Background Pain, stiffness and deformity of the feet are related to reduced mobility and participation restrictions in daily activities in patients with established rheumatoid arthritis (RA). The new biological medications are effective and reduce disease activity, but not disability to the same extent. Foot problems are assumed to be related to participation restrictions also in patients with early RA, diagnosed after the introduction of biological medications, hindering for example physical activity. Hence, there is a need for more knowledge about foot problems in order to identify possible needs for rehabilitative interventions.
Objectives To explore disability related to foot problems in women and men with early rheumatoid arthritis and its relation to participation in daily life.
Methods 59 patients (58% women, 20–63 years) with early RA were interviewed about participation dilemmas in daily life related to RA, using Critical Incident Technique. The interviews were audio-recorded and transcribed. Data related to foot problems were extracted and analysed thematically. A research partner with RA validated the retrieved categories. The study was approved by the Regional Ethics Committee.
Results More than 2/3 of the patients mentioned that they had participation restrictions related to foot problems. The analysis revealed 5 categories concerning foot problems and the relation to participation restrictions: 1) foot problems as an early indicator of the disease, 2) hindrance in managing the daily routine and house hold activities, 3) struggling to be mobile, 4) difficulties in doing a god job at work and 5) difficulties in participating in recreation and leisure activities. Both women and men shared many experiences, as difficulties to be physically active. Several women expressed difficulties to use the shoes they wanted. Being able to move on uneven ground in, for example, the forest was something that many men expressed as difficult.
Conclusions Patients with early RA with access to effective medications and multi professional interventions based on their individual needs still experience a wide range of foot related disability in major life arenas as work, in the household and during leisure time. This indicates a need to pay attention also in today's early RA patients to foot problems in the multi professional rehabilitation to prevent further disabilities and enable physical activity for men and women with RA.
Disclosure of Interest None declared