Background: Approximately third of older adults report foot pain that can lead to reduced physical activity. In this study, we examined whether a novel therapeutic shoe that addresses both aesthetics to enhance acceptability and biomechanical features to reduce foot pain, might improve daily physical activity in older adults with mild to moderate foot pain.

Methods: In a 12-week crossover randomized controlled trial, older adults with chronic foot pain were randomly assigned to either group AB or BA. Group AB wore therapeutic footwear (OrthoFeet, NY, USA) for six weeks (intervention A) before switching to their own shoes for six weeks (intervention B). Group BA followed the reverse order. Physical activity (daily steps, burned calories, metabolic equivalent of task) was tracked throughout the trial with a smartwatch. Generalized Estimating Equations were used to compare differences in foot pain and physical activity between interventions A and B.

Findings: Twenty-nine participants (mean age = 67 ± 5 years, 17 % male) completed the study. Compared to baseline, wearing OrthoFeet increased daily steps (p = 0.045; +698 steps/day), burned kilocalories (p = 0.048; +177 kcal/day), and metabolic equivalent of task (p = 0.046; +34 MET.min.wk.(-1)).

Interpretation: Findings suggest that the combination of both aesthetic and biomechanical features designed to encourage engagement in activities of daily living and reduce foot pain, respectively, increased daily physical activity among older adults with mild to moderate foot pain.