Evaluation of foot functionality in cases of rheumatoid arthritis through the FFI-BR and FHSQ-BR questionnaires: a cross-sectional observational study

Abstract

Rheumatoid arthritis (RA) is a chronic, progressive inflammatory disease that can cause limitations and difficulties in activities of daily living (ADLs), due to pain, gait impairment and difficulties with self-care. 1 Damage to the ankles and feet occurs in 85% to 100% of these patients and contributes greatly to their loss of quality of life. 2 Typically, foot involvement indicates more aggressive disease and requires more than just pharmacological care. 3 Studying functional disability of the feet is important because, in addition to causing the abovementioned limitations, this form of disability has been correlated with higher risk of falls due to stiffness, pain, muscle weakness and balance disorders, which increases mortality, health resource utilization and loss of patients' work capacity. 4,5 Although RA patients frequently complain about their feet, such complaints are often overlooked by healthcare professionals. Specific instruments for foot health assessment, including the Brazilian versions of the Foot Health Status Questionnaire (FHSQ-BR) and the Foot Function Index (FFI-BR), measure the day-today impact of involvement of the feet in RA. These instruments provide data that help in understanding the repercussions of this involvement and the respective therapeutic indications. This can improve the quality of life of the individuals affected. 3 OBJECTIVE The objectives of the present study were to assess the disability that originated through foot involvement among RA patients, as indicated using the FFI-BR and FHSQ-BR questionnaires, and to evaluate the influence of inflammatory activity on the dysfunction of foot joints.

Ultrasound imaging of the dorsalis pedis artery as an early indicator of the precursory changes for rheumatoid vasculitis: A case series

“…Due to the complex nature of RV diagnosis, we have incorporated a multifactorial evaluation. These evaluations include FHSQ 6 and RADAI-5, 44 with the impact of RA on quality of life and, in particular, foot health well documented. 6,7,10 However, these patient-reported outcome measures have not been specifically designed for people with RV and may not be sensitive enough to detect RV symptoms, which is consistent with our findings where no significant correlation between FHSQ and arterial inflammation was found.…”

“…3 The higher prevalence of foot problems for people with RA compared to the general population is part of this burden. 6,7 Sixty-nine percent of people with RA, in a recent study (n = 320), reported foot and ankle pain 8 and thus reported an unmet need for healthcare. 9,10 The burden of disease in people with RA is further increased with the coexistence of rheumatoid vasculitis (RV), including vascular symptoms of numbness, reduced foot muscle strength and skin lesions.…”

“…Furthermore, rheumatological autoimmune diseases are increasing up to 7.1%, adding to the medical and social burden 3 . The higher prevalence of foot problems for people with RA compared to the general population is part of this burden 6,7 . Sixty‐nine percent of people with RA, in a recent study (n = 320), reported foot and ankle pain 8 and thus reported an unmet need for healthcare 9,10 …”

Foot orthoses for people with rheumatoid arthritis, involving quantitative and qualitative outcomes: protocol for a randomised controlled trial

“… 1 2 The pain is due to structural and functional alterations associated with inflammation 3 and impacts on physical activity of patients with RA. 4 5 For example, Lee et al found that 42% of 176 patients with foot pain associated with RA failed to register any moderate/vigorous physical activity during a week-long evaluation. 6 Foot pain is strongly associated with a lack of physical activity.…”