OP0207-HPR EFFECT OF FOOT ORTHOSES IN REDUCING PAIN IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS: A 12-MONTH RANDOMISED CLINICAL TRIAL

Autor: A. Fellas, J. Chaitow, D. Singh-Grewal, D. Santos, M. Clapham, A. Coda
Rok vydání: 2022
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 81:136.3-136
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2022-eular.854
Popis: BackgroundJuvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and adolescents [1]. The manifestation of JIA may include joint swelling, tenderness, and painful limitation with joint movement. Only few studies have explored the effect of foot orthoses (FOs) alone in children with JIA [2,3]. These studies showed FOs can reduce pain in children with JIA, however, further research with larger sample sizes and longer follow-ups are needed [4]. Prescribing FOs on the same day of the initial assessment may promote early clinical and targeted intervention, which is the gold standard approach in paediatric rheumatology.ObjectivesThis single blinded multicentre randomised clinical trial (RCT) aims to investigate the effect of customised prefabricated FOs in reducing pain amongst children and adolescents with JIA.MethodsOverall, 66 children and adolescents with JIA presenting with foot symptoms were recruited from the Sydney Children’s Hospitals Network (Westmead and Randwick) and John Hunter Children’s Hospital (Newcastle). The primary outcome measure was pain with a minimal clinical significance of 8mm on the visual analogue scale (VAS). Participants were randomly allocated to receive either customised prefabricated or sham FOs. The trial intervention was a low-density Slimflex Simple device that was customised at chair-side. The control (sham) device was made of 2mm flat leather board with no corrective modifications. Standardised tests such as the Foot Posture Index, navicular drift and drop were used to identify biomechanical abnormalities. The FOs were worn for a total of 12 months, with data collected at baseline, 4 weeks, 3, 6 months and 12 months.ResultsReduction in self-reported pain was statistically and clinically significant at 4-weeks (p=0.018, -14.92 [-27.30, -2.55]) and 3 months (p=ConclusionResults of this clinical trial indicate customised preformed FOs can be effective in reducing pain and in children with JIA experiencing foot and ankle symptoms. Significant clinical effects appear to be within the first 3-months of intervention prescription and reduce beyond 6 months. Overall, this podiatric intervention was safe, inexpensive, well tolerated and it can be easily implemented as part of the multidisciplinary paediatric rheumatology care.References[1]Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet. 2007;369:767–78.[2]Powell M, Seid M, Szer IS. Efficacy of custom foot orthotics in improving pain and functional status in children with juvenile idiopathic arthritis: a randomized trial. J Rheumatol 2005;32:943–50.[3]Coda A, Fowlie PW, Davidson JE et al. Foot orthoses in children with juvenile idiopathic arthritis: a randomised controlled trial. Arch Dis Child 2014;99:649–51.[4]Fellas A, Coda A, Hawke F. Physical and mechanical therapies for lower-limb problems in juvenile idiopathic arthritis: a systematic review with meta-analysis. Journal of the American Podiatric Medical Association. 2017 Sep;107(5):399-412.AcknowledgementsWe would like to acknowledge all parents and children for their precious time.Disclosure of InterestsNone declared
Databáze: OpenAIRE
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