SLR - August 2009 - Susan Orabovic
Reference:
E. de P. Magalhaes, Davitt, M., Filho, D.J., Battistella, L.R., Bertolo, M.B. (2006). The effect of foot orthoses in rheumatoid arthritis. Rheumatology, 45(4): 449-453.
Scientific Literature Reviews
Reviewed by: Susan Orabovic, DPM
Residency Program: UHHS and the Ohio College of Podiatric Medicine
Podiatric Relevance:
This study demonstrates the high prevalence of foot abnormalities in rheumatoid arthritis (RA) patients and evaluates the effectiveness of foot orthoses in a group of patients with rheumatoid arthritis during a period of 6 months.
Methods:
Thirty-six patients from the arthritis clinic of UNICAMP were selected who met the criteria for RA including foot pain. Each patient was examined and foot orthoses were
prescribed in accordance with each patients need. After the initial visit, follow up appointments were scheduled for 30, 90, and 180 days. At each appointment, daily time
of wearing the orthoses, adverse effects and foot function index (FFI) values were calculated. The Stanford Health Assessment Questionnaire (HAQ) was administered at
the initial visit and used to evaluate the influence of physical condition on the patients FFI.
Results:
Insoles were prescribed according to each patients needs. EVA orthoses (ethyl-vinyl acetate) were indicated in 28 patients with results similar to those for the total group. The remaining 8 patients with made-to-measure orthoses had higher initial FFI values and worse evolution during the trial that was significant for pain and disability. Minor
adverse effects were noted in the first month; however, none required an interruption of treatment. With the use of the foot orthosis, the FFI values had decreased in all 3
subscales (pain, disability, and activity limitation). The reduction was noted in the first month and was maintained throughout the trial. There was no relation between HAQ and FFI evolution.
Conclusions:
In this study it was found that foot orthoses are effective as an adjuvant treatment in the management of the rheumatoid foot. Good results obtained with the foot orthoses can be explained by a better distribution of pressure under the foot attributing to relief of pain as the primary benefit. The FFI revealed significant reduction in pain, disability, and activity limitation with the improvement sustained during the whole trial.