Advertisement
-
1
Helliwell P, Reay N, Gilworth G, et al: Development of a foot impact scale for rheumatoid arthritis. Arthritis Care Res 53: 418, 2005.
-
2
Briggs PJ, Stainsbury GD: Metatarsal head preservation in forefoot arthroplasty and the correction of severe claw toe deformity. Foot Ankle Surg 7: 93, 2001.
-
3
Firth J, Helliwell P, Hale P, et al: The predictors of foot ulceration in patients with rheumatoid arthritis: a preliminary investigation. Clin Rheumatol 27: 1423, 2000.
-
4
Taal E, Bobietinska E, Lloyd J, et al: Successfully living with chronic arthritis: the role of the allied health professionals. Clin Rheumatol 25: 189, 2006.
-
5
Conrad KJ, Budiman-Mak E, Roach KE, et al: Impacts of foot orthoses on pain and disability in rheumatoid arthritis. J Clin Epidemiol 49: 1, 1996.
-
6
Hodge MC, Bach TM, Carter GM: Orthotic management of plantar pressure and pain in rheumatoid arthritis. Clin Biomech 14: 567, 1999.
-
7
Redmond AC, Landorf KB, Keenan AM: Contoured, prefabricated foot orthoses demonstrate comparable mechanical properties to contoured, customised foot orthoses: a plantar pressure study. J Foot Ankle Res 2: 20, 2009.
-
8
Landorf KB, Keenan AM: Efficacy of foot orthoses: what does the literature tell us? JAPMA 90: 149, 2000.
-
9
Otter SJ, Bowen CJ, Young AK: Forefoot plantar pressures in rheumatoid arthritis. JAPMA 94: 255, 2004.
-
10
Bowen CJ, Burridge J, Arden N: Podiatry intervention in the rheumatoid foot. Br J Podiatry 8: 76, 2005.
-
11
Egan M, Brosseau L, Farmer M, et al: Splints and orthoses in the treatment of rheumatoid arthritis. J Rheumatol 32: 2136, 2005.
-
12
Farrow SJ, Kingsley GH, Scott DL: Interventions for foot disease in rheumatoid arthritis: a systematic review. Arthritis Care Res 53: 593, 2005.
-
13
McCourt FJ, Bevans J, Cluskey L: A report of a survey on in-shoe orthoses provision. J Br Podiatr Med 49: 73, 1994.
-
14
Bennett PJ, Miskewitch V, Duplock LR: Quantitative analysis of the effects of custom-molded orthoses. JAPMA 86: 307, 1996.
-
15
Quinn MA, Conaghan PG, Emery P: The therapeutic approach of early intervention for rheumatoid arthritis: what is the evidence? Rheumatogy 40: 1211, 2001.
-
16
World Health Organization: Chronic rheumatic conditions. Available at: http://www.who.int/chp/topics/rheumatic/en. Accessed November 14, 2007.
-
17
Jackson L, Binning J, Potter J: Plantar pressure in rheumatoid arthritis using prefabricated metatarsal padding. JAPMA 94: 239, 2004.
-
18
Tuna H, Birtane M, Tastekin N, et al: Pedobarography and its relation to radiologic erosion scores in rheumatoid arthritis. Rheumatol Int 26: 42, 2005.
-
19
Semple R, Turner DE, Helliwell PS, et al: Regionalised centre of pressure analysis in patients with rheumatoid arthritis. Clin Biomech 22: 127, 2007.
-
20
Cameron V, Santos D, Osborne A: A preliminary survey of podiatry services for patients with RA. Podiatry Now 12: 27, 2009.
-
21
Minns RJ, Craxford AD: Pressure under the forefoot in rheumatoid arthritis: a comparison of static and dynamic methods of assessment. Clin Orthop Relat Res 187: 235, 1984.
-
22
Keenan MA, Peabody TD, Gronley JK, et al: Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis. J Bone Joint Surg Am 73: 237, 1991.
-
23
D'Amico JC: The pathomechanics of adult rheumatoid arthritis affecting the foot. JAPA 66: 227, 1976.
-
24
Hughes J, Clark P, Klenerman L: The importance of the toes in walking. J Bone Joint Surg Br 72: 245, 1993.
-
25
Myerson MS, Shereff MJ: The pathological anatomy of claw and hammer toe. J Bone Joint Surg Am 71: 45, 1989.
-
26
Moeckel BH, Sculco TP, Alexiades MM, et al: The double-stemmed silicone rubber implant for rheumatoid arthritis of the first metatarsophalangeal joint: long-term results. J Bone Joint Surg Am 74: 564, 1992.
-
27
Woodburn J, Helliwell PS: Relation between heel position and the distribution of forefoot plantar pressure and skin callosities in rheumatoid arthritis. Ann Rheum Dis 55: 806, 1996.
-
28
Santos D: The Development of a System to Measure the Effects of Plantar Foot Pressure on the Microcirculation of the Foot [PhD thesis], Queen Margaret University, Edinburgh, 2006.
Effects of Off-the-Shelf Foot Orthoses on Plantar Foot Pressures in Patients with Early Rheumatoid Arthritis
Search for other papers by Derek Santos in
Current site
Google Scholar
PubMed
Search for other papers by Vicki Cameron-Fiddes in
Current site
Google Scholar
PubMed
Background
Rheumatoid arthritis (RA) often affects feet with progressive pathologic changes to foot morphology and pressure distribution. Studies in RA suggest that reductions in forefoot peak pressures can reduce pain. We investigated the effects of off-the-shelf foot orthoses on plantar foot pressures in patients with early RA.
Methods
Thirty-five patients with early RA were recorded walking. Variables measured were forefoot peak plantar pressure (PPPft), forefoot pressure-time integral (PTIft), and hallux and lesser toe and midfoot contact areas. Patients were analyzed while walking barefoot, with shoes, and with shoes and foot orthoses. Measurements were taken at baseline and at 3 and 6 months.
Results
There were significantly increased PPPft values between barefoot and shod and between barefoot and orthoses (P < .01). However, there was a significant reduction in PPPft during the 6 months with orthoses compared with shoes only (P < .01). Foot orthoses significantly reduced PTIft over 6 months (P < .01). Results also demonstrated a significant increase in hallux and lesser toe (P < .01) and midfoot (P < .01) contact areas during the 6 months with foot orthoses.
Conclusions
In patients with early RA, off-the-shelf foot orthoses cause a significant reduction of 22% in PPPft and 14% in PTIft as soon as insoles are worn compared with shod. Further reductions for orthoses compared with baseline were found by 3 months (15% in PPPft and 14% in PTIft) and 6 months (33% in PPPft and 33% in PTIft). These findings could contribute to reductions in foot pain.
