Methods for assessing footwear comfort: a systematic review

Perceived footwear comfort influences wearability and can impact on physical mobility, performance and foot-related complaints. To date, there has been no comprehensive review of the characteristics or methods for measuring perceived footwear comfort. The aims of this systematic review were to identify, appraise and synthesise the literature on methods used to assess perceived footwear comfort, and report their validity and reliability. Electronic databases were systematically searched and the articles screened and appraised for methodological risk of bias using a modified Quality Index checklist. Data on footwear comfort assessment tools (methods, populations, footwear types, reliability/validity) was extracted by two reviewers. A narrative synthesis was undertaken to describe the findings. Ninety-nine articles involving 6980 participants were assessed as eligible for review. Perceived footwear comfort has been assessed by a variety of methods including the visual analogue scale (VAS), Likert-type scales, ranking scales and questionnaires. The studies have covered a range of populations, both healthy and pathological, ranging between ages 8 and 75 years, most commonly adults. Investigations into reliability of perceived footwear comfort scales were limited, and whilst some tools had evidence of moderate to high reliability, findings were population dependent. Developmental or independent validity testing was typically not undertaken. Risk of bias was variable across studies. Perceived footwear comfort assessment has been performed across a wide range of populations and footwear types. Whilst select measures had evidence for their reliability, the results were variable and population dependent. There is scope for further research into the reliability and validity of perceived footwear comfort assessment tools in different populations.