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Hendry GJ, Bearne L, Foster NE, Godfrey E, Hider S, Jolly L, Mason H, McConnachie A, McInnes IB, Patience A, Sackley C, Sekhon M, Stanley B, van der Leeden M, Williams AE, Woodburn J, Steultjens MPM. Gait rehabilitation for foot and ankle impairments in early rheumatoid arthritis: a feasibility study of a new gait rehabilitation programme (GREAT Strides). Pilot Feasibility Stud 2022; 8:115. [PMID: 35637495 PMCID: PMC9150324 DOI: 10.1186/s40814-022-01061-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Foot impairments in early rheumatoid arthritis are common and lead to progressive deterioration of lower limb function. A gait rehabilitation programme underpinned by psychological techniques to improve adherence, may preserve gait and lower limb function. This study evaluated the feasibility of a novel gait rehabilitation intervention (GREAT Strides) and a future trial. Methods This was a mixed methods feasibility study with embedded qualitative components. People with early (< 2 years) rheumatoid arthritis (RA) and foot pain were eligible. Intervention acceptability was evaluated using a questionnaire. Adherence was evaluated using the Exercise Adherence Rating Scale (EARS). Safety was monitored using case report forms. Participants and therapists were interviewed to explore intervention acceptability. Deductive thematic analysis was applied using the Theoretical Framework of Acceptability. For fidelity, audio recordings of interventions sessions were assessed using the Motivational Interviewing Treatment Integrity (MITI) scale. Measurement properties of four candidate primary outcomes, rates of recruitment, attrition, and data completeness were evaluated. Results Thirty-five participants (68.6% female) with median age (inter-quartile range [IQR]) 60.1 [49.4–68.4] years and disease duration 9.1 [4.0–16.2] months), were recruited and 23 (65.7%) completed 12-week follow-up. Intervention acceptability was excellent; 21/23 were confident that it could help and would recommend it; 22/23 indicated it made sense to them. Adherence was good, with a median [IQR] EARS score of 17/24 [12.5–22.5]. One serious adverse event that was unrelated to the study was reported. Twelve participants’ and 9 therapists’ interviews confirmed intervention acceptability, identified perceptions of benefit, but also highlighted some barriers to completion. Mean MITI scores for relational (4.38) and technical (4.19) aspects of motivational interviewing demonstrated good fidelity. The Foot Function Index disability subscale performed best in terms of theoretical consistency and was deemed most practical. Conclusion GREAT Strides was viewed as acceptable by patients and therapists, and we observed high intervention fidelity, good patient adherence, and no safety concerns. A future trial to test the additional benefit of GREAT Strides to usual care will benefit from amended eligibility criteria, refinement of the intervention and strategies to ensure higher follow-up rates. The Foot Function Index disability subscale was identified as the primary outcome for the future trial. Trial registration ISRCTN14277030 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01061-9.
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Rutkowski R, Gizińska M, Gałczyńska-Rusin M, Kasprzak MP, Budiman-Mak E. The Importance of Foot Function Assessment Using the Foot Function Index-Revised Short Form (FFI-RS) Questionnaire in the Comprehensive Treatment of Patients with Rheumatoid Arthritis. J Clin Med 2022; 11:2298. [PMID: 35566422 PMCID: PMC9101500 DOI: 10.3390/jcm11092298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Foot problems may have a substantial negative impact on rheumatoid arthritis (RA) patients' mobility. They affect walking and the functional capacity to perform daily tasks. METHODS This study included 61 patients with RA and foot pain or swelling. The study group comprised 37 patients (aged 54.3 ± 9.5 years) with foot lesions, as demonstrated in an ultrasound, and the control group comprised 24 patients (aged 57.3 ± 11.5 years) without foot lesions. The patients' health statuses were evaluated with the Foot Function Index-Revised Short Form (FFI-RS), the Polish version of the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the Disease Activity Score 28 (DAS 28). RESULTS The FFI-RS showed significant differences between the study and control groups in total results, as well as in the pain and stiffness subscales. Subsequent analyses showed numerous significant correlations. The FFI-RS total results correlated with the HAQ's standing up, walking, and total results. The FFI-RS pain results correlated with the social issues and HAQ's total results. The FFI-RS difficulty results correlated with the disease's duration. In the study group, there were significant correlations of the FFI-RS stiffness, difficulty, and social issues results with the HAQ's standing up, walking, and total results, and also of the FFI-RS activity limitation results with the HAQ's standing up results. In the control group, there were correlations of the FFI-RS stiffness, difficulty, and activity limitation results with the HAQ's walking and total results. Finally, in the study group, we also found correlations of the FFI-RS total, pain, stiffness, difficulty, and social issues results with the Visual Analog Scale (VAS) results, as well as of the FFI-RS total results with the DAS 28 results. CONCLUSIONS The FFI-RS is an effective tool for assessing RA patients' functional status and can be used to evaluate treatment effects. The FFI-RS detected RA-related changes in the foot joint function in patients without foot lesions, as assessed by ultrasound.
