If patients in early stages of rheumatoid arthritis have foot problems, it is “crucial” to refer them to podiatrists, according to recent findings.
Roughly 90% of people with RA eventually develop foot or ankle symptoms, according to investigator Marike van der Leeden, Ph.D., a senior researcher and project leader at Reade, rehabilitation and rheumatology in Amsterdam.
Prescription foot orthoses is one of the ways to manage the patients' foot problems.
However, “indications for foot orthoses are not clear, and the effectiveness of the intervention is highly variable among patients,” according to the study.
To determine the clinical and demographic factors that predict the outcome of customized foot orthoses on related pain and disability, researchers conducted a prospective cohort study, which included 135 RA patients who were given customized foot orthoses made by a podiatrist.
Pain and disability were measured before and after the intervention period using a Numeric Rating Scale (NRS) for foot pain, the Foot Function Index (FFI), the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC), and a 10-meter walking time test, according to the study.
The intervention period included one or more podiatrist appointments during which the foot problem was diagnosed and managed.
The results showed that the duration of RA was negatively associated with score changes in NRS foot pain (P = .018), WOMAC pain (P = .001), FFI disability (P = .003), and WOMAC physical function (P = .002).
Age was negatively associated with the change score in 10-meter walking time (P = .008).
Statistically significant improvements after the intervention with foot orthoses were found on all outcome measures (P less than .001), according to the study.
“Shorter disease duration predicted greater improvements in self-reported foot pain and disability after intervention with foot orthoses,” the authors concluded.
“Younger age predicted greater improvements in walking time. Referral for conservative management with foot orthoses in the early stage of RA seems important when aiming to achieve reduction in pain and improvement in daily activities.”
“To date, no evidence is available for which types of foot orthoses are most effective for RA. Further research is needed for evidence-based prescription protocols for foot problems in RA.” Dr. van der Leeden said.
The authors reported no financial disclosures.
To date there are no data on the most effective type of foot orthoses for patients with RA-induced foot pain.
Source DR. VAN DER LEEDEN