The effect of foot orthoses in rheumatoid arthritis

Magalhães, Eduardo; Davitt, Michael; Filho, Donaldo Jorge; Battistella, Linamara Rizzo; Bértolo, Manoel Barros

doi:10.1093/rheumatology/kei163

Cited by 54 publications

(25 citation statements)

References 15 publications

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“…I dati emersi da questo lavoro confermano l'opportunità dell'impiego, oltre ad adeguata terapia farmacologica, di una attenta valutazione clinica del piede reumatoideo anche in una fase precoce di malattia, che possa consentire di adottare rapidamente eventuali supporti meccanici, quali ortesi plantari, come ausilio nella prevenzione delle alterazioni anatomiche che si possono instaurare (19). Nonostante l'efficacia di supporti meccanici sia stata dimostrata sia in lavori di revisione (20,21) che in uno studio longitudinale di 6 mesi che ha evidenziato una riduzione, già entro il primo mese dall'applicazione della ortesi, del dolore e della limitazione funzionale (22), al momento non vi sono specifiche linee guida per la prescrizione della tipologia di ortesi plantare per i soggetti affetti da AR. La prescrizione spesso si basa su modelli standardizzati che non considerano il tipo specifico di alterazione strutturale presentata dal singolo soggetto e non ci si orienta sull'utilizzo di calzature idonee ed individualizzate in base alla tipologia dell'alterazione del piede (23)(24)(25).…”

Section: Discussioneunclassified

Analysis of foot structural damage in rheumatoid arthritis: clinical evaluation by validated measures and serological correlations

Biscontini¹,

Bocci²,

Gerli³

2011

Reumatismo

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tità del danno a carico delle strutture podaliche ha un andamento in genere variabile, talvolta ad evoluzione progressiva, con manifestazioni dipendenti dalle sedi anatomiche interessate, dall'età del soggetto affetto, ma in particolar modo dal grado di aggressività della malattia. In questo contesto, la determinazione del fattore reumatoide (FR) e, soprattutto, degli anticorpi anti-citrullina (anti-CCP) rappresentano, alla luce di numerose evidenze in letteratura, dei validi indici non solo diagnostici ma anche prognostici di malattia (3, 4). Il distretto più frequentemente colpito è l'avampiede dove si riscontrano segni e sintomi legati al danno anatomico che si crea, quali dolore, deformità e limitazione funzionale. Le sedi articolari selettivamente colpite sono le articolazioni metatarso-falangee (MTF) dove la flogosi prolungata produce nel tempo un indebolimento delle strutture di sostegno del piede (tendini e legamenti) che, uni-artrite reumatoide (AR) è una malattia infiammatoria cronica che colpisce elettivamente le piccole articolazioni delle mani e dei piedi. Frequente è l'interessamento podalico, riscontrabile sia in una fase precoce di malattia, con una incidenza riportata che va dal 16% al 45%, sia in una fase tardiva, in cui si vengono a realizzare deformità anatomiche clinicamente rilevanti in circa l'85% dei soggetti affetti dalla malattia (1, 2). L'en- Reumatismo, 2009; 61(1):48-53

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Section: Discussioneunclassified

Analysis of foot structural damage in rheumatoid arthritis: clinical evaluation by validated measures and serological correlations

Biscontini¹,

Bocci²,

Gerli³

2011

Reumatismo

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“…The results of this RCT agreed with the meta-analysis in that foot orthoses did not increase foot function. Additionally, 2 observational studies investigated foot function (27,34). These studies used the FFI and the FFI disability subscale, respectively, as their outcome measures.…”

Section: Significance and Innovationsmentioning

confidence: 99%

Custom foot orthoses for rheumatoid arthritis: A systematic review

Hennessy¹,

Woodburn²,

Steultjens³

2012

Arthritis Care & Research

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Objective. To identify and critically appraise the evidence for the effectiveness of custom orthoses for the foot and ankle in rheumatoid arthritis. Methods. Studies were identified in appropriate electronic databases (from 1950 to March 2011). The search term "rheumatoid arthritis" with "foot" and "ankle" and related terms were used in conjunction with "orthoses" and synonyms. Included studies were quantitative longitudinal studies and included randomized controlled trials (RCTs), case-control trials, cohort studies, and case series studies. All outcome measures were investigated. Quality assessment was conducted using the Cochrane Collaboration criteria with additional criteria for sample population representativeness, quality of statistical analysis, and compliant intervention use and presence of cointerventions. Meta-analyses were conducted for outcome domains with multiple RCTs. Qualitative data synthesis was conducted for the remaining outcome domains. Levels of evidence were then assigned to each outcome measure. Results. The inclusion criteria were met by 17 studies. Two studies had high quality for internal validity and 3 studies had high quality for external validity. No study had high quality for both internal and external validity. Six outcome domains were identified. There was weak evidence for custom orthoses reducing pain and forefoot plantar pressures. Evidence was inconclusive for foot function, walking speed, gait parameters, and reducing hallux abductovalgus angle progression. Conclusion. Custom orthoses may be beneficial in reducing pain and elevated forefoot plantar pressures in the rheumatoid foot and ankle. However, more definitive research is needed in this area.

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“…Non-pharmacological interventions for RA that include foot orthoses and footwear can reduce pain and disability and improve long-term outcomes with existing and potential foot problems [8]. Previous studies have reported on the clinical effectiveness of foot orthoses in people with established RA, ranging from simple insoles to customised foot orthoses [9][10][11][12]. Clark [13] reported that few studies have undertaken a cost effectiveness analysis to investigate the cost implication of the prescription of foot orthoses for people with established RA, despite the high prevalence of foot involvement and the high direct cost of RA related health care to the UK economy.…”

Section: Introductionmentioning

confidence: 99%

Clinical effectiveness and cost-effectiveness of foot orthoses for people with established rheumatoid arthritis: an exploratory clinical trial

Rome

Clark

Gray

et al. 2016

Scandinavian Journal of Rheumatology

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The effect of foot orthoses in rheumatoid arthritis

Abstract: Foot orthoses were effective as an adjuvant in the management of rheumatoid foot. They significantly reduced pain, disability and activity limitation, as measured by the FFI, with minor adverse effects.

Cited by 54 publications

References 15 publications

Analysis of foot structural damage in rheumatoid arthritis: clinical evaluation by validated measures and serological correlations

Analysis of foot structural damage in rheumatoid arthritis: clinical evaluation by validated measures and serological correlations

Custom foot orthoses for rheumatoid arthritis: A systematic review

Clinical effectiveness and cost-effectiveness of foot orthoses for people with established rheumatoid arthritis: an exploratory clinical trial

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