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Affiliation(s)
- Radosław Rutkowski
- Department of Physical Therapy and Sports Recovery, Poznan University of Physical Education, Królowej Jadwigi Str. 27/39, 61-871 Poznan, Poland;
| | - Małgorzata Gizińska
- Department of Physical Therapy and Sports Recovery, Poznan University of Physical Education, Królowej Jadwigi Str. 27/39, 61-871 Poznan, Poland;
| | - Małgorzata Gałczyńska-Rusin
- Department of Orthodontics and Temporomandibular Disorders, University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland;
| | - Magdalena Paulina Kasprzak
- Chair and Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznań, Poland;
| | - Elly Budiman-Mak
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, 5000 South 5th Ave, Hines, IL 60141-3030, USA;
- Department of Medicine, Stritch School of Medicine, Loyola University of Chicago, Maywood, IL 60513, USA
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Stolt M, Kielo-Viljamaa E, Laitinen AM, Suhonen R, Leino-Kilpi H. Reporting of Research Ethics in Studies Focusing on Foot Health in Patients with Rheumatoid Arthritis - A Systematic Review. J Empir Res Hum Res Ethics 2021; 17:39-51. [PMID: 34647510 PMCID: PMC8721538 DOI: 10.1177/15562646211047654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research ethics is a fundamental part of the entire research. Patients with rheumatoid arthritis are sensitive group of research participants because their long-term health problems cause significant changes in their foot health. In foot health research, data are usually collected through a clinical assessment of the foot or questionnaires. However, there is limited evidence of the reported research ethics of empirical studies on foot health in patients with rheumatoid arthritis. Therefore this review aimed to analyze the reported research ethics of peer-reviewed empirical studies focusing on foot health in patients with rheumatoid arthritis as research participants. This systematic review used the Medline/PubMed, CINAHL, and Embase databases. A total of 1,653 records were identified, and 32 articles were included in the final analysis. Reporting research ethics in studies of patients with rheumatoid arthritis is fragmented, focusing predominantly on ethical approval and informed consent and lacking a broader discussion about research ethics.
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Affiliation(s)
| | | | | | - Riitta Suhonen
- 8058University of Turku, Turku (Finland).,60652Turku University Hospital, Turku (Finland).,96892City of Turku, Turku (Finland)
| | - Helena Leino-Kilpi
- 8058University of Turku, Turku (Finland).,60652Turku University Hospital, Turku (Finland)
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4
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Stolt M, Kilkki M, Katajisto J, Suhonen R. Self-assessed foot health in older people with rheumatoid arthritis-A cross-sectional study. Int J Older People Nurs 2021; 16:e12380. [PMID: 34008331 DOI: 10.1111/opn.12380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/17/2021] [Accepted: 03/16/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Foot and ankle problems are especially common in patients with RA, causing significant disability and limitation in daily activities. Previous studies have mainly focussed on foot problems in the adult population whilst the evidence of foot health in the older population is scarce. OBJECTIVES The aim of the study was to analyse self-assessed foot health and associated factors in older people with rheumatoid arthritis (RA). METHODS The study applied a descriptive cross-sectional survey design and recruited older people with RA from the member register of one patient association. We collected the data in January 2019 with the Self-administered Foot Health Assessment Instrument, and sociodemographic and foot-related background questions and analysed the data with descriptive and inferential statistics. RESULTS Older people with RA had many self-reported foot problems. The most common problems were foot pain, dry skin and thickened toenails. In addition, structural deformities of the foot were prevalent. The level of foot health associated with the amount of daily walking or standing, and using walking or running shoes outdoors. Individuals who had consulted a physician due to their foot problems had more structural deformities in the foot. Foot problems limited their ability to perform daily activities. CONCLUSIONS This study demonstrates that older people with RA not only live with a long-term health condition, but they also live with complex foot problems. Older people with RA need healthcare services due to their foot problems. There is a need to develop and implement care practices to alleviate foot pain and support and promote foot health and functional ability in older people with RA. IMPLICATION FOR PRACTICE Understanding the nature and consequences of foot problems in older people with RA allows healthcare professionals to perform more accurate clinical foot evaluations and develop effective interventions to prevent further foot problems.
