Hospital Workers Find Relief in new Biofeedback Insole

During independent third party* at the emergency staff of one of Toronto’s busiest hospitals significant reductions in pain and discomfort at key areas within the body. The outcome measures were determined using an analog pain scale.


a. Objective: This study was conducted to evaluate the effect of a novel system of shoe inserts that stimulate foot function (BAREFOOTSCIENCE™ Foot Strengthening System) upon musculoskeletal pain.

b. Design:
A prospective cohort study in which volunteers acted as their own controls. Data were recorded for a one‐week baseline period and for the following four weeks while using the BAREFOOTSCIENCE™.


c. Participants: Participants were nurses, administrative and medical staff. Forty‐eight individuals initially agreed to participate in the study, 44 submitted pain logs for at least one week and 32 completed an exit questionnaire. The participants were recruited through the Emergency Department (ED) of the Toronto East General Hospital.


d. Methods: Data was collected through questionnaire during the use of the insole device during employment shifts at the hospital

e. Outcome measures: Pain logs were used to record self‐reported pain and “tiredness” for specific body parts on scales ranging from 0 to 10. Participants also completed entry questionnaires to provide basic demographic information and exit questionnaires that asked them about their experience with the BAREFOOTSCIENCE™.

f. Results:
When data were analyzed using repeated measured analysis of variance, there were clinically and statistically significant declines in pain scores for the feet, knees, shoulders, lower back and shoulders, as well as significant declines for “tiredness” for all body parts except the hips (all p values <.05). There was also a significant decline in general fatigue (p<.05). Between the baseline and the
end of the study, 73% of participants had a decline in foot tiredness, 69% in foot pain and 65% in general fatigue. Satisfaction with the product was high, with 87.5% of users reporting they thought it was “great” or “good.”


g. Conclusions: The study was able to demonstrate that the BAREFOOTSCIENCE™ can significantly reduce many types of musculoskeletal pain and fatigue.

Result Summary ‐ A significant number Users reported:
1) Significant decrease in fatigue of the foot
Significant decrease in foot pain.
Significant decrease in overall fatigue
4) Significant decrease in knee pain
5) Significant decrease in lower back pain
6) Significant decrease in shoulder pain
7) Decreased pain and discomfort in the knee.
8) Decreased pain and discomfort in the lower back
9) Decreased pain and discomfort in the shoulders


These results are as expected in that the muscle activation, muscle firing and resultant exercise and strengthening produce a more stable foot structure. The presence of stronger more efficient foot muscles allows for increase management of energy within the foot and a reduction in the need for energy dissipation through harmful modes such as soft tissue destruction.


The reductions in fatigue are attributed to the better utilisation and management of energy at the level of the foot as well as a resultant of improved muscular skeletal alignment through the body, thus necessitating less chronic muscular contractions at joints superior to the foot and ankle for purposes of stabilisation of the relevant joint. The reduction in required muscle contraction reduces energy consumption and related metabolic processes.


The reductions in pain are attributed to better localized energy management and reduction of energy dissipation through soft tissue destruction as well as improved pressure distribution over articulating surfaces resulting from improved musculoskeletal alignment.


*Third Party Pain Study Conducted at Toronto East General Hospital, Toronto Canada


Study Contacts:

1) Ned Amendola, MD Director, Professor, University of Iowa Sports Medicine,
   Department of Orthopaedic Surgery and Rehabilitation University of Iowa

   Ph: 319 356 4230 Fax: 319 384 9305 E:


2) Corinne Hodgson, M.Sc. CSH Associates Inc.
   378 Melores Drive Burlington, Ontario, Canada L7L 4T8
   Ph: 905‐634‐4019 Fax: 905‐634‐3515 E:



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