The study in Gait & Posture highlighted the effects of custom foot orthoses (FOs) on pain and function in people with rheumatoid arthritis (RA), who frequently experience foot pain. FOs are commonly prescribed, but the interaction between altered gait dynamics and pain is not fully understood.
The researchers set out to determine how custom-made FOs affect pain, gait biomechanics, and daily activity among people with RA, and found an ankle/foot pain-relieving effect in conjunction with alterations of the ankle joint with the FOs.
Twenty-five participants with RA and foot pain completed the study using a control insole for four weeks and then a custom-made FO in the following four weeks. The foot orthoses were customized by plantar foot shape targeting optimal restoration of normal arch height. A visual analog scale was used to monitor changes in ankle/foot, knee, hip joints, and global arthritis pain. In addition, the perceived pain area was measured using a body chart analysis. Kinematics and kinetics of the hip, knee, and ankle joints during gait were analyzed using 3D-motion capture. Daily steps were measured with a wrist-based activity tracker for both the control insole and custom-made FO period, respectively.
In comparison to the control insole, the custom-made FO reduced ankle/foot pain intensity in addition to a reduction of the perceived pain areas in the feet and legs, as well as in the arms and hands. Ankle plantarflexion and eversion moments were also reduced. No difference in daily steps was observed between the two periods.
The study’s authors concluded that the pain relief is plausibly attributed to alterations of the ankle joint moments when using custom-made FOs. However, future studies are needed to explore further into therapeutic implication of custom-made FO in pain management of people with RA.
The study, “The effect of foot orthoses on gait biomechanics and pain among people with rheumatoid arthritis: A quasi-experimental study,” was published in Gait & Posture.
Foot involvement is also a significant concern in psoriatic arthritis (PsA) as it can lead to severe levels of foot pain and disability and reduced mobility and quality of life, so a research team explored the effects of FOs on foot function, foot and lower-limb pain, gait function, and free-living walking activities in people with PsA. The results support the clinical and biomechanical plausibility of using FOs to reduce pain and improve foot function, and the researchers suggested large-scale, controlled studies to confirm their findings.
Twenty participants with PsA (mean age: 54.10 ± 9.06 years and disease duration: 11.53 ± 10.22 years) received and wore custom-made FOs for seven weeks. Foot and lower-limb pain and foot function were measured before and after the intervention using the numerical rating scale and the foot function index (FFI). Gait function was assessed by recording spatiotemporal parameters during a ten-meter walk test using an instrumented gait analysis system. Free-living walking activities (step count, free-living cadence, and time spent in different ambulatory physical activities) were recorded over seven days using an accelerometer-instrumented sock.
The FFI scores demonstrated severe baseline levels of foot pain (54.46 ± 14.58 percent) and disability (46.65 ± 16.14 percent). Statistically and clinically significant improvements in foot pain and foot function and large effect sizes were observed after the intervention period. A strong correlation between the FO wearing time and foot function was demonstrated. However, no significant changes were found for gait spatiotemporal parameters or free-living walking activities after seven weeks of CFO use.
The results support the clinical and biomechanical plausibility of using FOs for people with PsA to reduce pain and improve foot function, the researchers concluded, and large-scale and controlled studies are needed to confirm these findings.
The study, “The effects of custom-made foot orthoses on foot pain, foot function, gait function, and free-living walking activities in people with psoriatic arthritis (PsA): a pre-experimental trial,” was published in the journal Arthritis Research & Therapy.