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Affiliation(s)
- Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Mia Kilkki
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland.,Welfare Division, City of Turku, Turku, Finland
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Reina-Bueno M, Munuera-Martínez PV, Pérez-García S, Vázquez-Bautista MDC, Domínguez-Maldonado G, Palomo-Toucedo IC. Foot Pain and Morphofunctional Foot Disorders in Patients with Rheumatoid Arthritis: A Multicenter Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095042. [PMID: 34068737 PMCID: PMC8126220 DOI: 10.3390/ijerph18095042] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022]
Abstract
Foot problems are highly prevalent in people with rheumatoid arthritis. This study aims to explore the foot morphology, pain and function in rheumatoid arthritis patients and the relation with the time of disease debut. A cross-sectional study was designed. Footprint, the Foot Posture Index, the hallux valgus prevalence, foot pain and function in 66 rheumatoid arthritis patients and the association with time since diagnosis, were recorded. The Foot Function Index, the Manchester Foot Pain and Disability Index, the Visual Analogic Scale, and the Manchester Scale for hallux valgus were administered and analyzed in two groups, with less and more than 10 years of diagnosis of the disease. A high prevalence of pronated (right 36.8% and left 38.6%) and highly pronated (right 15.8% and left 15.8%) feet was observed, as well as an elevated percentage of low arched footprints (right 68.4 and left 66.7%) and hallux valgus (right 59.6% and left 54.4%). Hallux valgus prevalence, toe deformities and Foot Function Index (Functional limitation) factors were significantly associated with the time since RA diagnosed adjusted for the other factors. The adjusted odds ratio of Hallux valgus prevalence was 4.9 (1.2-19.7). In addition, the foot function was diminished, and foot pain was present in most participants. In conclusion, rheumatoid arthritis patients' feet showed altered morphology and function, and with longer rheumatoid arthritis history, metatarsophalangical stability and foot function, but not pain and global foot posture, were likely to deteriorate.
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Affiliation(s)
- María Reina-Bueno
- Department of Podiatry, University of Seville, 41004 Seville, Spain; (P.V.M.-M.); (M.d.C.V.-B.); (G.D.-M.); (I.C.P.-T.)
- Correspondence:
| | - Pedro V. Munuera-Martínez
- Department of Podiatry, University of Seville, 41004 Seville, Spain; (P.V.M.-M.); (M.d.C.V.-B.); (G.D.-M.); (I.C.P.-T.)
| | - Sergio Pérez-García
- Department of Health Sciences, University of A Coruña, 15001 A Coruña, Spain;
| | | | - Gabriel Domínguez-Maldonado
- Department of Podiatry, University of Seville, 41004 Seville, Spain; (P.V.M.-M.); (M.d.C.V.-B.); (G.D.-M.); (I.C.P.-T.)
| | - Inmaculada C. Palomo-Toucedo
- Department of Podiatry, University of Seville, 41004 Seville, Spain; (P.V.M.-M.); (M.d.C.V.-B.); (G.D.-M.); (I.C.P.-T.)
