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Ben Tekaya A, Abid Y, Hannech E, Ben Dhia S, Bouden S, Rouached L, Tekaya R, Mahmoud I, Saidane O, Abdelmoula L. Assessment of rheumatoid arthritis patients' knowledge about foot problems related to their illness and foot care practice. Musculoskeletal Care 2024; 22:e1891. [PMID: 38697770 DOI: 10.1002/msc.1891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION Foot problems are very common in rheumatoid arthritis (RA). Podiatric intervention through therapeutic education of RA patients on the different potential foot problems could improve patients' knowledge and management of their foot problems. This study aimed to evaluate the knowledge of RA patients on podiatric problems related to their illness and foot care practices. METHODS This was a cross-sectional study including patients diagnosed with RA and aged older than 18 years. Sociodemographic data, disease characteristics, and therapeutic data were collected. RA foot problems knowledge and foot care practice were assessed using a questionnaire combining questions developed from the literature search and a pretested validated questionnaire. RESULTS Overall, 103 patients were included of whom 94 were female. The mean age was 56 years (±10 years) and the mean disease duration was 15 years (±10 years). Over 77% of patients reported never having received foot-health-related education. With regard to their knowledge about RA foot involvement, patients were aware that RA can affect the feet similarly to the hands (83%), lead to deformation of the foot (86%), lead to walking difficulties and falling (68%), and produce skin lesions of the foot (31%). Regarding participant's knowledge of appropriate footwear, 65% agreed that it would be beneficial to wear quality standard sports shoes. However, less than one-third of patients know the podiatrist's skills. CONCLUSION Our study showed an awareness of the repercussions of RA on feet but a lack of knowledge on proper foot care, thus identifying a need for foot health therapeutic education.
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Affiliation(s)
- Aicha Ben Tekaya
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Yosr Abid
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Emna Hannech
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Siwar Ben Dhia
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Selma Bouden
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Leila Rouached
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Rawdha Tekaya
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Ines Mahmoud
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Olfa Saidane
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Leila Abdelmoula
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
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Effectiveness of a self-management program for joint protection and physical activity in patients with rheumatoid arthritis: A randomized controlled trial. Int J Nurs Stud 2021; 116:103752. [DOI: 10.1016/j.ijnurstu.2020.103752] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/09/2020] [Accepted: 08/14/2020] [Indexed: 12/29/2022]
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Samal M, Sahoo KC, Pati S, Tripathy SR, Parida MK, Das BK. Use of Animal and Animal Products for Rheumatoid Arthritis Treatment: An Explorative Study in Odisha, India. Front Med (Lausanne) 2020; 6:323. [PMID: 31993436 PMCID: PMC6970967 DOI: 10.3389/fmed.2019.00323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/18/2019] [Indexed: 11/13/2022] Open
Abstract
Severe fatigue, pain, deformity, and disability, are the major concerns for rheumatoid arthritis (RA). The extreme pain experienced by the patients often force them to experiment with various indigenous substances including animals and animal products. However, there is little evidence on the use of animals or animal products as traditional medicine in RA. Hence, this study was aimed to explore the experience and perception of patients toward the use of animals and animal products for the treatment of RA. A qualitative, explorative study was conducted at the out-patient-department of Rheumatology of a tertiary care medical college and hospital at Cuttack, Odisha, India. Out of 113 patients with RA, 18 patients gave history of use of animal and/or animal products and were selected for in-depth interviews. The content analysis methods were used for data analysis. Four major categories emerged: (1) prevailing patterns of traditional treatment of RA using animals, (2) beliefs and values behind the traditional treatment of RA, (3) sources and traditional learning pathway of indigenous practices on RA, and (4) ethical aspects of the indigenous practice of using animals and/or animal products in the treatment of RA. This study revealed the practice of eating dead animals to get relief from RA. However, there was hardly any perceived positive outcome of the practice; which indicates the lack of awareness of rational, scientific, treatment, and prevalence of irrational and unethical practices for the treatment of RA. Hence, community awareness, social mobilization, and newer screening tools are necessary to improve the timely detection and prevention of irrational treatment practices among RA patients.
