Two new studies presented at the World Congress on Osteoarthritis’ 2025 Annual Meeting in Incheon, South Korea, found that a shoe-based biomechanical intervention may have more benefits than traditional physical therapy, Medscape reported May 6.
Matthew Bartels, MD, director of rehabilitation medicine and professor of physical medicine and rehabilitation at Montefiore Medical Center and Albert Einstein College of Medicine in New York City presented data from two studies of the shoe-based intervention. The intervention, cleared by the FDA, “alters the foot’s pressure points to reduce loads, minimize symptoms and promote neuromuscular control training using adjustable, convex pods under the sole,” according to the report.
The intervention shows promise for low back pain and reducing the risk for total knee replacement. According to Dr. Bartels, people experiencing lower back pain may walk differently to compensate, which can worsen the problem by directing the ground force through the affected area of the body.
The first study was a randomized, controlled trial comparing the effects of the intervention and standard physical therapy on pain in 162 patients with low back pain. Participants were randomized in a 2-to-1 ratio, either to the shoe-based intervention from AposHealth — which was individually tailored and calibrated six times over one year — or to standard physical therapy.
After one year of randomization, those who received the shoe-based intervention reported significantly greater reduction in their pain scores, with an average 3.5-point reduction on a 10-point numeric rating scale. Those who received physical therapy reported an average 1.8-point reduction.
The second study presented by Dr. Bartels detailed the results of a retrospective registry review of 95 patients with knee osteoarthritis who had been prescribed the shoe intervention after exhausting other nonsurgical options. After an average follow-up time of 5.6 years, 12.6% of the patients using the shoe had undergone total knee replacement compared with 34.3% of a control group of patients from the same period who received traditional physical therapy.
“Increased use of biomechanical intervention to treat knee OA may help reduce some of the burden on healthcare and society associated with end-stage knee OA by delaying or avoiding surgery,” the researchers wrote.
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