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Stanmore EK, Oldham J, Skelton DA, O'Neill T, Pilling M, Todd C. Fear-of-falling and associated risk factors in persons with rheumatoid arthritis: a 1 year prospective study. BMC Musculoskelet Disord 2021; 22:260. [PMID: 33691660 PMCID: PMC7945213 DOI: 10.1186/s12891-021-04068-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/10/2021] [Indexed: 11/21/2022] Open
Abstract
Background Falls, associated injuries and fear-of-falling are common in adults with RA. Fear-of-falling can be a major consequence of, and as debilitating as falling, resulting in a cycle of activity restriction, reduced quality of life, institutionalisation and potentially increase risk of falls. The objective of this study was to examine the relationship between fear-of-falling and risk factors associated with fear-of-falling in adults with rheumatoid arthritis (RA) over a 1 year period. Methods Five hundred fifty-nine patients with RA were recruited from four outpatient clinics in this prospective cohort study. Baseline assessments included socio-demographic, medical and lifestyle related risk factors. Fall incidence was prospectively obtained monthly using postal cards over a 1 year period. Fear-of-falling was assessed at baseline and 1 year using the Short Falls Efficacy Scale-International (Short FES-I). Logistic regression was used to determine the association between high fear-of-falling (Short FES-I > 11) at baseline (outcome) and a range of putative predictor variables including previous falls, and also baseline factors associated with a high fear-of-falling at follow-up. Results Five hundred thirty-five (ninety-six percent) participants (mean age 62.1 yrs.; 18–88 yrs) completed 1 year follow-up and of these, 254 (47%) completed the Short FES-I questionnaire at 1 year. In a multivariate model, a history of multiple falls (OR = 6.08) higher HAQ score (OR = 4.87) and increased time to complete the Chair Stand Test (OR = 1.11) were found to be independent predictors of high fear-of-falling and had an overall classification rate of 87.7%. There were no significant differences found in fear-of-falling at 1 year follow-up in those who reported falls during the study, participant’s baseline fear appeared to predict future fear, regardless of further falls. Conclusions Fear-of-falling is significantly associated with previous falls and predictive of future falls and fear. RA patients would benefit from fall prevention measures whether or not they have previously fallen.
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Affiliation(s)
- Emma K Stanmore
- School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, Manchester, M13 9LP, UK. .,Manchester University NHS Foundation Trust, M13 9WL, Manchester, UK.
| | - Jackie Oldham
- School of Health Sciences, Citylabs, Nelson Street, University of Manchester, Manchester, M13 9LP, UK
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Rd, Glasgow, G4 0BA, UK
| | - Terence O'Neill
- Versus Arthritis Centre for Epidemiology and Centre for Musculoskeletal Research, University of Manchester, Manchester, M13 9PT, UK.,Department of Rheumatology, Salford Royal National Health Service Foundation Trust, Salford, M6 8HD, UK
| | - Mark Pilling
- Behaviour and Health Research Unit, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Cambridge, CB2 0SR, UK
| | - Chris Todd
- School of Health Sciences and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, University Place, University of Manchester, Manchester, M13 9LP, UK
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7
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Rosenblatt NJ, Girgis C, Avalos M, Fleischer AE, Crews RT. The Role of the Podiatrist in Assessing and Reducing Fall Risk: An Updated Review. Clin Podiatr Med Surg 2020; 37:327-369. [PMID: 32146988 DOI: 10.1016/j.cpm.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Falls present a tremendous challenge to health care systems. This article reviews the literature from the previous 5 years (2014-2019) in terms of methods to assess fall risk and potential steps that can be taken to reduce fall risk for patients visiting podiatric clinics. With regard to assessing fall risk, we discuss the role of a thorough medical history and podiatric assessments of foot problems and deformities that can be performed in the clinic. With regard to fall prevention we consider the role of shoe modification, exercise, pain relief, surgical interventions, and referrals.
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Affiliation(s)
- Noah J Rosenblatt
- Dr. William M. Scholl College of Podiatric Medicine's Center for Lower Extremity Ambulatory Research (CLEAR), 3333 Green Bay Road, North Chicago, IL 60064, USA.
| | - Christopher Girgis
- Dr. William M. Scholl College of Podiatric Medicine's Center for Lower Extremity Ambulatory Research (CLEAR), 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - Marco Avalos
- Dr. William M. Scholl College of Podiatric Medicine's Center for Lower Extremity Ambulatory Research (CLEAR), 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - Adam E Fleischer
- Dr. William M. Scholl College of Podiatric Medicine's Center for Lower Extremity Ambulatory Research (CLEAR), 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - Ryan T Crews
- Dr. William M. Scholl College of Podiatric Medicine's Center for Lower Extremity Ambulatory Research (CLEAR), 3333 Green Bay Road, North Chicago, IL 60064, USA
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8
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Abstract
Footwear is a modifiable risk factor for falls in older adults, including populations with metabolic disease, inflammatory arthritis, and neurodegenerative disease. Ill-fitting footwear, and specific design features, such as elevated heels and backless styles, can impair balance control and heighten the risk of falling. Although foot care is routine practice for some older adults to prevent ulceration (eg, diabetes) or relieve symptoms (eg, foot pain), new footwear interventions are emerging with the potential to ameliorate balance and walking impairments. Multifaceted podiatric interventions, which include appropriate footwear and importantly patient education, may have the capacity to reduce falls in older adults.
