Article

OBJECTIVES: Improving 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. METHODS: Forty-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.
RESULTS: Adapted 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.
CONCLUSIONS: Using 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.
CI - Copyright (c) 2016. Published by Elsevier B.V.

Langue : ANGLAIS