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Affiliation(s)
- Mousumi Samal
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
| | - Krushna Chandra Sahoo
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India
| | - Saumya Ranjan Tripathy
- Clinical Immunology and Rheumatology, Department of Medicine, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, India
| | - Manoj Kumar Parida
- Clinical Immunology and Rheumatology, Department of Medicine, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, India
| | - Bidyut Kumar Das
- Clinical Immunology and Rheumatology, Department of Medicine, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, India
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Effect of an orthosis on foot center of pressure translation for treatment of hallux valgus in patients with rheumatoid arthritis: A report of 17 cases. ASIA-PACIFIC JOURNAL OF SPORT MEDICINE ARTHROSCOPY REHABILITATION AND TECHNOLOGY 2020; 19:7-10. [PMID: 31768328 PMCID: PMC6872804 DOI: 10.1016/j.asmart.2019.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/16/2019] [Accepted: 10/28/2019] [Indexed: 11/23/2022]
Abstract
Objectives We aimed to investigate the change in the center of pressure (COP) path and distribution with or without orthosis for hallux valgus (HV) in patients with rheumatoid arthritis (RA). Methods In total, 17 patients and 21 feet were enrolled. We measured the COP path using the COP path measurement device (F-Scan II system). The HV angle (HVA); the anteroposterior COP path length, which was measured as a percentage of the foot length (%Long); transverse width of the COP path which was measured from the most medial to the most lateral point and expressed as a percentage of maximum foot width (%Trans); and the final site of the walking locus were analyzed by comparing patients with RA with and without orthosis. Results Testing without and with the orthosis showed that the HVAs were 31.8° ± 9.3° and 25.2° ± 6.8° (p < 0.001), the %Long values were 61.1% ± 5.5% and 69.2% ± 5.9% (p < 0.001), and the %Trans values were 28.0% ± 9.1% and 30.1% ± 8.3% (p = 0.108). The final site of the walking locus for the 1st interphalangeal joint without and with orthosis were 8 feet (38.1%) and 15 feet (71.4%) (p = 0.020), respectively. Conclusions The results indicated that the orthosis for HV improved the walking path and should be considered as a therapeutic option in nonpharmacological treatment of RA.
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Reina-Bueno M, González-López JR, López-López D, Calvo-Lobo C, Ballesteros-Mora M, Rodríguez-Moreno I, Munuera-Martínez PV. Development and Validation of the Overall Foot Health Questionnaire for Patients with Rheumatoid Arthritis: A Cross-Sectional Descriptive Analysis. ACTA ACUST UNITED AC 2019; 55:medicina55060290. [PMID: 31248227 PMCID: PMC6630793 DOI: 10.3390/medicina55060290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 11/21/2022]
Abstract
Background and Objectives: In general, patients with rheumatoid arthritis (RA) are ignorant of the physician’s role and of RA-related feet problems. The aim of our study was to validate a questionnaire on the knowledge of different aspects of overall foot health in patients with RA. Materials and Methods: A cross-sectional descriptive analysis was carried out between March 2017 and April 2017. A questionnaire was designed and validated through the Delphi method to evaluate the knowledge about the illness, the repercussions on feet, medical podiatry care, and the role of the medical podiatrist. Results: After being checked by a panel of experts, all the items obtained a Cronbach’s alpha over 0.70. Conclusions: The content of this questionnaire about the knowledge of different aspects of medical podiatry health in patients with RA has internal consistency.
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Affiliation(s)
- María Reina-Bueno
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain.
| | - José Rafael González-López
- Departament of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain.
| | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, 15403 Ferrol, Spain.
| | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Faculty of Health Sciences, University of León, 24401 Ponferrada, Spain.
| | - Marina Ballesteros-Mora
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain.
| | - Inmaculada Rodríguez-Moreno
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain.
| | - Pedro V Munuera-Martínez
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain.