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9
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Stewart S, Dalbeth N, Aiyer A, Rome K. Objectively Assessed Foot and Ankle Characteristics in Patients With Systemic Lupus Erythematosus: A Comparison With Age- and Sex-Matched Controls. Arthritis Care Res (Hoboken) 2019; 72:122-130. [PMID: 30629828 DOI: 10.1002/acr.23832] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 01/08/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To objectively identify foot and ankle characteristics in patients with systemic lupus erythematosus (SLE) compared to age- and sex-matched controls. METHODS A total of 54 patients with SLE and 56 control participants attended a study visit designed to comprehensively assess the foot and ankle. Objectively assessed foot characteristics included muscle strength, joint motion, foot posture, foot problems, protective sensation, vibration perception threshold (VPT), ankle brachial index (ABI), plantar pressure, and spatiotemporal gait characteristics. Self-reported measure of foot pain and impairment were also assessed using a 100-mm foot pain visual analog scale. Data were analyzed using regression models. Plantar pressure and gait models were adjusted for walking velocity, body mass index, and foot pain. RESULTS Compared to controls, participants with SLE had lower muscle force for plantarflexion, dorsiflexion, inversion, and eversion (all P < 0.001), higher foot posture indices (P = 0.007), higher foot problem scores (P = 0.001), higher VPT (P = 0.001), and more frequent abnormal ABI (odds ratio [OR] 3.13, P = 0.044). Participants with SLE also had lower peak pressure and higher pressure time integrals for all foot regions (all P < 0.001), lower step and stride length, velocity, and cadence, and higher step, swing, stance, and single and double support times compared to controls (all P < 0.001). Compared to controls, participants with SLE also reported greater foot pain (P < 0.001). CONCLUSION Patients with SLE experience a wide range of foot symptoms. This study has provided objective evidence of foot and ankle disease in patients with SLE, including reduced muscle strength and altered gait patterns when compared to controls. This highlights the importance of foot health assessments as part of SLE management.
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Affiliation(s)
- Sarah Stewart
- Auckland University of Technology, Auckland, New Zealand
| | - Nicola Dalbeth
- University of Auckland and Auckland District Health Board, Auckland, New Zealand
| | - Ash Aiyer
- Auckland University of Technology, Auckland, New Zealand
| | - Keith Rome
- Auckland University of Technology, Auckland, New Zealand
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10
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Static and Dynamic Balance Disorders in Patients With Rheumatoid Arthritis and Relationships With Lower Extremity Function and Deformities: A Prospective Controlled Study. Arch Rheumatol 2018; 33:328-334. [PMID: 30632523 DOI: 10.5606/archrheumatol.2018.6720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 12/09/2017] [Indexed: 01/20/2023] Open
Abstract
Objectives This study aims to evaluate the static and dynamic balance disorders of patients with rheumatoid arthritis (RA) and to disclose the relationships with clinical, functional, and radiological findings of lower extremities. Patients and methods A total of 81 patients with RA (15 males, 66 females; mean age 48.9±10.4 years; range 22 to 67 years) were compared with 84 age and sex-matched healthy controls (14 males, 70 females; mean age 45.9±12.1 years; range 24 to 70 years). Radiographic assessments of feet were performed to evaluate the presence of pes planus, hallux valgus, metatarsus primus varus, and splaying foot deformities. Foot functions of patients were determined with Foot and Ankle Outcome Score. The balance disorders of the subjects were evaluated with three static (modified clinical test of sensory interaction and balance, unilateral stance, weight bearing squat) and three dynamic (step-up-and-over, sit-to-stand, tandem walk) balance tests via the 'Neurocom Balance Master' device. Results Rheumatoid arthritis patients had significantly higher sway velocity in unilateral stance and modified clinical test of sensory interaction and balance tests, higher step width and lower speed when walking on a line, lower rising index and higher movement time in step-up-and-over test compared to healthy controls (p<0.05). Performances on the sit-to-stand and weight bearing squat tests were comparable between both groups. Of the patients, although 61% had hallux valgus, 52% had metatarsus primus varus, 33% had pes planus, and 26% had splaying foot, these deformities were not correlated with Foot and Ankle Outcome Score or balance disorders. Presence of swollen joint was determined as the most relevant factor for balance disorders of RA patients. Conclusion Patients with RA may have increased risk for balance disorders due to cumulative effect of the lower extremity impairments seen in the course of disease.
