The Effects of Custom-made Foot Orthoses on Foot Pain, Foot Function, Gait Function and Freeliving Walking Activities in Psoriatic Arthritis (PsA) Patients: a Pre-experimental Trial

Abstract Introduction: Foot involvement is a major concern in psoriatic arthritis (PsA) as it can lead to severe levels of foot pain and disability as well as reduced mobility and quality of life. Previous studies have shown moderate efficacy in reducing foot pain and disability in rheumatoid arthritis patients with the use of custom-made foot orthoses (CFO). However, evidence on the efficacy of CFO in PsA patients is lacking.Objectives: Explore the effects of CFO on foot function, foot and lower limb pain, gait function, and freeliving walking activities (FWA) in PsA patients.Methods: A Pre-experimental study including 20 PsA patients (mean age: 54.10 ± 9.06 y and disease duration: 11.53 ± 10.22 y), was conducted. All the participants received and wore CFO for a 7-week period. Foot and lower limb pain and foot function were measured before and after the intervention using the numerical rating scale (NRS) and the foot function index (FFI). Gait function was assessed from gait spatiotemporal parameters (STPs) extracted during a 10-meter walk test with an gait analysis system (Mobility Lab). Freeliving walking activities (step count, freeliving cadence, time spent in different ambulatory physical activities (APA)) were recorded over 7 days using accelerometer data collected from an instrumented sock worn during waking hours.Results: PsA patients reported severe baseline levels of foot pain (54.46 ± 14.58 %) and disability (46.65 ± 16.14%) on the FFI. Statistically and clinically significant improvements with large effect sizes (Cohen’s effect size > 1, p<0.005) in foot pain and foot function were observed after 7 weeks of CFO use. A significant correlation (r=-0.64, p<0.01) between CFO wear time after the adaption period and foot function on the FFI at 7 weeks was observed. However, no significant changes were demonstrated for gait STP nor for free-living walking activities after 7 weeks of CFO use.Conclusion: Results support the clinical and biomechanical plausibility of using CFO with PsA patients to reduce pain and improve foot function. Larger and controlled studies are needed to confirm these findings and a multidisciplinary approach including the prescription of exercise therapy and physiotherapy in combination with CFO could be relevant to improve STP and promote APA in PsA patients.Study registration: ClinicalTrials.gov, NCT05075343, Retrospectively registered on 29 September 2021.

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Effectiveness of preformed foot orthoses in reducing lower limb pain, swollen and tender joints and in improving quality of life and gait parameters in children with juvenile idiopathic arthritis: a randomised controlled trial (Protocol)

BMJ Paediatrics Open ◽

10.1136/bmjpo-2017-000121 ◽

2017 ◽

Vol 1 (1) ◽

pp. e000121

Author(s):

Antoni Fellas ◽

Davinder Singh-Grewal ◽

Jeffrey Chaitow ◽

Derek Santos ◽

Andrea Coda

Keyword(s):

Quality Of Life ◽

Lower Limb ◽

Controlled Trial ◽

Foot Orthoses ◽

Trial Protocol ◽

Limb Pain ◽

Gait Parameters ◽

Lower Limb Pain ◽

Randomised Controlled

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Is adiposity associated with back and lower limb pain? A systematic review

PLoS ONE ◽

10.1371/journal.pone.0256720 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0256720

Author(s):

Waruna L. Peiris ◽

Flavia M. Cicuttini ◽

Sultana Monira Hussain ◽

Mahnuma M. Estee ◽

Lorena Romero ◽

...

