Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood and adolescence and may generate short-term and long-term disability (1). The disease causes pain that may lead to posture and movement modifications and arouses muscular imbalance with reduced range of motion in the affected joints. Foot problems attributable to JIA include synovitis, tenosynovitis, enthesitis, pain, stiffness, and deformity (2). There is limited study about the foot impairments of patients with JIA.
Objectives The aim of this study was to investigate foot problems of JIA patients with pedobarographic assessment. Pedobarography is an objective, functional method that could be used in the diagnosis and treatment of foot disorders.
Methods 15 patients (10 female, 5 male) with JIA were enrolled in the study. Patients were included if they had a documented history of joint involvement affecting either two large lower limb joints, foot joint involvement or widespread polyarthritis as recorded by the physiotherapist. Plantar pressure assessment during walking and standing was used for Sensor Medica Pedobarographic System. Pedobarographic assessments as static (Forefoot loading, Rearfoot loading, Total loading, Maximum peak pressure - p.max) and dynamic (p. max, Loading in gait phases) were performed.
Results Mean age was 12.26±3.62 years. Parameters of static and dynamic pedobarographic assessment are shown in Tables 1 and 2. It was found difference for almost all parameters between affected and unaffected lower extremity but this difference was not significant. Only, it was found significant difference for pressure rate in loading response phase. It was found difference for almost all duration of gait phases between affected and unaffected lower extremity but this difference was not significant.
Conclusions Decreased duration of gait phases and impairment of plantar pressure distribution and was found in lower extremity affected patients with JIA in this study. Plantar pressure impairment and variation of duration in gait phases may cause increased energy consumption, fatigue and decreased functional ability in patient with JIA. We suggested that pedobarographic evaluation is important to reduce functional limitations and choose the appropriate orthosis in lower extremity affected patients with JIA.
Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet 2007;369:767–78.
Hendry GJ, Turner DE, Lorgelly PK, Woodburn J. Room for improvement: patient, parent, and practitioners' perceptions of foot problems and foot care in juvenile idiopathic arthritis.Arch Phys Med Rehabil. 2012 Nov;93(11):2062-7.
Disclosure of Interest None declared