The effect of foot orthoses on gait biomechanics and pain among people with rheumatoid arthritis: A quasi-experimental study |
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Institution: | 1. Sport Sciences – Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark;2. Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark;3. Department of Materials and Production, Aalborg University, Aalborg, Denmark;4. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark;5. Danish Hospital for Rheumatic Diseases, University of Southern Denmark, Sønderborg, Denmark;6. School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia |
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Abstract: | BackgroundFoot pain is frequent among people with rheumatoid arthritis (RA). Foot orthoses (FO) are commonly prescribed with the intention to reduce pain symptoms and improve function.Research questionHow do a custom-made FO affect pain, gait biomechanics and daily activity among people with RA?MethodsTwenty-five participants with RA and foot pain completed this quasi-experimental study using a control insole for four weeks and then a custom-made FO in the following four weeks. The foot orthoses were customized by plantar foot shape targeting optimal restoration of normal arch height. A visual analog scale was used to monitor changes in ankle/foot, knee, hip joints, and global arthritis pain. In addition, the perceived pain area was measured using a body chart analysis. Kinematics and kinetics of the hip, knee and ankle joints during gait were analyzed using 3D-motion capture. Daily steps were measured with a wrist-based activity tracker for both the control insole and custom-made FO period, respectively.ResultsIn comparison to the control insole, the custom-made FO reduced ankle/foot pain intensity (p < 0.001) in addition to a reduction of the perceived pain areas in the feet (p < 0.001), legs (p = 0.012), as well as the arms and hands (p = 0.014). Ankle plantar flexion and eversion moments were also reduced (p < 0.001). No difference in daily steps was observed between the two periods (p = 0.657).SignificanceThis study has demonstrated an ankle/foot pain-relieving effect in conjunction with alterations of the ankle joint moments in people with RA using custom-made FO. The pain relief is plausibly attributed to alterations of the ankle joint moments when using the custom-made FO. However, future studies are needed to explore further into therapeutic implication of custom-made FO in pain management of people with RA. |
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Keywords: | Biomechanics Foot orthotics Gait Pain Rheumatoid arthritis |
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