Foot orthoses in the management of chronic subtalar and talo crural joint pain in rheumatoid arthritis

Gatt, Alfred; Formosa, Cynthia; Otter, Simon

doi:10.1016/j.foot.2016.03.004

Cited by 10 publications

(18 citation statements)

References 25 publications

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“…17 This outcome has been widely used in previous studies on the effectiveness of foot orthoses in rheumatoid arthritis. 2,4,5,16,18–21 Pain was reduced in both groups. However, group A (custom-made foot orthoses) improved earlier and to a greater extent, demonstrating short-term clinical effectiveness of the foot orthosis as previously reported.…”

Section: Discussionmentioning

confidence: 86%

“…1,2 The most frequent problems in the foot are pain, increased plantar pressure, and decreased functional capacity which have a negative impact on quality of life and increase the risk of falling. 1,3–5 The forefoot is commonly affected, especially the metatarsophalangeal joints. 1 Common structural problems include hallux valgus deformity, deformities of the lesser toes, subluxation of the metatarsophalangeal joints, and displacement of the plantar fat-pad.…”

Section: Introductionmentioning

confidence: 99%

“…This treatment provides greater stabilization of the foot and ankle, which can reduce the risk of developing deformities, alleviate pain and the inflammation, and improve the function of the foot. 3,5 Furthermore, they have been proven to be a cost-effective intervention. 4…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of custom-made foot orthoses in patients with rheumatoid arthritis: a randomized controlled trial

et al. 2018

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Objective: To determine the effect of custom-made foot orthoses versus placebo insoles on pain, disability, foot functionality, and quality of life. Design: Double-blinded randomized controlled trial. Setting: University Podiatric Clinical Area. Subjects: Patients with rheumatoid arthritis. Interventions: Patients were randomly assigned to either group A, which received custom-made foot orthoses, or group B, which received placebo, flat cushioning insoles, for three months. Main measures: The primary outcome was foot pain, measured by visual analog scale. Foot functionality, foot-related disability, and quality of life were measured using the Foot Function Index, the Manchester Foot Pain and Disability Index, and 12-Item Short Form Health Survey (SF-12) questionnaires, respectively, at the beginning and at days 30, 60, and 90. Results: A total of 53 patients, aged 59.21 ± 11.38 years, received either the custom-made foot orthoses (N = 28) or the placebo (N = 25). For the analysis of the data, only participants who had been measured at the four time points (0, 30, 60, and 90 days) were included. In group A, all variables showed statistically significant differences when comparing the initial and final measurements. Pain showed 6.61 ± 2.33 and 4.11 ± 2.66 in group A, at baseline and at 90 days, respectively, and Group B showed 6.16 ± 1.77 and 5.60 ± 2.71 at baseline and at 90 days, respectively. This was the only variable that showed statistically significant difference between groups (P = 0.048). Conclusion: The custom-made foot orthoses significantly reduced the participants’ foot pain, although they did not have positive effects on disability, foot functionality, and quality of life compared with only cushioning.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Effectiveness of custom-made foot orthoses in patients with rheumatoid arthritis: a randomized controlled trial

et al. 2018

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“…Six included studies (two of high (75 participants) [31, 34], three of fair (72 participants) [33, 35, 36] and one of low quality (10 participants) [37]) investigated the effect of treatment with FOs constructed of a semi-rigid shell versus soft FOs constructed of a soft shell. Pooled scores showed a medium, statistically significant, immediate effect for reduction of forefoot plantar pressure-time integral (PTI) in favor of treatment with soft FOs (SMD 0.60, 95% CI 0.07–1.14; P = 0.03; 28 participants; Fig.…”

Section: Resultsmentioning

confidence: 99%

“…2b) shows inconsistent findings across the included studies, for one type of FOs over the other. Four (out of six) studies were performed in the Western parts of the world and showed all a beneficial effect of semi-rigid FOs over soft FOs [31, 34, 36, 37]. The other two studies were performed in Asian countries and showed contrary findings [33, 35].…”

Section: Discussionmentioning

confidence: 99%

Systematic review on the comparative effectiveness of foot orthoses in patients with rheumatoid arthritis

