How Footwear Is Assessed in Patient Reported Measures for People with Arthritis: A Scoping Review

Background: In people with arthritis, footwear may influence foot function, pain, and mobility. In order to measure the effectiveness of interventions and patient experience, patient-reported outcome measures (PROMs), and patient-reported experience measures (PREMs) are frequently used. The aim of the scoping review was to identify footwear item content within foot-specific PROMs and PREMs used in people with arthritis. Method: Original studies that developed or validated a footwear-inclusive PROM or PREM for use in people with arthritis affecting the foot were included. A comprehensive search was conducted using AMED, CINAHL, MEDLINE, Scopus, SPORTDiscus, and Ovid Emcare and Embase. A content analysis of extracted footwear content items was performed, by coding item content and grouping into broad themes, then further narrowing down and defining themes under five main categories. Results: Nineteen articles satisfied inclusion criteria for this scoping exercise. Eleven PROMs met the inclusion criteria, five of which were designed for use in disease-specific populations (rheumatoid arthritis and gout) and six designed for generic populations. Categories of the footwear specific content from the PROMs included pain, impairment and function, shoe-specific characteristics, and psychosocial aspects. None of the included PROMs assessed footwear satisfaction. Eight PREMs relating to footwear experiences were identified. Seven of the PREMs were disease specific (inflammatory arthritis, osteoarthritis, rheumatoid arthritis, and systemic sclerosis) and one was generic. Content of the footwear-related items of the included PREMs were categorized under pain, impairment and function, footwear satisfaction, and shoe-specific characteristics. None of the PREM studies reported on psychosocial aspects of footwear. Conclusions: Many different instruments have been used to measure the experience of footwear in patients with arthritis. However, no comprehensive tool that evaluates footwear and its relationship with pain, impairment, and disability; the psychosocial aspects of footwear; specific footwear features; and satisfaction is currently available for use in people with arthritis.