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

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

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Can Foot Orthoses Prevent Hallux Valgus Deformity in Rheumatoid Arthritis? A Randomized Clinical Trial

JCR Journal of Clinical Rheumatology ◽

10.1097/00124743-199512000-00001 ◽

1995 ◽

Vol 1 (6) ◽

pp. 313-322 ◽

Cited By ~ 40

Author(s):

Elly Budiman-Mak ◽

Kendon J. Conrad ◽

Kathryn E. Roach ◽

James W. Moore ◽

Yongsuk Lertratanakul ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Hallux Valgus ◽

Valgus Deformity ◽

Foot Orthoses ◽

Hallux Valgus Deformity

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FRI0686 The effect of foot orthoses on balance in rheumatoid arthritis patients: a randomized clinical trial

10.1136/annrheumdis-2018-eular.3770 ◽

2018 ◽

Author(s):

J. Z. Gaino ◽

M. B. Bertolo ◽

C. S. Nunes ◽

C. M. Barbosa ◽

Z. Sachetto ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Foot Orthoses

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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

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Efficacy and Safety of Subcutaneous Golimumab in Methotrexate-Naive Patients With Rheumatoid Arthritis: Five-Year Results of a Randomized Clinical Trial

Arthritis Care & Research ◽

10.1002/acr.22759 ◽

2016 ◽

Vol 68 (6) ◽

pp. 744-752 ◽

Cited By ~ 19

Author(s):

Paul Emery ◽

Roy M. Fleischmann ◽

Ingrid Strusberg ◽

Patrick Durez ◽

Peter Nash ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Efficacy And Safety

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Plasma interferon-alpha is associated with double-positivity for autoantibodies but is not a predictor of remission in early rheumatoid arthritis—a spin-off study of the NORD-STAR randomized clinical trial

Arthritis Research & Therapy ◽

10.1186/s13075-021-02556-1 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Marit Stockfelt ◽

Anna-Carin Lundell ◽

Merete Lund Hetland ◽

Mikkel Østergaard ◽

Till Uhlig ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Trial ◽

Disease Activity ◽

Randomized Clinical Trial ◽

Early Rheumatoid Arthritis ◽

Treatment Initiation ◽

Certolizumab Pegol ◽

Type I ◽

Protein Levels ◽

Early Ra

Abstract Background The type I interferon (IFN) gene signature is present in a subgroup of patients with early rheumatoid arthritis (RA). Protein levels of IFNα have not been measured in RA and it is unknown whether they associate with clinical characteristics or treatment effect. Methods Patients with early untreated RA (n = 347) were randomized to methotrexate combined with prednisone, certolizumab-pegol, abatacept, or tocilizumab. Plasma IFNα protein levels were determined by single molecular array (Simoa) before and 24 weeks after treatment initiation and were related to demographic and clinical factors including clinical disease activity index, disease activity score in 28 joints, swollen and tender joint counts, and patient global assessment. Results IFNα protein positivity was found in 26% of the patients, and of these, 92% were double-positive for rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). IFNα protein levels were reduced 24 weeks after treatment initiation, and the absolute change was similar irrespective of treatment. IFNα protein positivity was associated neither with disease activity nor with achievement of CDAI remission 24 weeks after randomization. Conclusion IFNα protein positivity is present in a subgroup of patients with early RA and associates with double-positivity for autoantibodies but not with disease activity. Pre-treatment IFNα positivity did not predict remission in any of the treatment arms, suggesting that the IFNα system is distinct from the pathways of TNF, IL-6, and T-cell activation in early RA. A spin-off study of the NORD-STAR randomized clinical trial, NCT01491815 (ClinicalTrials), registered 12/08/2011, https://clinicaltrials.gov/ct2/show/NCT01491815.

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