van der Leeden M, Steultjens M, Dekker JH, et al: Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics. .Rheumatology (Oxford)45::465. ,2006. .
van der Leeden M, Steultjens M, Dekker JH, et al: Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics. .Rheumatology (Oxford)45::465. ,2006. .)| false
Turner DE, Helliwell PS, Emery P, et al: The impact of rheumatoid arthritis on foot function in the early stages of the disease: a clinical case series. .BMC Musculoskelet Disord7::102. ,2006. .17184535)| false
Orlin M, Stetson K, Skowronski J, et al: Foot pressure distribution: methodology and clinical application for children with ankle rheumatoid arthritis. .Clin Biomech (Bristol, Avon)12::S17. ,1997. .)| false
Background: Rheumatoid arthritis is an autoimmune disease that causes chronic, progressive joint inflammation; it commonly affects the joints of the feet. Biomechanical alterations and daily pain in the foot are the common outcomes of the disease. Earlier studies focusing on plantar pressure in such patients reported increased vertical loading along with peak pressure-pain associations. However, footwear designed according to the pressure profiles did not relieve symptoms effectively. We examined plantar shear and pressure distribution in patients with rheumatoid arthritis and compared the findings with those of controls, and we investigated a potential relationship between foot pain and local shear stresses.
Methods: A custom-built platform was used to collect plantar pressure and shear stress data from nine patients with rheumatoid arthritis and 14 control participants. Seven patients reported the presence of pain under their feet. Pressure-time and shear-time integral values were also calculated.
Results: Peak pressure, pressure-time integral, resultant shear-time integral, and mediolateral shear stress magnitudes were higher in the complication group (P < .05). An association between peak shear-time integral and maximum pain locations was observed.
Conclusions: Increased mediolateral shear stresses under the rheumatoid foot might be attributable to gait instability in such patients. A correlation between the locations of maximum shear-time integral and pain indicate the clinical significance of plantar shear in patients with rheumatoid arthritis. (J Am Podiatr Med Assoc 100(4): 265–269, 2010)
Corresponding author: Brian L. Davis, PhD, Medical Device Development Center, Austen BioInnovation Institute in Akron, 1 S Main St, Ste 401, Akron, OH 44308. (E-mail: email@example.com)