Functionally Optimized Orthoses for Early Rheumatoid Arthritis Foot Disease: A Study of Mechanisms and Patient Experience
Gibson, Kellie S., Woodburn, James, Porter, Duncan and Telfer, Scott 2014. Functionally Optimized Orthoses for Early Rheumatoid Arthritis Foot Disease: A Study of Mechanisms and Patient Experience. Arthritis Care & Research. 66 (10), pp. 1456-1464.
|Authors||Gibson, Kellie S., Woodburn, James, Porter, Duncan and Telfer, Scott|
To investigate the mode‐of‐action and patient experience of functionally optimized foot orthoses in patients with early rheumatoid arthritis (RA).
We conducted an investigation of 2 functionally optimized foot orthoses (selective laser sintering [SLS] and fused deposition modelling [FDM]) in 15 patients with RA of <2 years duration. The novel devices were optimized for 3 biomechanistic targets exploiting computer‐aided design and additive manufacturing. A third standard device was used as the comparator (standard foot orthosis [SFO]). Foot and ankle biomechanical effects were compared. Adverse reactions, orthotic fit and comfort, and short‐term symptom benefits were also monitored.
Both FDM (P = 0.028) and SLS (P < 0.0001) orthoses significantly reduced peak rearfoot motion in comparison to shod. The average ankle internal moment was significantly decreased in the SFO (P = 0.010) and approached significance in the SLS (P = 0.052) orthosis. SFO, FDM, and SLS orthoses significantly increased the peak height of the medial foot arch between 3.6 to 4.4 mm (P < 0.001). Peak pressures in the medial (P = 0.018) and lateral forefoot (P = 0.022) regions of interest were significantly reduced for the SLS orthosis. SFO, FDM, and SLS orthoses significantly increased midfoot contact area (P < 0.001 for all conditions). In comparison to SFO, SLS and FDM orthoses provided equivalent or better patient experience. No adverse reactions were reported.
Functional optimization is a feasible approach for orthoses prescription in early RA and has the potential to provide superior mode‐of‐action responses for biomechanical therapeutic targets compared to standard devices.
|Journal||Arthritis Care & Research|
|Journal citation||66 (10), pp. 1456-1464|
|Publisher||Wiley for Association of Rheumatology Health Professionals and American College of Rheumatology|
|Digital Object Identifier (DOI)||doi:10.1002/acr.22060|
|Web address (URL)||https://doi.org/10.1002/acr.22060|
|Online||25 Sep 2014|
|Publication process dates|
|Deposited||21 Jun 2018|
|Accepted||03 Jun 2013|
|Accepted||03 Jun 2013|
|Funder||European Commission Framework Seven Program|
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