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Foot health in patients with rheumatoid arthritis—a scoping review. Rheumatol Int 2017; 37:1413-1422. [DOI: 10.1007/s00296-017-3699-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/08/2017] [Indexed: 12/19/2022]
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Graham AS, Williams AE. Foot health education provision for people with rheumatoid arthritis-an online survey of UK podiatrists' perceptions. J Foot Ankle Res 2016; 9:13. [PMID: 27118995 PMCID: PMC4845353 DOI: 10.1186/s13047-016-0145-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/20/2016] [Indexed: 11/25/2022] Open
Abstract
Background Patient education supports general disease self-management and in relation to foot problems, it is recommended as a key intervention for people with rheumatoid arthritis (RA). Further, it is known what the foot health educational (FHE) needs are in relation to their experiences of foot problems. Podiatrists are the key health professionals who provide the management of RA-related foot pathology and this includes the delivery of FHE. However, we do not know what is currently provided and what podiatrists’ perceptions are of this intervention. It is possible that there is a difference between what is provided and what patients need in order to maximise their foot health benefits and hence this may contribute to the persistence of foot problems and symptoms. This study primarily aims to define what UK podiatrists’ perceptions of FHE are in relation to; what is delivered, how it is delivered, and the timing of its delivery, in the context of its’ accessibility. The secondary aim is to identify any influence of the participants’ gender, age and duration of professional qualification on their responses. Method An online survey of UK HCPC registered podiatrists was used to capture quantitative data in relation to the perceived; aims, content, methods and effectiveness, timing and barriers to FHE provision to people with RA. Data was analysed to assess significant associations between the participant responses and their gender, age and duration of professional qualification. Free text comments were analysed using thematic analysis. Results 43 podiatrists across the UK completed the survey. The majority of participants stated that, they provided FHE and agreed with its overall aims. The most common methods of delivery that were perceived to be most effective were: verbal, written and website based information. The best times at which to deliver FHE were thought to be at the point of diagnosis of RA and at any available opportunity of health care delivery. The majority of participants thought they had enough knowledge and access to information resources to effectively deliver FHE, but half of the participants felt that consultation duration limited their ability to do so. Gender and duration of professional qualification influenced participants’ perceptions of FHE. Conclusion The importance and content of FHE for people with RA has been defined, but time limitations are seen to restrict its delivery. The development of an education needs analysis tool to facilitate efficient identification of patients FHE needs could enable timely and tailored delivery of FHE to people with RA. Electronic supplementary material The online version of this article (doi:10.1186/s13047-016-0145-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea S Graham
- Centre for Health Sciences Research, University of Salford, Frederick Road, Salford, UK ; Directorate of Prosthetics, Orthotics and Podiatry, University of Salford, Frederick Road, Salford, UK
| | - Anita E Williams
- Centre for Health Sciences Research, University of Salford, Frederick Road, Salford, UK ; Directorate of Prosthetics, Orthotics and Podiatry, University of Salford, Frederick Road, Salford, UK
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Brorsson S, Nilsdotter A, Thorstensson C, Bremander A. Differences in muscle activity during hand-dexterity tasks between women with arthritis and a healthy reference group. BMC Musculoskelet Disord 2014; 15:154. [PMID: 24886491 PMCID: PMC4060090 DOI: 10.1186/1471-2474-15-154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 04/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Impaired hand function is common in patients with arthritis and it affects performance of daily activities; thus, hand exercises are recommended. There is little information on the extent to which the disease affects activation of the flexor and extensor muscles during these hand-dexterity tasks. The purpose of this study was to compare muscle activation during such tasks in subjects with arthritis and in a healthy reference group. METHODS Muscle activation was measured in m. extensor digitorium communis (EDC) and in m. flexor carpi radialis (FCR) with surface electromyography (EMG) in women with rheumatoid arthritis (RA, n = 20), hand osteoarthritis (HOA, n = 16) and in a healthy reference group (n = 20) during the performance of four daily activity tasks and four hand exercises. Maximal voluntary isometric contraction (MVIC) was measured to enable intermuscular comparisons, and muscle activation is presented as %MVIC. RESULTS The arthritis group used a higher %MVIC than the reference group in both FCR and EDC when cutting with a pair of scissors, pulling up a zipper and-for the EDC-also when writing with a pen and using a key (p < 0.02). The exercise "rolling dough with flat hands" required the lowest %MVIC and may be less effective in improving muscle strength. CONCLUSIONS Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. It is important that hand training programs reflect real-life situations and focus also on extensor strength.
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Affiliation(s)
- Sofia Brorsson
- Health and Welfare, Dala Sports Academy, Dalarna University, SE-781 88 Falun, Sweden.
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Carl HD, Swoboda B. [Presurgical and postsurgical orthotic management of the rheumatoid foot]. Z Rheumatol 2012; 71:680-4. [PMID: 23052558 DOI: 10.1007/s00393-012-0970-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Foot complaints remain frequent in patients with rheumatoid arthritis (RA) even in the era of biological anti-rheumatic drugs. Orthotic management of rheumatoid foot disorders is able to improve mobility and thus the quality of life in RA patients. This article highlights the preoperative and postoperative orthotic management of the rheumatoid arthritic foot.
