AB1448-HPR The effect of customized inserts on pain, physical function and quality of life in rheumatological patients with foot pain
Authors: G. Gur, B. Dilek, F. Uygur, N. Bek, Y. Yakut
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Rheumatoid arthritis (RA), Ankylosing spondylitis (AS), Systemic lupus erythematosus (SLE) are rheumatological diseases which cause pain and loss of function affecting the foot and ankle. In foot pain with rheumatological origin, symptoms can be improved with customized inserts. However there are only few studies which investigate insoles' effectiveness on improving quality of life and gait parameters. <h3>Objectives</h3> To investigate the effectiveness of customized inserts on improving pain, physical function and quality of life in rheumatological patients who came with complaints concerning foot pain and walking disability. <h3>Methods</h3> Nine patients with RA (4 patients), AS (3 patients) and SLE (2 patients) aged between 39 and 60 years were included in the study. Mean average disease duration was 8 years. Foot deformities were determined by observational postural analysis and customized inserts were fabricated for these deformities. Evaluations were repeated before and one month after insole application. Foot function index (FFI), SF-36, Timed up and go test (TUG) was used for assessment. Heart rate was recorded before and immediately after walking. Time needed to walk 100 meters with a brisk gait was recorded for gait velocity. Physiologic cost index (PCI) which defines energy consumption in walking was calculated by dividing the difference of heart rates after walking and during rest to gait velocity. Significance of differences between before and after insole application values was calculated with Wilcoxon signed rank test. <h3>Results</h3> Common deformities were pes planus, calcaneal valgus/varus and hallux valgus. The only significant difference was found for FFI between first (no insole) and second assessment (p&lt;0.05). There was no difference for SF-36 and PCI values (p&gt;0,05). <h3>Conclusions</h3> It is known that foot pain affects walking ability and quality of life in patients with rheumatological diseases. We found in our study that if we support the feet, especially the arches with shock absorbing customized inserts, pain and physical function will improve in patients with rheumatological disease. But this application had no effect on physiologic cost index of gait or SF-36. <h3>References</h3> van der Leeden M, Steultjens M, Dekker JH, Prins AP, Dekker J. Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics.Rheumatology (Oxford). 2006 Apr;45(4):465-9. Epub 2005 Nov 15. Hennessy K, Woodburn J, Steultjens MP. Custom foot orthoses for rheumatoid arthritis: A systematic review. Arthritis Care Res (Hoboken). 2011 Dec 12. doi: 10.1002/acr.21559. [Epub ahead of print] Erdem CZ, Sarikaya S, Erdem LO, Ozdolap S, Gundogdu S. MR imaging features of foot involvement in ankylosing spondylitis. Eur J Radiol. 2005 Jan;53(1):110-9. Lehman TJ. Enthesitis, arthritis, and heel pain. J Am Podiatr Med Assoc. 1999 Jan;89(1):18-9. <h3>Disclosure of Interest</h3> None Declared