Background Wearing unstable shoes at work was found to induce a significant reduction of several dimensions of pain, in a randomized controlled trial conducted among employees of a university hospital who were complaining of chronic low back pain.1 Employees randomized to the intervention group (MBT unstable shoes) had a significant effect on pain but not on function at 6 weeks compared to the group wearing control shoes (Adidas).
Objectives The goal of the present study is to evaluate long term clinical effect on pain and function.
Methods At the end of the 6-weeks trials, all 35 participants who were still included in the trial were offered a pair of shoes. 34/35 selected MBT shoes (one in the MBT group declined) and were followed-up at 18 months. All dimensions (pain, function, and quality of life) were evaluated through an interview using previously validated questionnaires
Results Subjects were contacted after a mean time of 19 months. The follow-up rate was 100% (35/35). Low back pain was significantly reduced (4.2 (1.8) to 2.0 (2.4), p < 0.001) and function was increased (Roland and Morris back specific questionnaire decreased from 4.7 (5.2) to 1.8 (5.0), p = 0.01). On a 5-point scale, 14/35 (40%) reported an important or very important effect related to unstable shoes. The health related quality of life was not modified (EQ-5D). Duration of the current episode of pain was reduced (p<0.01) as was the consumption of pain medication (p<0.01). The effect on pain was higher among those (16/35) who continued to wear unstable shoes at least one weakly, but the difference was not statistically significant (-2.9 (2.7) vs. -1.6 (3.1), p=0.2). Eight subjects dropped the unstable shoes because of side effect: 6 because of musculoskeletal pain, 1 because shoes were too warm and 1 because of instability.
Conclusions Regularly wearing unstable shoes over a long period of time appear to decrease low back pain and pain medication consumption while increasing back related physical function in an important subset of persons. As this simple method could have an important societal impact, larger trials are needed.
Armand S, Tavcar Z, Turcot K, Allet L, Hoffmeyer P, Genevay S. Effects of unstable shoes on chronic low back pain in health professionals: a randomized clinical trial. SpineWeek 2012; Amsterdam (Netherlands)
Acknowledgements We thank the University Hospitals of Geneva for their financial support, allowing us to conduct an indepedant study and MBT for providing the shoes.
Disclosure of Interest S. Genevay Grant/research support from: MBT, Z. Tavcar: None Declared, S. Armand Grant/research support from: MBT