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Affiliation(s)
- H D Carl
- Abteilung für Orthopädische Rheumatologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Im Waldkrankenhaus St. Marien, Rathsberger Str. 57, 91054, Erlangen, Deutschland.
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Graham AS, Hammond A, Walmsley S, Williams AE. Foot health education for people with rheumatoid arthritis - some patient perspectives. J Foot Ankle Res 2012; 5:23. [PMID: 22937987 PMCID: PMC3519771 DOI: 10.1186/1757-1146-5-23] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 08/08/2012] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED BACKGROUND Patient education is an important component of foot health management for people with rheumatoid arthritis (RA). The content and strategies for delivery require investigation in relation to the patients' needs. This study explores patients' experiences of foot health education, to inform how the patients' needs could be identified in clinical practice and inform effective education delivery. METHOD A focus group was used to collect data. The dialogue was recorded digitally, transcribed verbatim and analysed using a structured thematic approach. Member checking and peer review added to credibility of the data.Six themes emerged; (i) content and purpose of patient education - what it should be, (ii) content of patient education - what it should not be, (iii) timing of information on foot health, (iv) method of delivery, (v) ability to engage with foot health education and (vi) the patient/practitioner relationship. CONCLUSIONS This study identified aspects of patient education considered important by this group of patients in relation to content, timing and delivery, forming the basis for further research on clinical and patient focussed outcomes of patient education.Identifying health education needs and provision of supportive verbal and written information can foster an effective therapeutic relationship, supporting effective foot health education for people with RA.
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Affiliation(s)
- Andrea S Graham
- Centre for Health, Sport and Rehabilitation Research, University of Salford, Frederick Road, Salford, UK
- Directorate of Prosthetics, Orthotics and Podiatry, University of Salford, Frederick Road, Salford, UK
| | - Alison Hammond
- Centre for Health, Sport and Rehabilitation Research, University of Salford, Frederick Road, Salford, UK
| | - Steven Walmsley
- Centre for Health, Sport and Rehabilitation Research, University of Salford, Frederick Road, Salford, UK
| | - Anita E Williams
- Centre for Health, Sport and Rehabilitation Research, University of Salford, Frederick Road, Salford, UK
- Directorate of Prosthetics, Orthotics and Podiatry, University of Salford, Frederick Road, Salford, UK
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Graham AS, Hammond A, Williams AE. Foot health education for people with rheumatoid arthritis: the practitioner's perspective. J Foot Ankle Res 2012; 5:2. [PMID: 22233879 PMCID: PMC3275442 DOI: 10.1186/1757-1146-5-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 01/10/2012] [Indexed: 12/02/2022] Open
Abstract
Background Patient education is considered to be a key role for podiatrists in the management of patients with rheumatoid arthritis (RA). Patient education has undoubtedly led to improved clinical outcomes, however no attempts have been made to optimise its content or delivery to maximise benefits within the context of the foot affected by rheumatoid arthritis. The aim of this study was to identify the nature and content of podiatrists' foot health education for people with RA. Any potential barriers to its provision were also explored. Methods A focus group was conducted. The audio dialogue was recorded digitally, transcribed verbatim and analysed using a structured, thematic approach. The full transcription was verified by the focus group as an accurate account of what was said. The thematic analysis framework was verified by members of the research team to ensure validity of the data. Results Twelve members (all female) of the north west Podiatry Clinical Effectiveness Group for Rheumatology participated. Six overarching themes emerged: (i) the essence of patient education; (ii) the content; (iii) patient-centred approach to content and timing; (iv) barriers to provision; (v) the therapeutic relationship; and (vi) tools of the trade. Conclusion The study identified aspects of patient education that this group of podiatrists consider most important in relation to its: content, timing, delivery and barriers to its provision. General disease and foot health information in relation to RA together with a potential prognosis for foot health, the role of the podiatrist in management of foot health, and appropriate self-management strategies were considered to be key aspects of content, delivered according to the needs of the individual. Barriers to foot health education provision, including financial constraints and difficulties in establishing effective therapeutic relationships, were viewed as factors that strongly influenced foot health education provision. These data will contribute to the development of a patient-centred, negotiated approach to the provision of foot health education for people with RA.
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Affiliation(s)
- Andrea S Graham
- Centre for Health, Sport and Rehabilitation Research, University of Salford, Frederick Road, Salford, UK.
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