Footwear characteristics and foot problems in community dwelling people with stroke: a cross-sectional observational study

Figures & data

Table 1. Stroke participant characteristics (n = 30).

Variable
Age (years)	Mean (SD)	68.2 (10.1)
	Min to max	46–84
Gender	Male/female	9/21
Side of weakness	Left	12 (40%)
	Right	15 (50%)
	Bilateral	2 (7%)
	None	1 (3%)
Walking aid use		20 (67%)
Ankle foot orthosis		6 (20%)
Months since stroke onset	Mean (SD)	66.8 (78.7)
	Min to max	5–384
Fall status	Non-faller	14 (47%)
	One-time-faller	7 (23%)
	Repeat-faller	9 (30%)
Indoor shoes age		0–6/6–12/>12 months
Fallers		2/3/11
No-fallers		5/3/14
Outdoor shoes age		0–6/6–12/>12 months
Fallers		4/1/11
Non-fallers		1/4/9
Living status	Alone/partner/family	10/17/3
SIS strength	Mean (SD)	57.1 (28.2)
0–100 higher scores better	Min to max	6–100
SIS memory	Mean (SD)	79.3 (22.4)
0–100 higher scores better	Min to max	18–100
SIS communication	Mean (SD)	80.2(22.1)
0–100 higher scores better	Min to max	18–100
SIS activity	Mean (SD)	64.8 (22.5)
0–100 higher scores better	Min to max	3–100
SIS mobility	Mean (SD)	68.1 (22.2)
0–100 higher scores better	Min to max	25–100
SIS hand ability	Mean (SD)	40.2 (40.8)
0–100 higher scores better	Min to max	0–100
SIS participation	Mean (SD)	65.7 (24.3)
0–100 higher scores better	Min to max	0–100
SIS overall recovery	Mean (SD)	64.4 (20.1)
0–100 higher scores better	Min to max	10–90
FPI
Mean (SD)	Affected foot	4.2 (4.3) –6 to 11
Min to max	Unaffected foot	3.4 (3.0) –1 to 11
Tinetti Falls Efficacy Scale	Mean (SD)	27.6 (18.8)
0–100 higher scores worse	Min to max	10–91

SIS: Stroke Impact Scale; FPI: Foot Posture Index.

Figures are number (%) unless stated otherwise.

Table 2. Footwear characteristics.

ID	Indoor shoe style	Indoor shoe fit	Indoor shoe features^a	Outdoor shoe style	Outdoor shoe fit	Outdoor shoe features^a
1	Slipper	Good	Bad	Walking shoe	Good	Good
2	Slipper boot	Too short	Bad	Moccasin	Too short/shallow	Bad
3	Slipper	Too short	Bad	Walking shoe	Too long	Good
4/AFO	Slipper	Too short	Bad	Walking shoe	Too narrow	Good
5	Slipper	Too short	Good	Walking shoe	Too short	Bad
6	Walking shoe	Good	Good	Walking boots	Good	Good
7	Slipper	Too short	Good	Walking shoe	Good	Good
8	Backless slipper	Good	Bad	Walking shoe	Too short	Good
9	Backless slipper	Good	Bad	Walking shoe	Good	Good
10/AFO	Slipper	Good	Good	Waking shoe	Too short	Good
11	Slipper	Good	Good	Oxford shoe	Too long	Good
12	Slipper	Good	Bad	Sandals	Good	Good
13	Backless slipper	Too short	Bad	Oxford shoe	Good	Good
14/AFO	Surgical bespoke	Good	Good	Surgical bespoke	Too short	Good
15	Sandals	Good	Good	Walking shoe	Good	Good
16	Ballerina	Too short	Good	Sandal	Good	Good
17/AFO	Slipper boot	Good	Bad	Mary Jane	Good	Good
18	Slipper	Good	Bad	Mary Jane	Good	Good
19/AFO	Walking boot	Too long	Good	Walking boots	Too long/wide	Good
20	Sandals	Good	Good	Court shoe	Good	Good
21	Ballerina	Too short/narrow/shallow	Bad	Moccasin	Too short/shallow	Bad
22	Slipper	Too short/narrow shallow	Bad	Walking shoe	Good	Good
23	Athletic shoe	Too short/narrow/shallow	Good	Moccasin	Too shallow	Good
24	Court shoe	Too narrow/shallow	Bad	Walking shoe	Good	Good
25	Walking shoe	To narrow	Good	Oxford shoe	Good	Bad
26	Backless slipper	Too short/narrow/shallow	Bad	Moccasin	Too short/narrow/shallow	Bad
27	Walking shoe	Good	Bad	Walking shoe	Good	Bad
28	Moccasin	Good	Bad	Moccasin	Good	Good
29	Slipper	Good	Good	Walking shoe	Too wide	Good
30/AFO	Surgical bespoke	Too long	Good	Surgical bespoke	Too long	Good

AFO: ankle foot orthosis.

