Influence of Foot Orthoses on Plantar Pressures, Foot Pain and Walking Ability of Rheumatoid Arthritis Patients - A Randomised Controlled Study
By Novak, Primoz; Burger, Helena; Tomsic, Matija; Marincek, Crt; Vidmar, Gaj; Disability and Rehabilitation, Vol. 31, No. 8, pp. 638-645Publication Date: 2009
Study compared the effectiveness of functional foot orthoses and unshaped orthotic material on plantar pressure redistribution, forefoot pain reduction, and walking ability in patients with rheumatoid arthritis (RA). For the study, 40 patients with RA were randomized to receive flat unshaped material (UM) made of three layers of cork, Plastazote foam and Dynoshaum, or custom-designed functional orthoses (FOs) made of the same materials. To avoid possible influence of different footwear on outcomes, patients also received orthopedic shoes. Plantar pressure was recorded in-shoe using the F-Scan system. Foot pain was assessed by the pain subscale of the Foot Function Index (FFI). The influence of pain on patients’ walking ability was objectively assessed by the 6-minute walking test, wherein patients walked as fast as possible along a 70-meter circular path. Investigations were performed at baseline, 1 week after the patients received shoes with orthoses, and 6 months later. Results showed plantar pressures to be significantly higher at painful foot areas than at non-painful ones. No differences in plantar pressure redistribution were found between the FO and UM groups. Notable reduction of pain and improvement of walking ability were observed in both groups. The study concludes that foot pain has moderate impact on the walking ability of RA patients. Implications for further research with a larger group of participants, likely proving the superiority of the FO over the UM, are discussed.
Published by: Taylor & Francis, Limited (Website:http://taylorandfrancis.org)
International Society of Physical and Rehabilitation Medicine (Web Site: http://www.isprm.org )
