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Insoles, added toe orthoses can improve RA, OA metatarsalgia outcomes
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Polypropylene terephthalate and custom silicone toe orthoses improved outcomes in forefoot involvement in rheumatoid arthritis and osteoarthritis patients, especially if treatment began with insoles and combined with toe orthoses at a later time.
Researchers recruited 13 patients with rheumatoid arthritis (RA) and 11 with osteoarthritis (OA) and metatarsalgia from the outpatient clinic at Piero Palagi Hospital in Florence, Italy, between September to November 2012 and the study continued through May 2013. RA and OA were confirmed by X-rays. Patients were excluded for prior foot surgery, diabetes, skin lesions, use of foot orthoses in the preceding 30 days or other confounding factors.
All of the patients were randomly assigned to one of two treatment protocols to evaluate the improvement of metatarsalgia. Group A wore polypropylene terephthalate (PPT) insoles for 30 days and wore custom silicone toe orthoses in addition to the insoles during the next 30 days. Group B wore custom silicone toe orthoses for the first 30 days, which were replaced by PPT insoles alone during the following 30 days.
Patients were administered the Foot Function Index (FFI), which comprised 23 questions rated with a verbal numeric scale, and pain and disability scores were calculated. Walking patterns were evaluated using a portable electronic walkway mat that identified and recorded footfall contacts and gait parameters and calculated the Functional Ambulation Performance score. Tests were conducted at baseline, once during treatment and once after treatment.
Data analysis showed FFI pain and disability scores were significantly reduced by both treatment protocols during the study period, particularly with more time after initial treatment. However, group A responded more favorably with FFI pain and disability, but not in FFI functional limitation. Reduction in plantar pressure was shown with better results in right foot pressure in group A, according to the researchers.
Disclosure: The authors have no relevant financial disclosures.
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