Background Foot involvement happens early in RA patients and situation becomes ugly and painful rather very fast. There is a blank gap between starting of foot involvement and the time where patient needs surgical intervention for correcting the damages done by RA. No guideline exists for determining when and what we can do in these patients to detect and prevent the changes or at least reduce their damages.(1)
Objectives 1. Evaluating foot pressure changes by pedobaroghy:
comparing maximum force/peak pressure distributed in different regions of foot between RA patients and healthy individuals.
comparing maximum force/peak pressure distributed in different regions of foot between men and women.
determining effects of aging on maximum force/peak pressureby comparing them between two age groups.
determining effects of duration of RA on force/peak pressure in RA patients.
2. Evaluating radiologic findings in symptomatic RA patients and comparing them with pedobarographic findings.
3. Evaluating and comparing quality of life in RA patients and healthy individuals with SF36 questionnaire.
Methods 90 RA patients and 45 healthy individuals were chosen and entered this research. Patients divided into two groups: 45 patients without any previous foot symptoms, 45 with foot symptoms. All these groups underwent dynamic pedobarography with Novel emed pedobargraphy.
We took foot and ankle X-rays for symptomatic group.
Based on Larsen score, symptomatic patients were divided into individuals with and without radiologic changes.
Results There was a significant difference in total maximum force between patients and healthy individuals; healthy individuals had lesser amount of maximum force in different parts of their feet compared to RA patients.
Fore foot region endured the most amount of maximum force and pressure in all three groups with no significant difference between groups.
RA patients both symptomatic and asymptomatic had more force and pressure upon their midfoot regions compared to the healthy group p-value:.000.
Since we excluded patients with severe deformities and those who couldn't walk alone from the study, and our cases were relatively in early stages of disease, we didn't find any significant difference in pressure or force between symptomatic patients with and without radiographic findings. This can be explained by the fact that foot pressure alteration detectable in pedobarography is already begun in all patients with foot symptoms but radiologically evident pathologies had not happened yet.
Conclusions RA has considerable effect on patients' feet along with other physical and mental issues. While conventional radiologic methods has a limited eficacy in predicting and diagnosing the pathologic changes in foot region, pedobarography can easily shows these changes in foot pressure values and can be used to detect RA patients that need simple interventions like using proper insoles to prevent surgical interventions
Schmiegel A, Rosenbaum D, Schorat A, Hilker A, Gaubitz M. Assessment of foot impairment in rheumatoid arthritis patients by dynamic pedobarography. Gait & posture. 2008;27(1):110–4.
Disclosure of Interest None declared