RESEARCH - A clinical trial of specialist footwear for patients with RA

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Rheumatology Advance Access originally published online on July 28, 2006

Rheumatology 2007 46(2):302-307; doi:10.1093/rheumatology/kel234

A clinical trial of specialist footwear for patients with rheumatoid arthritis

A. E. , K. Rome1 and C. J. Nester

Centre for Rehabilitation and Human Performance Research, University

of Salford, Salford and 1Teesside Centre for Rehabilitation Sciences,

University of Teesside, Middlesbrough, UK.

Objectives. The structural and functional changes in the RA foot often

affect the patient's gait and mobility, impacting on the patient's

quality of life. Successful management of these foot pathologies and

resultant problems can involve the provision of specialist therapeutic

footwear. The aim of the study was to evaluate the value of a new

footwear design based on patients' opinions compared with a

traditional footwear design.

Method. A total of 80 patients with RA of 5 yrs or more duration, foot

deformity, difficulty in being able to obtain suitable retail footwear

and self-reported foot pain were recruited. Patients were randomly

assigned to either an intervention group (new design) or the control

group (traditional design). Patients completed two specific

health-related quality of life scales (Foot Health Status

Questionnaire and the Foot Function Index) at baseline and after 12

weeks.

Results. Only 36 patients completed the trial. Ten refused the

footwear outright and 34 withdrew from the study after the footwear

was supplied, due to either non-footwear related problems or reasons

related to the footwear. Both the specific health-related quality of

life scales demonstrated significant improvement from baseline to week

12 with the intervention group (P < 0.05). There was no significant

difference in both specific health-related quality of life scales

after week 12 with the traditional group (P > 0.05).

Conclusions. Improvement in pain and patient satisfaction with the new

design of footwear for patients with RA over the traditional design

indicates the importance of patient involvement in the design process

and throughout the process of supplying and monitoring the footwear.

The fact that the new-design shoe was based on patients' involvement

in the design process in a previous study may be the most important

factor in its success. In order to meet the clinical goals of this

footwear the patients need to wear them, and to achieve this the

patients' requirements need to be acknowledged.

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Read the entire article here:

http://rheumatology.oxfordjournals.org/cgi/content/full/46/2/302

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