There was weak evidence for  custom orthoses reducing pain and forefoot plantar pressures .
Evidence was inconclusive for foot function , walking speed , gait parameters , and reducing hallux abductovalgus angle progression .
CONCLUSION Custom orthoses may be beneficial in reducing pain and elevated forefoot plantar pressures in the rheumatoid foot and ankle .
OBJECTIVE To identify and critically appraise the evidence for the effectiveness of custom orthoses for the foot and ankle in rheumatoid arthritis .
Randomized controlled trial for clinical effects of varying types of insoles combined with specialized shoes in patients with rheumatoid arthritis of the foot.
OBJECTIVE To determine the effects of specialized shoes with insoles in patients with rheumatoid arthritis and the differences in terms of type of insole and anatomical location of foot pathology . DESIGN Single-blinded r and omized controlled trial . SETTING Out patients of physical medicine and rehabilitation clinic at university hospital . SUBJECTS Forty-two patients with rheumatoid foot lesions were r and omly assigned to two different orthotic intervention groups . The anatomical locations of the foot lesions were recorded ( hindfoot or forefoot ) . INTERVENTION Participants were provided with an extra deep forefoot-rockered shoe and either a custom-made semi-rigid insole or a ready-made simple soft insole . They wore the provided footwear for at least 3 hours a day over six months . MAIN OUTCOME MEASURES Primary outcome measures were foot pain visual analogue scale ( VAS ) scores and Foot Function Index ( FFI ) . Secondary outcome measures were erythrocyte sedimentation rate and C-reactive protein levels in blood , amounts of medications and active joint counts . These were checked at baseline and post intervention . RESULTS Eight patients dropped out at follow-up after six months of treatment . At six-month follow-ups , VAS scores and total Foot Function Index scores had decreased significantly in both groups versus baseline but intergroup comparison showed no significant differences in view of type of insoles and anatomical locations of foot pathology . CONCLUSIONS We were unable to identify differences between the types of insoles in terms of their clinical effects or between anatomical locations of foot lesions in the two groups , but both groups improved . Therapeutic shoes plus soft insoles might be effective enough in terms of foot pain and foot function for specific patients with rheumatoid foot problems regardless of the location of foot pathology
There was weak evidence for  custom orthoses reducing pain and forefoot plantar pressures .
Evidence was inconclusive for foot function , walking speed , gait parameters , and reducing hallux abductovalgus angle progression .
CONCLUSION Custom orthoses may be beneficial in reducing pain and elevated forefoot plantar pressures in the rheumatoid foot and ankle .
OBJECTIVE To identify and critically appraise the evidence for the effectiveness of custom orthoses for the foot and ankle in rheumatoid arthritis .