Keyword(s):

Systematic Review ◽

Musculoskeletal Pain ◽

Lower Limb ◽

Evidence Synthesis ◽

Risk Of Bias ◽

Low Back ◽

Foot Pain ◽

Limb Pain ◽

Lower Limb Pain ◽

Best Evidence Synthesis

Background Back and lower limb pain have a major impact on physical function and quality of life. While obesity is a modifiable risk factor for musculoskeletal pain, the role of adiposity is less clear. This systematic review aimed to examine the relationship between both adiposity and its distribution and back and lower limb pain. Methods A systematic search of electronic databases was conducted to identify studies that examined the association between anthropometric and/or direct measures of adiposity and site specific musculoskeletal pain. Risk of bias was assessed and a best evidence synthesis was performed. Results A total of 56 studies were identified which examined 4 pain regions, including the lower back (36 studies), hip (two studies), knee (13 studies) and foot (eight studies). 31(55%) studies were assessed as having low to moderate risk of bias. 17(30%) studies were cohort in design. The best evidence synthesis provided evidence of a relationship between central adiposity and low back and knee pain, but not hip or foot pain. There was also evidence of a longitudinal relationship between adiposity and the presence of back, knee and foot pain, as well as incident and increasing foot pain. Conclusions This systematic review provides evidence of an association between both body fat and its central distribution and low back and knee pain, and a longitudinal relationship between adiposity and back, knee and foot pain. These results highlight the potential for targeting adiposity in the development of novel treatments at these sites.

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The effects of custom-made foot orthosis using the Central Stabilizer Element on foot pain

Prosthetics and Orthotics International ◽

10.1177/0309364614531012 ◽

2014 ◽

Vol 39 (4) ◽

pp. 293-299 ◽

Cited By ~ 1

Author(s):

Gabriel Gijon-Nogueron ◽

Encarnacion Cortes-Jeronimo ◽

Jose Antonio Cervera-Marin ◽

Esther Diaz-Mohedo ◽

Eva Lopezosa-Reca ◽

...

Keyword(s):

Clinical Study ◽

Lower Limb ◽

Manufacturing Process ◽

Clinical Relevance ◽

Foot Orthoses ◽

Foot Pain ◽

Analog Scale ◽

Custom Made ◽

Foot Posture ◽

Foot Orthosis

Background: Foot orthoses have been applied for the management of lower limb disorders, mainly for those who develop foot pain. The Central Stabilizer Element (CSE) is a new element that contains the midfoot laterally when a plantar insole is manufactured. Objectives: To determine the effect on foot pain of adding the Central Stabilizer Element during the manufacturing process of foot orthosis, and to describe the proportions of Central Stabilizer Element in terms of width and length of this element. Study design: A clinical study. Methods: A sample comprising 130 patients (57 males and 73 females) with foot pain was recruited for this study, with the patients having supinated, neutral, pronated and overpronated feet. All the patients received a custom-made foot orthosis with the Central Stabilizer Element. The Central Stabilizer Element was made of resins of polyvinyl chloride, and is a device insert in foot orthosis that contains the midfoot laterally to control pronation and supination movements. Perceived patient’s foot pain was collected using a Visual Analog Scale at baseline, 15, 60 and 90 days after treatment. Results: A statistically significant decrease was found after foot orthosis application at all times in all foot types. There was a statistically significant correlation between all the ratio proportions according to foot posture (Foot Posture Index scores), except for heel length proportion. Conclusions: The Central Stabilizer Element, applied at midfoot level of a custom-made foot orthoses through a directly mould technique, can reduce foot pain, when a previous foot posture status is considered. Clinical relevance The Central Stabilizer Element can be of interest for those professionals who are involved in the manufacturing process of foot orthosis, throughout the control of an excesive pronated or a supinated foot condition that is provoking foot pain.

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Test yourself question: a 19-year-old male presents with progressive distal lower limb pain

Skeletal Radiology ◽

10.1007/s00256-021-03854-0 ◽

2021 ◽

Author(s):

Ramanan Rajakulasingam ◽

Miriam Ficial ◽

Asif Saifuddin

Keyword(s):

Lower Limb ◽

Limb Pain ◽

Lower Limb Pain

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Incapacitating lower limb pain syndrome in cord blood stem cell transplant recipients with calcineurin inhibitor

Pathology & Oncology Research ◽

10.1007/bf03033761 ◽

2004 ◽

Vol 10 (4) ◽

pp. 204-206 ◽

Cited By ~ 19

Author(s):

Aiko Kida ◽

Kazuteru Ohashi ◽

Takeshi Kobayashii ◽

Miwa Sakai ◽

Takuya Yamashita ◽

...

