Background Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by peripheral polyarthritis, which may cause joint destruction and deformities, resulting in reduced function and disability. RA patients ofter have foot joint involvement in 85-100% of the cases. The use of insoles has been a routine in the treatment of rheumatoid feet, despite the weak evidence.
Objectives To assess the effectiveness of the use of insoles for foot pain, function, gait analysys, foot load distribution, quality of life and patient satisfaction regarding the use of the insoles in patients with RA.
Methods Eligible patients included women classified as RA according to the ACR criteria, aged 18-65 years old with pain in feet between 3 and 8 on a 10-cm pain scale (END) for walking; functional classes I, II, and III. Of the 208 patients evaluated, 80 met the eligibility criteria and were randomized into experimental (EG) or control groups (CG). The EG group made use of EVA insoles with arch support and medial retrocapital support, and CG group employed flat insoles during the study. Pacients were evaluated for pain (VAS) when walking and at rest, function (HAQ), function of the feet (FFI), quality of life (SF-36), 6-minute walk test, Likert scale, and examination of baropodometry dynamics (Pro FootWalk, AMcube ®, Gargas, France) at baseline, 45 days (T45), 90 days (T90) and 180 days after the onset of the use of the insoles by a blinded evaluator.
Results Thirty-nine and 41 patients were randomly divided into EG and CG groups, respectively. In the comparison between the groups using ANOVA for repeated measures, we found better results for the EG with a statistical difference for the variables END walking and at rest on the right and left foot with p <0.001 for all these variables, stride length (p = 0.001), and Likert scale (p = 0.039). For other variables, we found no statistically significant difference between groups.
Conclusions The use of insoles with medial arch and retrocapital support is effective in reducing pain when walking and at rest on both feet, increasing stride length and satisfaction with the use of insoles.
References Chalmers AC, Busby C, Goyert J, Porter B, Schulzer M. Metatarsalgia and rheumatoid arthritis: a randomized, single blind, sequential trial comparing 2 types of foot orthoses and supportive shoes. J Rheumatol. 200;27(7):1643-47.
Farrow SJ, Kingsley GH, Scott DL. Interventions for foot disease in rheumatoid arthritis: a systematic review. Arthritis Rheum 2005;53:593-602.
Acknowledgements FAPESP and CAPES
Disclosure of Interest None Declared
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