Figures are number (%) unless stated otherwise.

^a Good: broad heel, thin and firm midsole, adequate means of fixation and adjustment and a textured slip-resistant outer sole.

Table 3. Foot problems identified by the podiatrist using the IMFAA (n = 30).

Participant characteristics						IMFAA foot problem (see KEY)
ID	Age (years)	Gender	Months since onset	Faller	Self report foot problems
						Number	A	B	C	D	E	F	G	H	I	J	K	L
1	71	Male	17	No	No	1				x
2	66	Female	8	No	No	3	x		x					x
3	77	Male	91	Yes	No	3	x	x			x
4	50	Female	16	Yes	No	4	x	x	x					x
5	71	Female	14	No	No	4	x			x			x					x
6	66	Male	9	No	No	4	x				x		x			x
7	76	Male	240	Yes	Yes	4	x		x				x	x
8	59	Female	6	No	No	5	x	x	x	x					x
9	73	Female	5	Yes	Yes	5	x			x		x			x		x
10	57	Male	10	Yes	Yes	5	x	x	x							x	x
11	67	Male	15	Yes	Yes	5		x		x		x	x		x
12	60	Female	23	No	No	5	x	x	x	x					x
13	78	Male	88	Yes	No	5	x	x	x	x						x
14	71	Female	77	No	No	5	x	x	x						x		x
15	59	Female	77	Yes	No	6	x	x	x		x	x			x
16	74	Female	44	No	No	7	x	x	x		x	x	x				x
17	77	Female	51	Yes	Yes	7	x	x	x	x	x			x	x
18	52	Female	132	No	Yes	7	x	x	x	x	x	x	x
19	66	Male	115	Yes	Yes	7	x	x	x	x		x	x	x
20	77	Female	94	Yes	Yes	7	x	x	x	x	x		x	x
21	77	Female	30	No	Yes	7	x	x		x		x	x	x	x
22	46	Female	10	No	Yes	7	x		x	x	x	x	x	x
23	84	Female	39	Yes	Yes	8	x	x	x	x	x		x		x	x
24	81	Female	96	Yes	Yes	8	x	x	x		x	x		x		x		x
25	78	Female	64	Yes	Yes	8	x	x	x	x	x	x			x	x
26	64	Female	24	No	Yes	8	x	x	x	x		x		x	x	x
27	57	Female	72	Yes	Yes	8	x	x	x	x	x	x	x			x
28	84	Female	101	No	Yes	9	x	x	x	x	x	x	x	x			x
29	67	Male	51	No	Yes	9	x	x	x	x	x	x			x	x		x
30	61	Female	384	Yes	Yes	12	x	x	x	x	x	x	x	x	x	x	x	x
KEY (IMFAA: International Musculoskeletal Foot and Ankle Assessment).
	Foot problem	Podiatrist foot problems (n = 30), number (%)
A	Impaired single limb heel raise	28 (93%)
B	Impaired range of foot and ankle movement	23 (77%)
C	Gait abnormalities	23 (77%)
D	Palpation abnormalities	19 (63%)
E	Hallux valgus	15 (50%)
F	Pain	15 (50%)
G	Impaired sensation	14 (47%)
H	Reduced muscle strength	13 (43%)
I	Swollen joints	12 (30%)
J	Skin and nail changes	10 (33%)
K	Toe deformities	7 (23%)
L	Foot morphologies	4 (13%)

The “x” links specific problems for each participant to a key outlined below the table so as to enable readers to identify which foot problems and combination of foot problems were experienced.

Figure 1. Four scatter plots showing the correlation between number of foot problems identified by the podiatrist during the assessment and three different Stroke Impact Scale sections and balance confidence as measured using the Tinetti Falls Efficacy Scale.

Plots a, b, and d show a negative correlation between foot problems and upper limb movement, physical activity and community participation as measured using the Stroke Impact Scale and plot c shows a positive correlation for balance confidence. The correlations shown suggest that people who presented with a greater number of foot problems were also observed to present with reduced upper limb function, were less physically active and had reduced balance confidence and reduced community participation.