title: Do shock absorbing insoles in recruits undertaking high levels of physical activity reduce lower limb injury? A randomized controlled trial.
abstract: OBJECTIVE
  To assess the benefits, if any, of the use of shock absorbing insoles in reducing lower limb injury among Air Force recruits, and to assess the differences, if any, in the efficacy of two commonly available shock absorbing insoles.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  RAF Halton, UK. Site of all basic training for RAF personnel.
  
  
  METHODS
  1205 recruits participating in basic training between 17 September 2003 and 7 April 2004.
  
  
  METHODS
  Participants were randomized to receive either standard issue Saran non-shock absorbing insoles, or shock absorbing Sorbothane or Poron insoles, on a 1:1:1 basis.
  
  
  METHODS
  The primary outcome measure was withdrawal from training for lower limb injury. The two primary comparisons were shock absorbing insole versus non-shock absorbing insole, and Sorbothane versus Poron (comparison of different shock absorbing insoles). Secondary outcomes were medical withdrawals for reasons other than those qualifying for the primary outcome measure.
  
  
  RESULTS
  When comparing the non-shock absorbing insole to the shock absorbing insoles 72/401 participants (18.0%) allocated to Saran insoles were removed from training because of a qualifying lower limb injury, compared with 149/804 (18.5%) allocated to the shock absorbing insole (Sorbothane or Poron), odds ratio 1.04 (95% CI 0.75 to 1.44; P=0.87). When comparing the two shock absorbing insole 73/421 participants (17.3%) randomized to Sorbothane were removed from training because of a qualifying lower limb injury, compared with 76/383 for Poron (19.8%), odds ratio 0.85 (95% CI 0.58 to 1.23; P=0.37).
  
  
  CONCLUSIONS
  Similar rates of lower limb injuries were observed for all insoles (shock absorbing and non-shock absorbing) in the trial. The trial provides no support for a change in policy to the use of shock absorbing insoles for military recruits.
authors.affiliation: Regional Medical Centre & Regional Rehabilitation Unit, RAF Halton, Aylesbury, Bucks HP22 5PG, UK. richwithnall@doctors.org.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Withnall
authors.forename: Joanne
authors.initials: J
authors.lastname: Eastaugh
authors.forename: Nick
authors.initials: N
authors.lastname: Freemantle
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000517:prevention & control*; D015444:Exercise / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D007869:Leg Injuries / Q000517:prevention & control*; D008889:Military Personnel; D009989:Orthotic Devices; D011140:Polyurethanes; D011312:Pressure; D011379:Prognosis; D011482:Protective Devices; D012775:Shoes
chemical_list: D011140:Polyurethanes; C040864:sorbothane