Foot deformities in patients with rheumatoid arthritis the relationship functions

foot deformities in patients with rheumatoid arthritis the relationship functions

Common foot structure deformities in RA patients are subluxation of the pain; and (iii) the relationship between foot function and disability in patients with foot. Foot involvement occurs early in rheumatoid arthritis but the extent to which this clinical measures of disease activity, pain and foot deformity. in foot function in a small cohort of RA patients with disease duration relationship between disease activity, impairment and function in the foot. Introduction: Rheumatoid arthritis (RA) is a chronic, inflammatory and multiple- system to the assessment of foot deformity in patients with rheumatoid arthritis . E. The relationships of Clarke's angle with structural features of the forefoot and.

A prolonged stance phase and delayed heel lift are related to disability in daily activities. FootRheumatoid arthritisForefoot joint damageGaitPlantar pressurePainDisabilityRelationships Foot complaints are a major problem in patients with rheumatoid arthritis RA.

Despite the number of patients reporting foot complaints and the consequences for daily activities, the rheumatoid foot has so far received little attention in scientific research. In the present study, a model describing the assumed relationships between pathology, impairments and disability in the rheumatoid foot was used Fig.

The model might be useful in clinical diagnosis and decision-making regarding the rheumatoid foot. Inflammation of joints and soft tissues, even when vigorously treated, can severely disrupt foot structure by causing joint damage and structural deformities [ 2 ]. Common foot structure deformities in RA patients are subluxation of the metatarsophalangeal joints MTPstoe deformities and valgus alignment of the rearfoot.

Changes in foot structure may be associated with impaired foot function during weight-bearing. Furthermore, impaired foot function, expressed as alterations in gait and pressure, may relate to pain and disability during daily activities [ 45 ].

Model of RA-related foot impairments and disability. View large Download slide Model of RA-related foot impairments and disability. In recent years, a limited number of studies have been performed aimed at identifying relationships between foot function on the one hand and foot structure, pain and disability on the other. To assess foot function, plantar pressure measurements have been used, yielding gait characteristics and pressure distribution patterns.

Patients with RA showed modified gait patterns: Additionally, pressure, especially under the forefoot, is elevated [ 7—10 ]. Evidence linking radiological erosion scores and increased plantar pressure was found [ 11 ]. Foot deformities have been shown to relate to changed pressure distribution patterns and increased peak pressure [ 1213 ].

foot deformities in patients with rheumatoid arthritis the relationship functions

Also, relationships between increased forefoot pressure and pain in RA have been reported [ 914 ]. Furthermore, gait characteristics were found to relate to disability in daily activities [ 1516 ].

The relationship between pressure and disability has not been investigated, to our knowledge. Knowledge about relationships between foot impairments and disability, especially regarding the role of plantar pressure and gait characteristics, is limited.

Thus, there is a need for replication and extension of research on these relationships. The purpose of the present study was to assess: Materials and methods Patient selection Sixty-two patients at an out-patient clinic for rehabilitation and rheumatology Jan van Breemen Institute in the Netherlands served as the study population.

Foot deformities in patients with rheumatoid arthritis: the relationship with foot functions.

The following inclusion criteria were used: The medical ethics committee of the Slotervaart Hospital in Amsterdam approved this study and written informed consent was obtained from each subject. The 10 MTP and two interphalangeal joints of the big toes were scored for erosions and joint space narrowing.

The erosion score per joint site can range from 0 to 5, where 0 is no erosion and 10 is severe erosions on both sites of the joint.

Joint space narrowing is combined with a score for sub luxation and scored from 0 to 4, where 0 is normal and 4 is a bony ankylosis or complete subluxation. The maximum erosion score for all joints in both feet is The maximum score for joint space narrowing in all joints of both feet is The total score is the sum of erosions and joint space narrowing in all joints of both feet. The platform was mounted in the middle of a walkway of 5 m.

The two-step method of collecting plantar pressure measurements was used [ 19 ]. This method requires the patient to stand barefoot two steps away from the pressure platform and, at a self-selected pace, step onto the platform and continue walking for at least three steps.

Foot deformities in patients with rheumatoid arthritis: the relationship with foot functions.

The measurements started after instruction of the patient and familiarization with the procedure. Definition and classification of metatarsalgia.

foot deformities in patients with rheumatoid arthritis the relationship functions

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