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If the shoe fits...

Published on 01 April 2011
Source: Arthritis Today

Designer at work

Women whose rheumatoid arthritis affects their feet often struggle to find stylish footwear that doesn’t cripple them. Arthritis Research UK has taken the first steps to finding a solution.

One of the most painful symptoms of rheumatoid arthritis is painful feet. People with the condition have compared the sensation in the soles of their feet to walking on broken glass or pebbles, and the toes and joints can often become deformed as the condition progresses.

Finding comfortable shoes then is essential, but inevitably these tend to be more practical shoes which can be lacking in style, and not much good for a formal occasion when smart shoes are called for to go with a skirt or dress.

That was the background to a two-day footwear design challenge funded by Arthritis Research UK, held last year at the University of Central Lancashire (UCLan). The aim of the challenge was to bring together women with rheumatoid arthritis, podiatrists and orthotists with top designers, to produce design concepts with the potential to become a prototype of a smart shoe.

Dr Lynn Goodacre“Through previous research we’ve carried out to explore how rheumatoid arthritis affects women’s self-image, we know that the poor choice of comfortable, smart shoes on the High Street limits their clothing choices and has an impact on their ability to present themselves in the ways that they want to,” explained Dr Lynne Goodacre, senior lecturer in long-term conditions at UCLan occupational therapy (who led the project), Julia Cassim, senior research fellow at the Helen Hamlyn Centre at the Royal College of Art and Fiona Candy, senior lecturer at the School of Art, Design and Performance at UCLan.

“Women with rheumatoid arthritis find it really difficult to find the right shoes for a special occasion such as a wedding or an evening out, or in their professional life. Whilst the women are able to find comfortable orthopedic shoes that look good with trousers or casual wear, they often described them as being ‘clumpy’ and spoiling a nice outfit.”

Not an easy brief then, and it was very important to get all the perspectives – not just from the women with rheumatoid arthritis who acted as design partners but also from the orthotists and podiatrists who understand the need for shoes to provide the right support and to protect the joint. “We had to make sure that the concepts accommodated the clinical need as well as the aesthetic,” added Lynne.

One of the big design dilemmas the teams faced was that the trainers and “comfort” shoes, worn by a large number of people with arthritis, are designed to be functional and practical, whereas in formal shoes style is much more important and comfort secondary; it’s also much more difficult to insert customised inserts or orthoses into court shoes or a high-heeled shoe.

Over a period of two days three teams, each comprising women with rheumatoid arthritis, designers, orthotists, podiatrists and student iterns, came up with a range of interesting early design concepts, which demonstrated how, through using an inclusive approach to design, attractive High Street fashion shoes could be developed to meet the footwear health needs of people with arthritis.

One of the designs to emerge from the footwear design challenge

Ideas included gel inserts and increasing the internal depth of the shoe to make enough space; wedge heels (recommended height: no more than 2.5cms); a rocker sole to relieve pressure on the ball of the foot, a wide-base heel to provide stability and grip, and so on.

Said Lynne: “Inclusive design is based on the principle of bringing together people with different perspectives to inform the design process and come up with workable solutions. The experience was highly productive.”

Added Julia Cassim: “We’re all united in a desire to take our findings forward in a way that will transform not only the shoe industry but the lives of many people for whom comfortable yet stylish footwear remains a seemingly unattainable dream.”

Designers working on show designThe design challenge has demonstrated that the needs of people with arthritis can be integrated into fashionable shoes. The next challenge is of raising awareness of the problems within the footwear industry and showing ways in which they can be overcome. The outcomes of the workshop have the potential to be used in a national forum with representatives from the footwear industry to open up the debate and encourage them to think more inclusively in their designs. Arthritis Today will keep you in touch with future developments.

• Arthritis Research UK is currently also evaluating the experiences of both patients and health professionals in the way that arthritis-related foot problems are dealt with.

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