In-shoe plantar pressure measurements for the evaluation and adaptation of foot orthoses in patients with rheumatoid arthritis: A proof of concept study |
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| Institution: | 1. Channing Division of Network Medicine, Department of Medicine, Brigham and Women''s Hospital, and Harvard Medical School, USA;2. California Pacific Medical Center Research Institute, USA;3. Department of Health Studies, Center for Behavioral Neuroscience, American University, USA;4. Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, USA;5. Department of Psychiatry, University of California San Diego, USA;6. Department of Medicine, University of California San Diego, USA;7. Department of Psychiatry, University of California San Francisco, USA;8. Department of Neurology, University of California San Francisco, USA;9. Department of Epidemiology, University of California San Francisco, USA;10. Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, USA;11. Department of Medicine, University of Minnesota, USA;12. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, USA;13. Department of Epidemiology and Biostatistics, University of California San Francisco, USA;14. Departments of Medicine, Brigham and Women''s Hospital and Beth Israel Deaconess Medical Center, and Harvard Medical School, USA;15. Oregon Clinical and Translational Research Institute and School of Medicine, Oregon Health and Science University, USA;p. Department of Epidemiology, H.T. Chan Harvard School of Public Health, USA;q. Department of Epidemiology, Center for Public Health, Medical University of Vienna, Austria |
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| Abstract: | ObjectivesImproving foot orthoses (FOs) in patients with rheumatoid arthritis (RA) by using in-shoe plantar pressure measurements seems promising. The objectives of this study were to evaluate (1) the outcome on plantar pressure distribution of FOs that were adapted using in-shoe plantar pressure measurements according to a protocol and (2) the protocol feasibility.MethodsForty-five RA patients with foot problems were included in this observational proof-of concept study. FOs were custom-made by a podiatrist according to usual care. Regions of Interest (ROIs) for plantar pressure reduction were selected. According to a protocol, usual care FOs were evaluated using in-shoe plantar pressure measurements and, if necessary, adapted. Plantar pressure–time integrals at the ROIs were compared between the following conditions: (1) no-FO versus usual care FO and (2) usual care FO versus adapted FO. Semi-structured interviews were held with patients and podiatrists to evaluate the feasibility of the protocol.ResultsAdapted FOs were developed in 70% of the patients. In these patients, usual care FOs showed a mean 9% reduction in pressure–time integral at forefoot ROIs compared to no-FOs (p = 0.01). FO adaptation led to an additional mean 3% reduction in pressure–time integral (p = 0.05). The protocol was considered feasible by patients. Podiatrists considered the protocol more useful to achieve individual rather than general treatment goals. A final protocol was proposed.ConclusionsUsing in-shoe plantar pressure measurements for adapting foot orthoses for patients with RA leads to a small additional plantar pressure reduction in the forefoot. Further research on the clinical relevance of this outcome is required. |
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| Keywords: | Rheumatoid arthritis Foot orthoses In-shoe plantar pressure measurements |
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