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Objectives: To compare balance, foot function and mobility in patients with rheumatoid arthritis with and without foot orthoses. Design: Randomized controlled trial. Setting: Outpatient rheumatology clinic. Subjects: A total of 94 subjects with rheumatoid arthritis were randomized; of these, 81 were included in the analyses (Intervention group: 40; Control group: 41). Intervention: The Intervention Group received custom-made foot orthoses while the Control Group received none intervention. Main measure: The “Foot Function Index,” the “Berg Balance Scale,” and the “Timed-up-and-go Test” were assessed at baseline an after four weeks. The chosen level of significance was P < 0.05. Results: Average (standard deviation) participant age was 56.7 (±10.6) years old and average disease duration (standard deviation) was 11.4 (± 7.2) years. Groups were similar at baseline, except for comorbidity index and race. After four weeks, significant interaction group versus time was observed for Foot Function Index (change: Intervention group: −1.23 ± 1.58; Control group: −0.12 ± 1.16 – P = 0.0012) and for Berg Balance Scale (change: Intervention group: 2 ± 3; Control group: 0 ± 3 – P = 0.0110), but not for the Timed-up-and-go Test (change: Intervention group: −1.34 ± 1.99; Control group: −0.84 ± 2.29 – P = 0.0799). Conclusion: Foot orthoses improved foot function and balance in patients with rheumatoid arthritis.

Objectives In a longitudinal case–control observational study, we evaluated the benefits of a self-management programme for hands developed for patients with SSc. Methods Patients with SSc included in the intervention group (IG) received a concise self-management programme with emphasis on hand exercises and were evaluated during 24 weeks regarding hand pain, hand function, range of motion, grip and tip and key pinch strength. Results were compared with a control group (CG) with no intervention using an analysis of variance for repeated measures with variables transformed into ranks (P ≤ 0.05). Effect sizes were calculated using Cohen’s test. Results Of 90 patients who were evaluated, seven were excluded at enrolment and 26 were excluded during the follow-up. Data from 57 subjects (IG 40, CG 17) were used for analysis. Groups were similar at baseline, except for the Scleroderma HAQ and tip and key pinch strength. Outcome improvements were noted only in the IG (P ≤ 0.05, large effect size). In the CG, variables did not change or had even worsened (hand grip strength and finger motion). Conclusions This self-management programme based on hand exercises for SSc resulted in pain reduction and hand function, strength and range of motion improvement. It can be a simple and useful intervention, especially when a regular rehabilitation programme is not available.

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