Keyword(s):

Stem Cell ◽

Lower Limb ◽

Calcineurin Inhibitor ◽

Stem Cell Transplant ◽

Pain Syndrome ◽

Cell Transplant ◽

Transplant Recipients ◽

Limb Pain ◽

Cord Blood Stem Cell ◽

Lower Limb Pain

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The transplanted patient who suffered from excruciating lower limb pain and developed nodular skin lesions

Nephrology Dialysis Transplantation ◽

10.1093/ndt/14.12.2947 ◽

1999 ◽

Vol 14 (12) ◽

pp. 2947-2949 ◽

Cited By ~ 1

Author(s):

Minh-Truc Vo-cong ◽

Alexandre Persu ◽

Liliane Marot ◽

Eric Goffin

Keyword(s):

Lower Limb ◽

Skin Lesions ◽

Limb Pain ◽

Lower Limb Pain

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Spatiotemporal Parameters And Gait Variability In People With Psoriatic Arthritis (Psa) : A Cross-Sectional Study.

10.21203/rs.3.rs-883851/v1 ◽

2021 ◽

Author(s):

Roua Walha ◽

Nathaly Gaudreault ◽

Pierre Dagenais ◽

Patrick Boissy

Keyword(s):

Psoriatic Arthritis ◽

Gait Speed ◽

Gait Variability ◽

Functional Mobility ◽

Clinical Settings ◽

Foot Pain ◽

Wide Range ◽

Spatiotemporal Parameters ◽

Foot Function ◽

And Function

Abstract Background: Foot involvement is a major manifestation of psoriatic arthritis (PsA) and could lead to severe levels of foot pain and disability and impaired functional mobility and quality of life. Gait spatiotemporal parameters (STPs) and gait variability, used as a clinical index of gait stability, have been associated with several adverse health outcomes including risk of falling, functional decline, and mortality in a wide range of populations. Previous studies showed some alterations in STPs in people with PsA. However, gait variability and the relationships between STPs, gait variability and self-reported foot pain and disability have never been studied in this populations. Body-worn inertial measurement units (IMUs) are gaining interest in measuring gait parameters in clinical settings.Objectives: To assess STPs and gait variability in people with PsA using IMUs and, to explore their relationship with self-reported foot pain and function and to investigate the feasibility of using IMUs to discriminate patient groups based on gait speed-critical values.Methods: 21 participants with PsA (Age: 53.9 ± 8.9 yrs; median disease duration: 6 yrs) and 21 age and gender-matched healthy participants (Age 54.23 ± 9.3 yrs) were recruited. All the participants performed three 10-meter walk test trials at their comfortable speed. STPs and gait variability were recorded and calculated using six body-worn IMUs and the Mobility Lab software (APDM®). Foot pain and disability were assessed in participants with PsA using the foot function index (FFI).Results: Cadence, gait speed, stride length, and swing phase, were significantly lower, while double support was significantly higher, in the PsA group (p< 0.006). Strong correlations between STPs and the FFI total score were demonstrated (|r|> 0.57, p< 0.006). Gait variability was significantly increased in the PsA group, but it was not correlated with foot pain and function (p< 0.006). Using the IMUs three subgroups of participants with PsA with clinically meaningful differences in self-reported foot pain and disability were discriminated.Conclusion: STPs were significantly altered in participants with PsA which could be associated with self-reported foot pain and disability. Future studies are required to confirm the increased gait variability highlighted in this study and its potential underlying causes. Using IMUs in clinical settings has been useful to objectively assess foot function in people with PsA. Study registration: ClinicalTrials.gov, NCT05075343, Retrospectively registered on 29 September 2021.

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