Assessment of the functional impact of foot involvement in patients with Rheumatoid Arthritis

Background:Orthoses and footwear can play an important role in managing foot pathology in patients whose systemic disease is controlled. Foot orthoses are frequently prescribed in clinical practice as an intervention for people with rheumatoid arthritis (RA).Objectives:The aim of our study is to evaluate the impact of thermoformable orthoses on the functional index of the foot (FFI) in patients with rheumatoid arthritis.Methods:We conducted an open clinical trial, having consecutively included 14 patients (85.7% female, average age 54.8 ± 10 years) suffering from rheumatoid arthritis (median progression time of 9 years [5 - 12]). The average DAS28 was 2.7 ± 1.2 and the functional impact objectified by the Health Assessment Questionnaire (HAQ) was on average 0.9 ± 0.7.The median deadline from the start of RA and the onset of the foot problem was 3 years [0 – 7,75]. The foot problem was bilateral in 100% of the cases and inaugural in 85.7% of the cases.We evaluated the functional impact of foot injury for all our patients at baseline and 8 weeks after the use of thermoformable orthoses, based on the FFI (Foot function Index) measuring the impact of foot pathology on function in terms of pain, disability and activity limitation.The comparison of the FFI domains before and after the use of orthoses was carried out using parametric or nonparametric paired tests using The SPSS statistical software.Results:With the use of foot orthoses, FFI values decreased in all subscales (p=0,024) (pain, disability and activity limitation). This reduction was significant for disability (0,011) but not for pain and activity limitation.There were no significant correlations between the global FFI and the progression of RA, the duration of foot damage and the functional impact measured by the HAQ.Table 1. The comparison of the FFI domains before and after the use of orthoses.psignificatif if< 0,05; Test used: Non-parametric test for two linked samples.Conclusion:Foot orthoses were effective as an adjuvant in the management of rheumatoid foot. They significantly reduced disability as measured by the FFI. The absence of factors associated with pain and limitation of activity could possibly be related to the small sample size.Disclosure of Interests:None declared

Download Full-text

Functional Impact of a Spectrum of Interstitial Lung Abnormalities in Rheumatoid Arthritis

CHEST Journal ◽

10.1378/chest.13-1394 ◽

2014 ◽

Vol 146 (1) ◽

pp. 41-50 ◽

Cited By ~ 37

Author(s):

Tracy J. Doyle ◽

Paul F. Dellaripa ◽

Kerri Batra ◽

Michelle L. Frits ◽

Christine K. Iannaccone ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Functional Impact ◽

Lung Abnormalities

Download Full-text

Is improvement of fatigue in Rheumatoid Arthritis a proper effect of biologics?

Romanian Journal of Internal Medicine ◽

10.2478/rjim-2020-0028 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Mahmoud Ines ◽

Ben Tekaya Aicha ◽

Rouached Leila ◽

Mrabet Ali ◽

Guerman Thouraya ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Health Assessment ◽

Study Cohort ◽

Functional Impact ◽

Disease Response ◽

Highly Active ◽

Chronic Illness Therapy ◽

Significant Amelioration ◽

Persistent Fatigue

AbstractBackground: The objective of our present study is to assess the relation between persistent fatigue and rheumatoid arthritis (RA) disease activity and its functional impact and to determine if the positive effect of biologics on fatigue is due to good disease response or to a different pathway.Methods: A study cohort of patients with established RA was conducted. We included patients who were initiation a biologic after at least failure of one conventional synthetic Disease Modifying Anti-Rheumatic Drug synthetic (csDMARDs). At baseline, patients had a moderately to highly active disease. Demographic characteristics, disease activity and functional impact were assessed by disease activity score (DAS28CRP) and health assessment questionnaire (HAQ) scores. Fatigue was evaluated by the Functional Assessment of Chronic Illness Therapy–Fatigue scale questionnaire (FACIT-F). Patients were examined before initiating biotherapy, then after three months and six months.Results: Thirty women with RA, with a mean age of 52.5 years, were included. At baseline, 57% received anti-TNFα: Etanercept (n=9), Adalimumab (n=6), Infliximab (n=2) and 43% received Rituximab. Good Eular response was obtained in 80% of patients at the third month and 97% of patients at the sixth month. In the analytic study, a significant amelioration after 3 months of biotherapy was found in both disease response (DAS28CRP) and fatigue (FACITF), respectively (p=0.01,p<0.001 and p<0.001). The disease activity decreased significantly also after sixth month (p=0.01, p<0.001 and p=0.012). In the linear multivariate analysis, the regression of visual analogic pain (VAS pain) was the only predictors of the improvement of fatigue.Conclusion: Biologics contribute to improve fatigue in patients with established RA and this effect seems to be independent from the clinical efficacy of this treatment.

Download Full-text

POS0549 FUNCTIONAL IMPACT OF FOREFOOT INVOLVEMENT IN RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2727 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 509.1-509

Author(s):

