Measuring sensation in the feet of patients with rheumatoid arthritis

Wilson, Oonagh; Kirwan, John R.

doi:10.1002/msc.32

Cited by 20 publications

(8 citation statements)

References 23 publications

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“…The FPS is calculated based on a grading of hallux valgus [ 30 ], lesser toe deformity, hyperkeratotic lesions, abnormal bony prominences and VAS foot pain [ 19 ]. Plantar sensation at six sites [ 31 ] was assessed as fine touch, using a 10 g monofilament, and as vibration perception threshold, using a biothesiometer [ 32 , 33 ]. Foot and ankle muscle strength (dorsiflexion, plantarflexion, inversion, eversion) was assessed using a hand-held dynamometer (HHD) using the make-test, in which the assessor resists the movement of the muscle [ 34 ].…”

Section: Methodsmentioning

confidence: 99%

Foot and ankle characteristics associated with falls in adults with established rheumatoid arthritis: a cross-sectional study

Brenton‐Rule

Dalbeth

Menz

et al. 2016

BMC Musculoskelet Disord

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BackgroundPeople with rheumatoid arthritis (RA) have an increased risk of falls. The foot is a common site of pathology in RA and foot problems are reported in up to 90 % of patients with established disease. The aim of this study was to determine whether foot and ankle characteristics are associated with falls in people with RA.MethodsAdults with RA were recruited from rheumatology outpatient clinics in Auckland, New Zealand. Participants reported whether they had fallen in the preceding year, and the number of falls. Clinical characteristics, common fall risk factors, and foot and ankle variables were measured. Univariate parametric and non-parametric analysis compared fallers and non-fallers on all variables to determine significant differences. Logistic regression analysis identified variables independently associated with falls.ResultsTwo hundred and one participants were prospectively recruited. At least one fall in the preceding 12-months was reported by 119 (59 %) participants. Univariate analysis showed that fallers had significantly longer mean disease duration, more co-morbid conditions, an increase in lower limb tender joints, higher midfoot peak plantar pressures and were more likely to have a history of vascular disease than non-fallers. Fallers also reported greater difficulty with activities of daily living, increased fear of falling and greater self-reported foot impairment. Logistic regression analysis revealed that increased midfoot peak plantar pressures (odds ratio (OR) 1.12 [for each 20 kPa increase], 95 % confidence interval (CI) 1.00-1.25), self-reported foot impairment (OR 1.17 [for each three point increase], 95 % CI 1.05-1.31) and history of vascular disease (OR 3.22, 95 % CI 1.17-8.88) were independently associated with a fall in the preceding 12 months.ConclusionsElevated midfoot peak plantar pressures, self-reported foot impairment and vascular disease are associated with falls in people with RA. Assessment of foot deformity, foot function and self-reported foot impairment may be of benefit when considering falls prevention strategies in people with RA.Trial registrationAustralia New Zealand Clinical Trial Registry (trial ACTRN12612000597897).

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Section: Methodsmentioning

confidence: 99%

Foot and ankle characteristics associated with falls in adults with established rheumatoid arthritis: a cross-sectional study

Brenton‐Rule

Dalbeth

Menz

et al. 2016

BMC Musculoskelet Disord

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“…A 10 g monofilament was used to detect sensory loss. Six sites were tested twice on the plantar aspect of each foot: the hallux and all metatarsophalangeal joints . Reduced protective sensation was identified if the patient was sensitive to less than 11 of 12 applications for each limb with a response yes/no .…”

Section: Methodsmentioning

confidence: 99%

Clinical characteristics of foot ulceration in people with chronic gout

Rome

Erikson

Otene

et al. 2014

International Wound Journal

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Gout is the most common form of inflammatory arthritis and it has an affliction to the foot. Foot involvement in gout has been linked to foot pain, impairment and disability. There has been limited research on the effect of ulceration on foot pain, impairment, disability and health-related quality of life in patients already living with gout. The aim of the study was to describe the wound characteristics and the effect on foot pain, disability and health-related quality of life in patients with foot ulceration associated with gout. Participants were recruited from rheumatology clinics in Auckland, New Zealand. All the current foot ulceration sites and wound characteristics were recorded using the TIME wound assessment tool. The outcome measures included general pain, patient global assessment scale, foot pain, disability and impairment. Participants completed the Cardiff Wound Impact Schedule to assess the effect of ulcers on health-related quality of life. Sensory loss, vibrational thresholds and ankle brachial pressure index were collated to assess for lower limb arterial disease. Six participants were predominantly older men with a long duration of gout, high rates of obesity and co-morbidities such as hypertension, hyperlipidaemia, diabetes and cardiovascular disease. The mean (SD) duration of the foot ulcers was 4 (2) months. The majority of foot ulcers observed were 0·5 cm(2) or smaller superficial thickness with surrounding callus. Partial thickness and full-thickness ulcers were also observed. Two patients presented with ulcers on multiple sites. There was only one case of infection. Gouty tophi were evident in most of the wounds. The dorsal aspect of the third toe was found to ulcerate in most cases. Moderate scores of foot pain, disability, impairment and health-related quality of life were observed. Most participants wore shoes deemed as poor. Foot ulceration in gout is chronic and multiple ulcers can occur with the potential of leading to delayed wound healing, infection and a reduced quality of life. Poor footwear may contribute to the development and delayed healing of ulceration in people with gout.

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“…Muscle power of the toes was assessed by the paper grip test [12]. Plantar sensation was assessed at 6 sites using a 10-gm monofilament (fine touch) [13]. Assessment of the range of motion of ankle joint was done using a modified lunge test [14] and passive subtalar ROM was performed clinically .…”

Section: Methodsmentioning

confidence: 99%

Falls in Rheumatoid Patients: Does Ankle and Foot Ultrasonography have a Predictive Role? A Single-blind Study

Alkady

Abdelaziz

Abdelwahed

et al. 2021

Aktuelle Rheumatologie

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Background Rheumatoid arthritis (RA) patients have a higher prevalence of falls compared with the healthy population. Several risk factors of falls in RA have been postulated, including high disease activity, low balance, muscle weakness and non-treatment with biologics. Aim of the work We investigated our hypothesis that the sonographically detected ankle and foot changes in RA patients can predict falls in this population. To our knowledge, no previous study had investigated this before. Methods In a total of 101 RA patients, we performed assessments of disease activity, disability level, gait speed, balance status, clinical examination of ankle and foot and an MSUS assessment of the ankle and foot joints and tendons as possible risk factors of falls. Results The Berg balance test had the highest fall-predicting power (71.3%), followed by a gait speed test and restricted range of motion (ROM) of the Rt. subtalar joint, each with a predictive power of 70.3%. Of the sonographic findings, erosion of the first metatarsophalangeal (MTP) joint was the most accurate fall predictor, followed by erosion of the talonavicular joint and tenosynovitis of the ankle dorsal flexors with an area under the curve of 0.656, 0.642 and 0.614, respectively. Conclusion The use of the MSUS as an adjunct objective method for predicting falls in RA patients has not been studied before. It was found that clinical foot and balance testing was a superior and easier way of predicting falls in RA patients than using ultrasonography.

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Measuring sensation in the feet of patients with rheumatoid arthritis

Cited by 20 publications

References 23 publications

Foot and ankle characteristics associated with falls in adults with established rheumatoid arthritis: a cross-sectional study

Foot and ankle characteristics associated with falls in adults with established rheumatoid arthritis: a cross-sectional study

Clinical characteristics of foot ulceration in people with chronic gout

Falls in Rheumatoid Patients: Does Ankle and Foot Ultrasonography have a Predictive Role? A Single-blind Study

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