Custom foot orthoses for rheumatoid arthritis: A systematic review

Abstract

Objective. To identify and critically appraise the evidence for the effectiveness of custom orthoses for the foot and ankle in rheumatoid arthritis. Methods. Studies were identified in appropriate electronic databases (from 1950 to March 2011). The search term "rheumatoid arthritis" with "foot" and "ankle" and related terms were used in conjunction with "orthoses" and synonyms. Included studies were quantitative longitudinal studies and included randomized controlled trials (RCTs), case-control trials, cohort studies, and case series studies. All outcome measures were investigated. Quality assessment was conducted using the Cochrane Collaboration criteria with additional criteria for sample population representativeness, quality of statistical analysis, and compliant intervention use and presence of cointerventions. Meta-analyses were conducted for outcome domains with multiple RCTs. Qualitative data synthesis was conducted for the remaining outcome domains. Levels of evidence were then assigned to each outcome measure. Results. The inclusion criteria were met by 17 studies. Two studies had high quality for internal validity and 3 studies had high quality for external validity. No study had high quality for both internal and external validity. Six outcome domains were identified. There was weak evidence for custom orthoses reducing pain and forefoot plantar pressures. Evidence was inconclusive for foot function, walking speed, gait parameters, and reducing hallux abductovalgus angle progression. Conclusion. Custom orthoses may be beneficial in reducing pain and elevated forefoot plantar pressures in the rheumatoid foot and ankle. However, more definitive research is needed in this area.

The effectiveness of a multidisciplinary foot care program for children and adolescents with juvenile idiopathic arthritis: An exploratory trial

“…Evidence from systematic reviews suggests that customised foot orthoses are sustainably effective in reducing painful foot symptoms and disability in patients with RA (39). The positive effects of foot orthoses for reducing pain and image-guided ICIs for reducing synovial hypertrophy in JIA were not demonstrated at follow-up in this study (14,17).…”

Dynamic plantar loading index detects altered foot function in individuals with rheumatoid arthritis but not changes due to orthotic use

“…In patients with RA affecting the foot, custom foot orthoses are a recommended intervention (Hennessy et al, 2012). Therefore it was hypothesized that the DPLI could provide an additional biomechanical target that may assist in the designing functionally optimized foot orthoses (Gibson et al, in press).…”

“…Moreover, recent research has demonstrated that abnormal foot mechanics as well as inflammatory disease factors contribute independently to the overall burden of foot disease (Barn et al, 2013;Hooper et al, 2012;. Conservative treatment options are available, with prescription footwear (Dahmen et al, 2014;Williams et al, 2007) and custom orthotic interventions (Chang et al, 2012;Hennessy et al, 2012;Woodburn et al, 2002) shown to be effective at reducing pain and peak forefoot plantar pressures.…”

Rheumatic Diseases

“…Further, although Hennessy et al (2012) found that custom orthoses may be beneficial in reducing pain and elevated forefoot plantar pressures, they also concluded that the evidence was inconclusive for foot function, walking speed, gait parameters, and for reducing hallux valgus angle progression.…”