This study—the Veterans Shoe Size Survey—was undertaken specifically to evaluate the prevalence and extent of change in foot length over time in a male veteran population and examine various possible causes for these changes.
Inclusion criteria included male veterans who were able to confidently self-report weight and shoe size upon entry into military service.
Following enrolment, a survey was completed to document self-reported shoe size and weight upon entering military service, maximum lifetime weight, and occupational activity scale.
In the study population of 200 male veterans, the authors found that forty-eight percent of the participants showed a significant change in shoe size.
Ninety-eight percent of those individuals experienced this change as an increase in shoe size, which calls into question the assertion that neuropathic patients select smaller shoes to increase sensation.
There was no clear association found between changing foot length and measured study variables, meaning the underlying cause was likely one or more excluded variables – the authors believed ligamentous laxity to be the likely one.
The authors were of the opinion that the substantial percentile drop in the number of people with significant shoe size change in the group of participants who were 80 years and older may represent increased mortality associated with weight gain.
Based on the findings of the study, the authors advocated that future work should focus on a) building surveillance systems that could validate these findings in a prospective design, b) standardising therapeutic shoe sizing, c) improving patient compliance by improving the perceived value of using therapeutic shoe wear, and d) educating providers about the prevalence of changing adult shoe size and the use of clinical screening tools for at-risk populations.
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