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11
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Hanssen MM, Peters ML, Boselie JJ, Meulders A. Can positive affect attenuate (persistent) pain? State of the art and clinical implications. Curr Rheumatol Rep 2017; 19:80. [PMID: 29119260 PMCID: PMC5683052 DOI: 10.1007/s11926-017-0703-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Purpose of Review Pain is an intense experience that can place a heavy burden on peoples’ lives. The identification of psychosocial risk factors led to the development of effective pain treatments. However, effect sizes are modest. Accumulating evidence suggests that enhancing protective factors might also impact on (well-being despite) pain. Recent findings on positive affect (interventions) towards pain-related outcomes will be reviewed, and new avenues for treatment of persistent pain will be discussed. Recent Findings Positive affect significantly attenuates the experience of pain in healthy and clinical populations. Positive affect interventions effectively reduce pain sensitivity and bolster well-being despite pain. Through both psychological and (neuro-)biological pathways, but also through its effect on central treatment processes such as inhibitory learning, positive affect can optimize the efficacy of existing treatments. Summary Comprehensive understanding of the unique roles and dynamic interplay of positive and negative affect in moderating pain may optimize the treatment of (persistent) pain.
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Affiliation(s)
- Marjolein M Hanssen
- Clinical Psychological Science, Research Group Behavioral Medicine, Maastricht University, P.O. 616, 6200 MD, Maastricht, The Netherlands
| | - Madelon L Peters
- Clinical Psychological Science, Research Group Behavioral Medicine, Maastricht University, P.O. 616, 6200 MD, Maastricht, The Netherlands
| | - Jantine J Boselie
- Clinical Psychological Science, Research Group Behavioral Medicine, Maastricht University, P.O. 616, 6200 MD, Maastricht, The Netherlands
| | - Ann Meulders
- Clinical Psychological Science, Research Group Behavioral Medicine, Maastricht University, P.O. 616, 6200 MD, Maastricht, The Netherlands. .,Research Group Health Psychology, KU Leuven, Leuven, Belgium.
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12
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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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13
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Bowen C, Ashburn A, Cole M, Donovan-Hall M, Burnett M, Robison J, Mamode L, Pickering R, Bader D, Kunkel D. A survey exploring self-reported indoor and outdoor footwear habits, foot problems and fall status in people with stroke and Parkinson's. J Foot Ankle Res 2016; 9:39. [PMID: 27688813 PMCID: PMC5034630 DOI: 10.1186/s13047-016-0170-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 09/10/2016] [Indexed: 01/19/2023] Open
Abstract
Background Ill-fitting shoes have been implicated as a risk factor for falls but research to date has focused on people with arthritis, diabetes and the general older population; little is known about people with neurological conditions. This survey for people with stroke and Parkinson’s explored people’s choice of indoor and outdoor footwear, foot problems and fall history. Methods Following ethical approval, 1000 anonymous postal questionnaires were distributed to health professionals, leads of Parkinson’s UK groups and stroke clubs in the wider Southampton area, UK. These collaborators handed out survey packs to people with a confirmed diagnosis of stroke or Parkinson’s. Results Three hundred and sixty three completed surveys were returned (218 from people with Parkinson’s and 145 from people with stroke). Most respondents wore slippers indoors and walking shoes outdoors and considered comfort and fit the most important factors when buying footwear. Foot problems were reported by 43 % (95 % confidence intervals 36 to 52 %; stroke) and 53 % (95 % confidence interval 46 to 59 %; Parkinson’s) of respondents; over 50 % had never accessed foot care support. Fifty percent of all respondents reported falls. In comparison to non-fallers, a greater proportion of fallers reported foot problems (57 %), with greater proportions reporting problems impacting on balance and influencing choice of footwear (p < 0.01) in comparison to non-fallers in each case. Forty-seven percent of fallers with foot problems had not accessed foot care support. Conclusions Many people with stroke and Parkinson’s wear slippers indoors. A high percentage of these individuals reported both foot problems and falls impacting on footwear habits and choice of footwear; however many did not receive foot care support. These findings highlight that further exploration of footwear and foot problems in these populations is warranted to provide evidence based advice on safe and appropriate footwear to support rehabilitation and fall prevention. Electronic supplementary material The online version of this article (doi:10.1186/s13047-016-0170-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catherine Bowen
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Ann Ashburn
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Mark Cole
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | - Malcolm Burnett
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Judy Robison
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Louis Mamode
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Ruth Pickering
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Dan Bader
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Dorit Kunkel
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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