Outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritis
Abstract Background Foot problems are highly prevalent in patients with rheumatoid arthritis. Treatment of foot problems related to rheumatoid arthritis often consists of custom made foot orthoses. One of the assumed working mechanisms of foot orthoses is redistribution of plantar pressure by creati...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03364-5 |
| _version_ | 1811333687141203968 |
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| author | Marloes Tenten-Diepenmaat Joost Dekker Jos W. R. Twisk Elleke Huijbrechts Leo D. Roorda Marike van der Leeden |
| author_facet | Marloes Tenten-Diepenmaat Joost Dekker Jos W. R. Twisk Elleke Huijbrechts Leo D. Roorda Marike van der Leeden |
| author_sort | Marloes Tenten-Diepenmaat |
| collection | DOAJ |
| description | Abstract Background Foot problems are highly prevalent in patients with rheumatoid arthritis. Treatment of foot problems related to rheumatoid arthritis often consists of custom made foot orthoses. One of the assumed working mechanisms of foot orthoses is redistribution of plantar pressure by creating a larger weight bearing area. Overall, the reported treatment effect of foot orthoses on foot pain in rheumatoid arthritis is small to medium. Therefore, we developed a foot orthoses optimization protocol for evaluation and adaptation of foot orthoses by using the feedback of in-shoe plantar pressure measurements. The objectives of the present study were: 1) to evaluate the 3-months outcomes of foot orthoses developed according to the protocol on pain, physical functioning and forefoot plantar pressure in patients with foot problems related to rheumatoid arthritis, and 2) to determine the relationship between change in forefoot plantar pressure and change in pain and physical functioning. Methods Forty-five patients with foot problems related to rheumatoid arthritis were included and received foot orthoses developed according to the protocol. Outcome measures were assessed at baseline and after three months of wearing foot orthoses in 38 patients. Change scores and effect sizes (ES) were calculated for pain, physical functioning and plantar pressure. In a subgroup of patients with combined forefoot pain and high plantar pressure, the relationship between change in plantar pressure and change in pain and physical functioning was analyzed. Results In the total group of 38 patients, statistically significant changes in pain (ES 0.69), physical functioning (ES 0.82) and forefoot plantar pressure (ES 0.35) were found. In the subgroup (n = 23) no statistically significant relationships were found between change in plantar pressure and change in pain or physical functioning. Conclusion Foot orthoses developed according to a protocol for improving the plantar pressure redistribution properties lead to medium to large improvements in pain and physical functioning. The hypothesis that more pressure reduction would lead to better clinical outcomes could not be proven. |
| first_indexed | 2024-04-13T16:56:39Z |
| format | Article |
| id | doaj.art-3413b9474b2b43df938a15a73121ba81 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-13T16:56:39Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-3413b9474b2b43df938a15a73121ba812022-12-22T02:38:47ZengBMCBMC Musculoskeletal Disorders1471-24742020-06-012111910.1186/s12891-020-03364-5Outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritisMarloes Tenten-Diepenmaat0Joost Dekker1Jos W. R. Twisk2Elleke Huijbrechts3Leo D. Roorda4Marike van der Leeden5Amsterdam Rehabilitation Research Center | ReadeDepartment of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Epidemiology and Biostatistics, Amsterdam Public Health research instituteAmsterdam Rehabilitation Research Center | ReadeAmsterdam Rehabilitation Research Center | ReadeAmsterdam Rehabilitation Research Center | ReadeAbstract Background Foot problems are highly prevalent in patients with rheumatoid arthritis. Treatment of foot problems related to rheumatoid arthritis often consists of custom made foot orthoses. One of the assumed working mechanisms of foot orthoses is redistribution of plantar pressure by creating a larger weight bearing area. Overall, the reported treatment effect of foot orthoses on foot pain in rheumatoid arthritis is small to medium. Therefore, we developed a foot orthoses optimization protocol for evaluation and adaptation of foot orthoses by using the feedback of in-shoe plantar pressure measurements. The objectives of the present study were: 1) to evaluate the 3-months outcomes of foot orthoses developed according to the protocol on pain, physical functioning and forefoot plantar pressure in patients with foot problems related to rheumatoid arthritis, and 2) to determine the relationship between change in forefoot plantar pressure and change in pain and physical functioning. Methods Forty-five patients with foot problems related to rheumatoid arthritis were included and received foot orthoses developed according to the protocol. Outcome measures were assessed at baseline and after three months of wearing foot orthoses in 38 patients. Change scores and effect sizes (ES) were calculated for pain, physical functioning and plantar pressure. In a subgroup of patients with combined forefoot pain and high plantar pressure, the relationship between change in plantar pressure and change in pain and physical functioning was analyzed. Results In the total group of 38 patients, statistically significant changes in pain (ES 0.69), physical functioning (ES 0.82) and forefoot plantar pressure (ES 0.35) were found. In the subgroup (n = 23) no statistically significant relationships were found between change in plantar pressure and change in pain or physical functioning. Conclusion Foot orthoses developed according to a protocol for improving the plantar pressure redistribution properties lead to medium to large improvements in pain and physical functioning. The hypothesis that more pressure reduction would lead to better clinical outcomes could not be proven.http://link.springer.com/article/10.1186/s12891-020-03364-5Rheumatoid arthritisFootOrthosesOrthotic deviceOutcome assessment (health care)In-shoe plantar pressure measurements |
| spellingShingle | Marloes Tenten-Diepenmaat Joost Dekker Jos W. R. Twisk Elleke Huijbrechts Leo D. Roorda Marike van der Leeden Outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritis BMC Musculoskeletal Disorders Rheumatoid arthritis Foot Orthoses Orthotic device Outcome assessment (health care) In-shoe plantar pressure measurements |
| title | Outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritis |
| title_full | Outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritis |
| title_fullStr | Outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritis |
| title_full_unstemmed | Outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritis |
| title_short | Outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritis |
| title_sort | outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritis |
| topic | Rheumatoid arthritis Foot Orthoses Orthotic device Outcome assessment (health care) In-shoe plantar pressure measurements |
| url | http://link.springer.com/article/10.1186/s12891-020-03364-5 |
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