is often recommended in the management of plantar heel pain (PHP), theoretically to reduce tissue stress during standing and walking; however, limited data exist to guide footwear design and recommendations.
Plantar pressures, impact forces and comfort during walking were recorded in 29 women with PHP (mean age 47 ± 12 years) in six randomised shoe and insert conditions. A test shoe (polyurethane outsole, 14-mm heel-toe pitch) was compared to a control shoe (rubber outsole, 4-mm heel-toe pitch), and within the test shoe, five different insoles that varied by material, density and arch contouring were also compared.
The test shoe reduced heel peak pressure (15%, p < 0.01) and reduced the loading rate but not the peak magnitude of the vertical ground reaction force (average loading rate reduction: 7%, p < 0.01; maximum loading rate: 29%, p < 0.01) and was more comfortable (47%-67%, p < 0.01) compared to the control shoe. Within the test shoe, dual-density inserts with arch contouring showed lower heel peak pressure compared to a lightweight flat insert (11%-12%, p < 0.03). The insert with the firmest material and higher arch contouring showed higher midfoot peak pressure (16%-21%, p < 0.01) compared to other inserts. Forefoot peak pressure did not differ between shoe or insert conditions (p > 0.05). There were no differences in impact forces or comfort between the different inserts within the test shoe (p > 0.05).
Findings suggest that shoe and insert properties are both important and provide data to guide footwear design and management recommendations for PHP.
在足底足跟痛（PHP）的治疗中，通常建议使用特定鞋类，理论依据是其可减轻站立和行走时的组织压力；然而，目前用于指导鞋类设计和建议的数据有限。
对29名PHP女性患者（平均年龄47±12岁）在六种随机的鞋子和鞋垫条件下记录行走时的足底压力、冲击力和舒适度。将测试鞋（聚氨酯外底，14毫米后跟至脚尖坡度）与对照鞋（橡胶外底，4毫米后跟至脚尖坡度）进行比较，并且在测试鞋内，还比较了五种因材料、密度和足弓轮廓不同的鞋垫。
与对照鞋相比，测试鞋降低了足跟峰值压力（15%，p<0.01），降低了加载速率，但未降低垂直地面反作用力的峰值大小（平均加载速率降低：7%，p<0.01；最大加载速率：29%，p<0.01），并且更舒适（47%-67%，p<0.01）。在测试鞋内，具有足弓轮廓的双密度鞋垫与轻质平底鞋垫相比，足跟峰值压力更低（11%-12%，p<0.03）。与其他鞋垫相比，材料最硬且足弓轮廓更高的鞋垫中足峰值压力更高（16%-21%，p<0.01）。在不同的鞋子或鞋垫条件下，前足峰值压力没有差异（p>0.05）。测试鞋内不同鞋垫之间的冲击力和舒适度没有差异（p>0.05）。
研究结果表明，鞋子和鞋垫的特性都很重要，并提供了数据以指导PHP的鞋类设计和治疗建议。