K. Maatallah ◽

H. Boussaa ◽

H. Riahi ◽

H. Ferjani ◽

W. Triki ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Significant Positive Correlation ◽

Foot Deformities ◽

X Rays ◽

Functional Impact ◽

Positive Correlation ◽

Larsen Score ◽

The Mean ◽

Hands And Feet

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease that mainly affects small joints of the hands and feet. Foot deformities may affect the patient’s gait, thus compromising their daily activities and autonomy.Objectives:The aim of this study was to analyze its functional impact.Methods:We conducted a cross-sectional study including patients diagnosed with RA according to the ACR/EULAR 2010 criteria. Demographic variables, Foot Function Index (FFI), and Health Assessment Questionnaire (HAQ) scores were analyzed. We collected data on the following clinical variables: The pain Visual Analog Scale (VAS), forefoot deformities, erythrocyte sedimentation rate (ESR), and Disease Activity Score 28 (DAS28). All patients had feet X-rays and the Larsen score was calculated. A blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer performed ultrasonography (US) of MTP joints. Synovitis was defined as an abnormal hypoechoic synovial tissue within the capsule that is not displaceable and poorly compressible and that may exhibit Doppler signals. The composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:We included 31 patients (25 men and six women) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. The mean ESR and DAS28 ESR were 33±26 mm [5-102] and 3.8±1.5 [0.6-7], respectively. Twenty-nine percent of patients had a high disease activity.Metatarsalgia was reported by 54.8% of patients with a mean VAS of 4.5±3.7 [0-9]. Forefoot deformities were noted in 42% of patients: round forefoot in 13% of cases, triangular forefoot in 29% of cases, hallux valgus in 29% of cases, Quintus varus in 29% of cases, and claw toes in 13% of cases. Corns and calluses were noted in 42% and 29% of cases respectively.X-rays showed abnormalities in 75% of patients. The mean Larsen score was 9.8±6.2 [0-28].US showed synovitis in 46.3% of MTP1, in 53.7% of MTP2, in 48.3% of MTP3, in 42.6% of MTP4, and in 37% of MTP5 joints. Doppler signal was detected in 5.6% of MTP1 and MTP2, and in 3.7% of MTP3, MTP4, and MTP5 joints. The mean US score was 5.3±4.3 [0-15].The mean FFI was 66.5%. Mean rates of pain, difficulty, and disability were 89.5%, 40%, and 70% respectively. The mean HAQ score was 0.5±0.5 [0-2]. Severe disability was noted in 20% of patients.A significant positive correlation was noted between FFI and, Larsen score (r=0.214, p=0.014) and US score (r=0.420, p=0.021). A significant positive correlation was also noted between HAQ score and, foot pain VAS (r=0.555, p=0.009).Conclusion:Foot involvement is frequently seen in RA. This condition may affect patients’ autonomy. Early diagnosis and appropriate treatment are necessary in order to preserve the quality of life.Disclosure of Interests:None declared

Download Full-text

Kinetic and Functional Impact of Foot Orthoses in Rheumatoid Arthritis Feet: A Randomized Clinical Trial

Journal of Arthritis ◽

10.4172/2167-7921.1000157 ◽

2015 ◽

Vol 04 (03) ◽

Cited By ~ 1

Author(s):

Cristiano Sena da Conceicao ◽

Mansueto Gomes Neto

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Foot Orthoses ◽

Functional Impact

Download Full-text

FRI0620-HPR THE EFFECT OF THERMOFORMABLE FOOT ORTHOSES ON WALKING IN RHEUMATOID ARTHRITIS PATIENTS: PRELIMINARY RESULTS FROM AN OPEN CLINICAL TRIAL

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5698 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 915.3-915

Author(s):

S. Fellous ◽

H. Rkain ◽

A. Ilham ◽

L. Benzakour ◽

T. Latifa ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Trial ◽

Small Sample ◽

Foot Orthoses ◽

Walk Test ◽

Functional Impact ◽

Before And After ◽

The Impact ◽

10 Meter Walk Test ◽

Difficulty Walking

Background:Foot pain is common in rheumatoid arthritis and appears to persist despite modern day medical management.Objectives:To evaluate the impact of thermoformable foot orthoses on walking in rheumatoid arthritis (RA) patients.Methods:This is a open clinical trial, that included 14 consecutive patients (85,7% female, mean age 54,8 ± 10 years) with RA (median duration of progression of 9 [5-12] years), the average DAS28 was 2,7+/-1,2 and the functional impact objectified by the Health Assessment Questionnaire (HAQ) was on average 0.9 ± 0.7.The foot problem was bilateral in 100% and inaugural in 85.7% of the cases.The 14 rheumatoid subjects were examined and appropriate foot orthoses were prescribed according to each patient’s needs. All the patients were evaluated at baseline and 8 weeks after use of orthoses. Gait pain, difficulty walking and the 10 Meter Walk test were noted at each appointment.We used dynamic baropodometric analysis to assess postural evaluation. We calculated the lateral-medial index of each foot before and after the use of orthoses.Table 1.Assessment of walking before and after the use of orthosesBefore orthosesAfter orthosespPain when walking*(EVA 0-10)5 [3-5,2]0 [0-2]0,002Difficulty walking* (0-10)- In house4 [3-5,2]2 [0-2]0,002- Outside6 [4,7-7]2 [1,5-2,5]0,0210 Meter Walk test**(Normal comfortable speed)- Nomber of steps18,64 ± 3,716,9 ± 50,2- Duration (sec)11,9 ± 4,611,8 ± 5,20,9- Walking speed (m/min)56,4 ±17,758,6 ± 20,30,6latero-medial (L/M) index**- L/M index of the right foot1,18 ± 0,171,23 ± 0,230,1- L/M index of the left foot1,25 ± 0,171,26 ± 0,190,9*median and quartile**average and standard deviationp significant if< 0,05Results:A significant decrease in walking pain (p = 0.002) and difficulty walking (p = 0.02) was found with the use of orthoses. The variations in 10 meter walk test and dynamic baropodometric parameters were not significant (p>0,05).There were no significant correlations between pain and difficulty walking, the progression of RA, the duration of foot damage and the functional impact measured by the HAQ.Conclusion:Thermoformable foot orthoses significantly reduced pain and difficulty walking. The absence of factors associated with pain and difficulty walking could possibly be related to the small sample size.Disclosure of Interests:None declared

Download Full-text