Use and effects of custom-made therapeutic footwear on lower-extremity-related pain and activity
limitations in patients with rheumatoid arthritis: A prospective observational study of a cohort
Sammanfattning
OBJECTIVES: An estimated 55–90% of patients with rheumatoid arthritis have foot problems.
Therapeutic footwear is frequently prescribed as part of usual care, but data on its use and effect is
incomplete. This study aimed to investigate the use and effects of therapeutic footwear.
METHODS: Patients with rheumatoid arthritis receiving
custom-made therapeutic footwear for the first time formed an inception cohort. Patients reported their
therapeutic footwear use on 3 consecutive days in activity diaries 14 and 20 weeks after delivery of
the footwear. The Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) was
used as the primary outcome of lower-extremity-related pain and activity limitations, and the Health
Assessment Questionnaire (HAQ) as a secondary outcome measure of activity limitations, both at
baseline and 26 weeks after therapeutic footwear delivery.
RESULTS: The cohort comprised 114 rheumatoid arthritis patients (median disease duration 10
years). Mean (standard deviation) therapeutic footwear use was 54 (25)% of the time patients were out
of bed. The median (interquartile range) WOMAC score improved from 41 (27-59) to 31 (16-45) (p <
0.001). Secondary outcome measures improved significantly.
CONCLUSION: Therapeutic footwear was used with moderate intensity by most rheumatoid arthritis
patients and was associated with a substantial decrease in pain and activity limitations. Therapeutic
footwear is a relevant treatment option for patients with rheumatoid arthritis and foot problems.