Being barefoot best bet for patients with knee osteoarthritis

Patients with knee osteoarthritis may do well to spend more time in bare feet than wearing footwear and performing moderate physical activity (PA), as the latter may increase instead of lower the risk of pain flares, a study reports.

The study included 120 patients (mean age, 59.9 years; 90 percent female; mean body mass index, 28.0 kg/m²) who had previous episodes of pain flares. All patients were assessed every 10 days for up to 3 months. The majority (84.6 percent) of the population resided in urban areas, and about half (40.9 percent) had no permanent employment.

The mean number of flares per person was 1.91. The patients reported being barefoot for a mean of 12.7 hours and wore footwear an average of 5.1 hours daily. Nearly all (99 percent) wore footwear with a heel height of <2.5 cm.

Conditional logistic regression analysis revealed that longer duration of being barefoot, 1 and 2 days prior, lowered the odds of having pain flares by 15 percent (odds ratio [OR], 0.85, 95 percent confidence interval [CI], 0.80–0.90).

In contrast, moderate PA performed 1 or 2 days prior was associated with a significantly elevated risk of pain flares (OR, 4.29, 95 percent CI, 2.52–7.30 and OR, 3.36, 95 percent CI, 2.01–5.61, respectively). Similarly, prolonged use of footwear at 1 and 2 days prior conferred a risk increase (OR, 1.15, 95 percent CI, 1.07–1.23 and OR, 1.10, 95 percent CI, 1.03–1.18, respectively).

The findings provide evidence that being barefoot is associated with lower mechanical loads on the knee and can prevent the occurrence of pain flares.