Tenten-Diepenmaat

Dekker

Heymans

et al. 2019

Journal of Foot and Ankle Research

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Background Foot orthoses (FOs) are prescribed as an important conservative treatment option in patients with foot problems related to rheumatoid arthritis. However, a broad variation in FOs is used, both in clinical practice and in research. To date, there is no overview on the outcomes of the treatment with different kinds of FOs in patients with rheumatoid arthritis and a specific foot problem. The objectives of the present study were to summarize the comparative effectiveness of FOs in the treatment of various foot problems in patients with rheumatoid arthritis, on the primary outcomes foot function and foot pain, and the secondary outcomes physical functioning, health related quality of life, compliance, adverse events, the costs of FOs and patient satisfaction. Methods Studies comparing different kinds of FOs, with a presumed therapeutic effect, in the treatment of foot problems related to rheumatoid arthritis were included. A literature search was conducted in The Cochrane Central Registry for Controlled Trials (CENTRAL), PubMed, EMBASE and PEDro up to May 18th, 2018. Data was meta-analyzed, when this was not possible qualitative data analysis was performed. Results Ten studies were identified, with a total number of 235 patients. These studies made a comparison between different materials used (soft versus semi-rigid), types of FOs (custom-made versus ready-made; total-contact versus non-total contact), or modifications applied (metatarsal bars versus domes). Also, different techniques to construct custom-made FOs were compared (standard custom-molding techniques versus more sophisticated techniques). A medium effect for (immediate) reduction of forefoot plantar pressure was found in favor of treatment with soft FOs compared to semi-rigid FOs (SMD 0.60, 95% CI 0.07–1.14; P = 0.03; 28 participants). Other comparisons between FOs resulted in non-significant effects or inconclusive evidence for one kind of FOs over the other. Conclusions Foot orthoses made of soft materials may lead to more (immediate) forefoot plantar pressure reduction compared to foot orthoses constructed of semi-rigid materials. Definitive high quality RCTs, with adequate sample sizes and long-term follow-up, are needed to investigate the comparative (cost-) effectiveness of different kinds of foot orthoses for the treatment of foot problems related to rheumatoid arthritis. Electronic supplementary material The online version of this article (10.1186/s13047-019-0338-x) contains supplementary material, which is available to authorized users.

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A clinical practice guideline for the management of the foot and ankle in rheumatoid arthritis

Ramos-Petersen,

Reinoso-Cobo,

Ortega-Avila

et al. 2024

Rheumatol Int

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Rheumatoid arthritis causes progressive joint destruction in the long term, causing a deterioration of the foot and ankle. A clinical practice guideline has been created with the main objective of providing recommendations in the field of podiatry for the conservative management of rheumatoid arthritis. Thus, healthcare professionals involved in foot care of adults with rheumatoid arthritis will be able to follow practical recommendations. A clinical practice guideline was created including a group of experts (podiatrists, rheumatologists, nurses, an orthopaedic surgeon, a physiotherapist, an occupational therapist and patient with rheumatoid arthritis). Methodological experts using GRADE were tasked with systematically reviewing the available scientific evidence and developing the information which serves as a basis for the expert group to make recommendations. Key findings include the efficacy of chiropody in alleviating hyperkeratotic lesions and improving short-term pain and functionality. Notably, custom and standardized foot orthoses demonstrated significant benefits in reducing foot pain, enhancing physical function, and improving life quality. Therapeutic footwear was identified as crucial for pain reduction and mobility improvement, emphasizing the necessity for custom-made options tailored to individual patient needs. Surgical interventions were recommended for cases which were non-responsive to conservative treatments, aimed at preserving foot functionality and reducing pain. Moreover, self-care strategies and education were underscored as essential components for promoting patient independence and health maintenance. A series of recommendations have been created which will help professionals and patients to manage podiatric pathologies derived from rheumatoid arthritis.

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Foot orthoses in the management of chronic subtalar and talo crural joint pain in rheumatoid arthritis

Abstract: Background: This pilot study investigated whether semi-rigid and soft orthoses had

Cited by 10 publications

References 25 publications

Effectiveness of custom-made foot orthoses in patients with rheumatoid arthritis: a randomized controlled trial

Effectiveness of custom-made foot orthoses in patients with rheumatoid arthritis: a randomized controlled trial

Systematic review on the comparative effectiveness of foot orthoses in patients with rheumatoid arthritis

A clinical practice guideline for the management of the foot and ankle in rheumatoid arthritis

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