The effect of foot orthoses in rheumatoid arthritis / Efeito do uso de palmilhas no tratamento de pes reumatoides
AUTOR(ES)
Eduardo de Paiva Magalhães
DATA DE PUBLICAÇÃO
2007
RESUMO
Objective: To evaluate the effectiveness of foot orthoses, using the Foot Function Index (FFI), in a group of patients with rheumatoid arthritis (RA) in a period of six months. To compare the foot pressures in rheumatoid patients after the use of foot orthoses during a period of fifteen days. Methods: Thirty-six rheumatoid subjects with foot pain were examined and appropriate foot orthoses were prescribed according to each patient needs. All the patients were evaluated in 30, 90 and 180 days after baseline visit. FFI values, daily wearing time and adverse effects were noted in each appointment. The Stanford Health Assessment Questionnaire (HAQ) was obtained in the initial visit and it was used to evaluate the influence of physical condition on FFI response. Fifteen women with RA and foot pain were also examined and their foot pressure values measured using the F-SCAN program in first appointment and after fifteen days using appropriate insoles. Results: After the use foot orthoses, FFI values decreased in all subscales (pain, disability and activity limitation) for the patients studied. This reduction was noted early, in the first month and maintained during all the trial. Those using EVA (n=28) orthoses presented similar results to the total group. Otherwise, patients with made to measure orthoses (n=8) exhibited higher initial FFI values and worse evolution during the trial, still significant for pain and disability, but not for activity limitation. Minor adverse reactions were noted and none of them required treatment interruption. Orthoses were worn on an average for 7.14 hours in the first month without significant differences in the others visits. There was no relation between HAQ and FFI evolution. The patients using the foot orthoses achieved a significant plantar pressure reduction in forefoot and hindfoot. Conclusions: Foot orthoses were effective as an adjuvant management of rheumatoid foot. They significantly reduced pain, disability and activity limitation accessed by the FFI, with minor adverse effects. They also promote a better plantar pressure distribution and relief in forefoot and hindfoot
ASSUNTO(S)
artrite reumatoide rehabilitaiton aparelhos ortopedicos orthotic devices reabilitação rheumatoid arthritis
