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Footwear and rheumatoid arthritis

Discussion in 'General Issues and Discussion Forum' started by NewsBot, Aug 1, 2006.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1

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    A clinical trial of specialist footwear for patients with rheumatoid arthritis.
    Rheumatology (Oxford). 2006 Jul 28;
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. Scorpio622

    Scorpio622 Active Member

    I seem to treat the 55% that withdrew/refused the shoes.
     
  4. One Foot In The Grave

    One Foot In The Grave Active Member

    I don't seem to have much luck with RA patients wearing their custom footwear either...

    Why do you think that is?
     
  5. Scorpio622

    Scorpio622 Active Member

    Fashion > Function
     
  6. caf002

    caf002 Active Member

    Many patients with RA are ferred to us for footwear +/- modifications.

    We have no emperical evidence but the anecdotal evidence suggests that shoe design is the ovewhelming objection to prefabricated medical grade footwear. Making the patient comfortable with appropriate footwear is easy. Putting square pegs into round holes is the challenge. What we realy need is an orthopaedic high heeled sling back stilletto and we will be the champions of the RA foot
     
  7. One Foot In The Grave

    One Foot In The Grave Active Member

    PMSL! :D
     
  8. vcameron@qmuc.ac.uk

    vcameron@qmuc.ac.uk Welcome New Poster

    footwear and insole as a single therapeutic intervention

    I was interested to read that the new footwear design which was found to be favourable had a contoured insole, compared to the traditional shoe which had a flat cushioning insole. I do agree that the footwear and insole should be considered as a single therapeutic intervention, however, I do believe that the contributions of the insole and footwear can be separated out, to distinguish the true effectiveness of the shoe. The reason that I would argue that this is important is because is it not often the case that when RA patients are prescribed a functional foot orthosis, the insole which comes with the shoe is removed, so that there is enough space to accomodate the prescribed device? So, I would be interested to know if the new design shoe is still more effective than the traditional design, with the insoles removed. Is the therapeutic effect of the shoe because of the insole, or does it have its own therapeutic merits when considered without the insole? If the insole determines the shoes effectiveness, surely one shoe is not any better than the next. What do you think? (This is my first time on the forum so please be gentle with your responses!)
     
  9. Phil Wells

    Phil Wells Active Member

    'V'
    My own interpretation of this research is that it is the patient involvement in the process rather than purely the mechanical aspects of the footwear. (However I am unable to get a copy of the full research at the moment to commnet directly on it.)
    I work in a situation where time is no issue, so when patients are prescribed footwear, they have input into the cosmetics of the shoe with compromises being made on both sides. This results in excellent patient satisfaction so far.
    I think your question re the importance of a contoured insole is a good one and I would be interested in knowing peoples thoughts.

    Phil
     
  10. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Patient perceptions of stock footwear design features.
    Prosthet Orthot Int. 2006 Apr;30(1):61-71
    Williams AE, Nester CJ
     
  11. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Reducing plantar pressure in rheumatoid arthritis: A comparison of running versus off-the-shelf orthopaedic footwear
    Kym Hennessy, Joshua Burns, Stefania Penkala
    Clinical Biomechanics. In Press
     
  12. jackie fairbrass

    jackie fairbrass Welcome New Poster

    I'm not a podiatrist. I am a nurse and came to this site to prove a point that the Croc brand of footwear is ideal for nurses as they are comfortable, washable, they allow the feet to breathe and resist bacteria. However my NHS trust has taken it into their heads that they are unsuitable and have banned them. I could do with some expert backing to change their minds as 90% of the staff where I work are wearing them and rave about them. Incidently I first went on an artheritis site and artheritis sufferers are also raving about them and many rate them 10/10. Could someone please give me the professional ammunition I need to change minds. Jackie Suffolk UK
     
  13. admin

    admin Administrator Staff Member

  14. caf002

    caf002 Active Member

    I personally do not like them as there is absoluely no torsional strength in this product and no support. Furthermore, there is only one width in this shoe which does not cater for a narrow or very wide foot. There is no room for a foot orthoses, and the shoes cannot be modified. The perforations on the vamp will allow "fluids" to enter the shoe. I had one client with a slim foot who advised me that her foot kept on moving from side to side and she asked my advice as to how to prevent this. The implications for this on foot pathology does not need an explanation.

    This place for this shoe(everything else being equal) is for casual informal wear but not for industrial use.

    I hope this helps

    Regards
     
  15. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Rheumatoid arthritis patients' experiences of wearing therapeutic footwear - A qualitative investigation
    Anita E Williams , Christopher J Nester and Michael I Ravey
    BMC Musculoskeletal Disorders 2007, 8:104doi:10.1186/1471-2474-8-104
     
  16. Boots n all

    Boots n all Well-Known Member

    l find our RA clients are amongst the most compliant of all our clients with few exceptions, we put 90% into custom footwear and 60% (maybe more) also go into TCI's(we may only see the real bad ones?) they just love picking out styles and the colour leather they want.
    Its hard to find an off the shelf shoe that is tight enough on the heel yet accommodates these other altered features of the forefoot that we see with RA.
    Two clients l saw last night are sisters. 1st sister,foot length 235mm, heel width 65mm, Met width 105mm, Depth 1st MP 40mm.
    2nd sister foot length 255mm, heel width 65mm, Met width 115mm, Depth 1st MP 40mm

    We tend to build an accomadative shoe with a rocker sole which off loads the fore foot and helps redirect the "Push off point"reducing the abduction of the foot, but it is often the TCI that helps to recreate that trans metatarsal arch taking pressure of the met heads, especially the head of the often troublesome 2nd MPJ.

    l dont know that you can separate the two items for the more serve clients if you want a positive outcome?

