Prolonged standing in the workplace – a mixed methods approach to exploring, developing and evaluating footwear solutions

Prolonged standing at work, or prolonged periods maintaining an upright posture is required in 58-72% of working populations and is associated with the development of work-related musculoskeletal disorders in the lower back, legs and feet. This can result in the loss of workforce and a reduced quality of life for workers and has financial implications at a government level, for the individuals and for the employers. This thesis is comprised of 6 peer-reviewed journal papers as a focussed body of work and a critical analysis of these papers and how they relate to the work of others in the field. It is presented in two parts. The first explores the demands of prolonged standing, considering the previous literature, definitions of workplace activity and the prevalence of musculoskeletal disorders. The second part develops and evaluates a footwear solution for prolonged standing workers through: interviews with end-users; studying biomechanical changes over time and assessing footwear comfort. The adopted mixed methods approach enables footwear development based on quantitative biomechanical outcomes and qualitative consumer data, demonstrating a novel approach to the problem of prolonged standing at work. The impact of the published works is considered in the critical analysis chapter that also critiques the key methodological strengths and limitations, provides documentation of a research-based footwear development process and develops suggestions for future research. Overall, this thesis identifies that workers spending prolonged periods of time standing demonstrate a high prevalence of musculoskeletal disorders, recognises the need to redefine standing into multiple activities and develops a range of insoles for footwear that optimise comfort for the individual based on the identification that a one-shoe-fits-all approach is not adequate. The footwear solution comprised a range of insoles varying in hardness under the medial arch alongside an exploration of factors related to insole preference and comfort. However, perhaps the most important conclusion that can be drawn from these works relate to the need for future research, and specifically the relationships between time, standing, foot health and footwear