In-shoe plantar pressure measurements for the evaluation and adaptation of foot orthoses in patients with rheumatoid arthritis: A proof of concept study

Outcomes and potential mechanism of a protocol to optimize foot orthoses in patients with rheumatoid arthritis

“…Patients of an outpatient center for rehabilitation and rheumatology in the Netherlands served as the study population for this quasi-experimental clinical trial. In a previously published proof of concept study the outcomes of FOs (developed by using a FOs optimization protocol) on immediate plantar pressure redistribution and the feasibility of the protocol were reported [18]. In this FOs optimization protocol, the feedback of in-shoe plantar pressure measurements was used for the evaluation and adaptation of FOs.…”

“…However, the relationship between change in forefoot plantar pressure and change in pain has never been investigated. Furthermore, in our previous study investigating the FOs optimization protocol we found that a subgroup of patients with forefoot pain also had high forefoot plantar pressure at baseline [18]. This implies that only in the patients with combined forefoot pain and high forefoot plantar pressure, the mode of action of FOs may be related to plantar pressure reduction.…”

“…The protocol included: (1) setting individual treatment goals on plantar pressure redistribution, (2) manufacturing custommade FOs according to the patient's needs, based on the clinical reasoning process of the podiatrist, and (3) evaluating and, if necessary, adapting FOs according to the feedback of in-shoe plantar pressure measurements (in one to three rounds). The adapted FOs showed, in a repeated single session design, small additional forefoot plantar pressure reduction over usual care FOs [18]. The immediate feedback of in-shoe plantar pressure measurements provided guidance in the clinical reasoning process of the podiatrist.…”

“…The immediate feedback from in-shoe plantar pressure measurements seems promising in optimizing the treatment effect of FOs, as shown in treatment with therapeutic footwear (including FOs) in diabetic foot patients [17]. Since the evaluation and subsequent adaptations of FOs in patients with RA is usually based on the patient's feedback, a protocol for the use of in-shoe plantar pressure measurements was developed, based on the protocol previously tested by Bus et al [17,18]. The protocol included: (1) setting individual treatment goals on plantar pressure redistribution, (2) manufacturing custommade FOs according to the patient's needs, based on the clinical reasoning process of the podiatrist, and (3) evaluating and, if necessary, adapting FOs according to the feedback of in-shoe plantar pressure measurements (in one to three rounds).…”

Prilagođeni uložak - dio 2

“…Potrebe na području ortopedskih uložaka sve su veće. Medicinska svrha ovih plantarnih proteza je ispraviti držanje ili biomehaničku neravnotežu koja ima tendenciju uzrokovati bol u različitim područjima tijela ovisno o patologiji pacijenta [7] [8][9] [10]. Terapeutske indikacije, koje se najčešće preporučuju, pronalaze se u slučaju osteoartritisa koljena ili bokova, nogu, nejednake dužine, kavusnog (visoki svod) i ravnog stopala (niski svod) ili zoni visokog tlaka [11] [12].…”