    For those that want to see the image of the first sisters foot it is at the bottom of my home page, we have written consent:D
     
  17. Phil Wells

    Phil Wells Active Member

    David

    Do you angle the rocker peak point to match the 1st to 5th angle?
    I have found that if this is not done then the 5th can get over loaded.
    Your opinion about this and any other Rocker 'tweaks' would be great fully received.

    Cheers

    Phil
     
  18. Boots n all

    Boots n all Well-Known Member

    l am sure there are others here that do more of this work than l do but for me it really is a case by case assessments process.
    Some of the guiding factors are ROM's available from as far away as the hip or closer at the STJ. all things okay l dont always align 1st to 5th it can adduct the foot in some of the weaker muscle cases, then again l dont see all the clients and their gait as some are just documents posted/Emailed to me.

    You really need to know the reason for the abduction, was it because the MPJ's where just so sore at Extension or not able to extend, or is the STJ really painful to dorsiflex/Plantaflex

    If for the last 15years(?) they have been coming off the midfoot (foot really abducted) it maybe difficult to push that foot around as the hip may have become involved and the rocker may have to be placed at that almost midfoot/abducted line, l have done this only a few times when there was no choice as the standard rocker caused to many problems further up.
    If STJ needs help a sash heel is a good idea for the elderly/frail otherwise a mild heel rocker is done.
    How do you handle your clients?
     
  19. Phil Wells

    Phil Wells Active Member

    David

    My approach tends to be more symptom specific. Usually with a Rocker I am trying to accelerate the CoM or CoP in an attempt to 'un-load' the damaged tissues. The orientation of the rocker peak is usually based on there current propulsive phase mechanics - if they are propelling through the 1st then then a 90 degree angulation is used. If more 4th-5th then closer to 80 degrees.
    I have found that the pain caused by incorrect angulation seems to be overloading of a structure not used to it - maybe they will get used to it but again I tend to concentrate on one thing at a time as I can't always address the global lower limb mechanics.
    I don't usually need to use SACH heels as I find that if the Rocker is balanced via the heel raise, the patient is ok. I do use SACH and similar to try and decelerate PF moments at heel strike in attempt to slow down forefoot loading - verdicts out on that one at the moment.

    Phil
     
  20. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Randomized controlled trial for clinical effects of varying types of insoles combined with specialized shoes in patients with rheumatoid arthritis of the foot.
    Cho NS, Hwang JH, Chang HJ, Koh EM, Park HS.
    Clin Rehabil. 2009 Apr 29. [Epub ahead of print]
     
  21. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Women's experiences of wearing therapeutic footwear in three European countries
    Anita E Williams, Christopher J Nester, Michael I Ravey, Anke Kottink and Gaspar Morey-Klapsing
    Journal of Foot and Ankle Research 2010, 3:23
     
  22. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    'Choosing shoes': a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid patients
    Renee N Silvester, Anita E Williams, Nicola Dalbeth and Keith Rome
    Journal of Foot and Ankle Research 2010, 3:24doi:10.1186/1757-1146-3-24
     
  23. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    "I could cry, the amount of shoes I can't get into": A qualitative exploration of the factors that influence retail footwear selection in women with rheumatoid arthritis
    Serena Naidoo, Stephanie Anderson, Joanna Mills, Stephanie Parsons, Stephanie Breeden, Emma Bevan, Camilla Edwards and Simon Otter
    Journal of Foot and Ankle Research 2011, 4:21
     
  24. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Use and effects of custom-made therapeutic footwear on lower-extremity related pain and activity limitations in patients with rheumatoid arthritis: A prospective observational study of a cohort.
    Dahmen R, Buijsmann S, Siemonsma PC, Boers M, Lankhorst GJ, Roorda LD.
    J Rehabil Med. 2014 Apr 22. doi: 10.2340/16501977-1807.
     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    An evaluation of seasonal variations in footwear worn by adults with inflammatory arthritis: a cross-sectional observational study using a web-based survey
    Angela Brenton-Rule, Gordon J Hendry, Georgina Barr and Keith Rome
    Journal of Foot and Ankle Research 2014, 7:36 doi:10.1186/s13047-014-0036-7
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Footwear experiences of people with chronic musculoskeletal diseases.
    Hendry GJ, Brenton-Rule A, Barr G, Rome K.
    Arthritis Care Res (Hoboken). 2015 Jan 20.
     
  27. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    PATIENT PERSPECTIVES ON FOOTWEAR IN RHEUMATOID ARTHRITIS – A PATIENT-LED QUALITATIVE STUDY
     
  28. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Erosions in the Foot at Baseline Are Predictive of Orthopedic Shoe Use after 10 Years of Treat to Target Therapy
    Sytske Anne Bergstra et al
    2015 ACR/ARHP Annual Meeting
     
  29. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Footwear characteristics in people with inflammatory arthritis in Singapore
    K. Carter, M. Lahiri, P. P. Cheung, A. Santosa and K. Rome
    Journal of Foot and Ankle Research20169:29
     
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