Comparison between Total Contact Custom-Made Insole versus Over the Counter Insole in Rehabilitation of Rheumatoid Arthritis Patients

Abstract

Objective To compare the effect of total contact custom-made foot insoles versus over-thecounter flat silicone insoles on pain and foot function in rheumatoid arthritis patients. Patients and Methods This study included 30 patients diagnosed with rheumatoid arthritis according to the 2010ACR/EULAR classification criteria. All underwent history, clinical examination of foot, plantar pressure assessment, pain assessment by visual analog scale (VAS), foot functionality, assessed by Lower Extremity Functional Scale (LEFS). Patients were randomly assigned to group (A) 15 patients which received total contact custom made insoles. And group B, 15 patients received a flat over the counter insole made of silicone, follow up was done after two weeks using VAS and LEFS scores. Results A total of 30 patients, aged 46.07 ± 10.78 years, with disease duration ranged from 2 – 18 years with Median (IQR) of 5.50, body mass index (BMI) ranged from 19.5 to 37 kg/m2 with mean ±SD of 29.01 ± 4.00. In both groups, significant difference in the VAS after using insoles, observed more in -group A with mean ± SD 22.67 ± 11.47, while mean ± SD of group B was 39.00 ± 14.04. Regarding LEFS score: significant improvement of the score ―improved lower limb functionality‖ in both groups after using the insoles, slightly higher in group B more than group A. No significant differences in functionality between the two groups (LEFS score after intervention for group A with Mean ± SD 40.13 ± 9.88, group B with Mean ± SD 43.20 ± 6.82). Conclusion The custom-made foot orthoses significantly reduced the patients’ foot pain, although they did not have significantly positive effects on disability and foot functionality compared with only cushioning.