Rheumatology Advance Access originally published online on November 15, 2005
Rheumatology 2006 45(4):449-453; doi:10.1093/rheumatology/kei163
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The effect of foot orthoses in rheumatoid arthritis
Department of Rheumatology, State University of Campinas-UNICAMP, 1 Orthotics and Prosthetics Unit, Department of Orthopedics, State University of Campinas-UNICAMP, Campinas and 2 Physical and Medical Rehabilitation Division-DMR, State University of São Paulo-USP, São Paulo/SP, Brazil.
Correspondence to: E. de P. Magalhães, Disciplina de Reumatologia, Departamento de Clínica Médica, FCM/UNICAMP, Campinas (SP), Postal 6111–CEP 13083-970, Brazil. E-mail: epmagalhaes{at}uol.com.br
Objective. To evaluate the effectiveness of foot orthoses using the foot function index (FFI) in a group of patients with rheumatoid arthritis (RA) during a period of 6 months.
Methods. Thirty-six rheumatoid subjects with foot pain were examined and appropriate foot orthoses were prescribed according to each patient's needs. All the patients were evaluated 30, 90 and 180 days after the baseline visit. FFI values, daily time of wearing the orthoses and adverse effects were noted at each appointment. The Stanford Health Assessment Questionnaire (HAQ) was used at the initial visit to evaluate the influence of physical condition on FFI response.
Results. With the use of foot orthoses, FFI values decreased in all subscales (pain, disability and activity limitation). This reduction was noted in the first month and was maintained throughout the trial. Those using EVA (ethyl-vinyl acetate; n = 28) orthoses presented results similar to those for the total group. Patients wearing made-to-measure orthoses (n = 8) exhibited higher initial FFI values and worse evolution during the trial, significant for pain and disability but not for activity limitation. Minor adverse reactions were noted; none required interruption of treatment. There was no relation between HAQ and FFI evolution.
Conclusions. Foot orthoses were effective as an adjuvant in the management of rheumatoid foot. They significantly reduced pain, disability and activity limitation, as measured by the FFI, with minor adverse effects.
KEY WORDS: Orthoses, Rheumatoid foot, Foot function index, Rheumatoid arthritis
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