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The impact of rheumatoid arthritis on foot function in the early stages of disease: a clinical case series

Turner, D.E., Helliwell, P.S., Emery, P. and Woodburn, J. (2006) The impact of rheumatoid arthritis on foot function in the early stages of disease: a clinical case series. BMC Musculoskeletal Disorders, 7 (102). ISSN 1471-2474

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Abstract

BACKGROUND

Foot involvement occurs early in rheumatoid arthritis but the extent to which this impacts on the structure and function leading to impairment and foot related disability is unknown. The purpose of this study was to compare clinical disease activity, impairment, disability, and foot function in normal and early rheumatoid arthritis (RA) feet using standardised clinical measures and 3D gait analysis.

METHODS

Twelve RA patients with disease duration ≤2 years and 12 able-bodied adults matched for age and sex underwent 3D gait analysis to measure foot function. Disease impact was measured using the Leeds Foot impact Scale (LFIS) along with standard clinical measures of disease activity, pain and foot deformity. For this small sample, the mean differences between the groups and associated confidence intervals were calculated using the t distribution

RESULTS

Moderate-to-high foot impairment and related disability were detected amongst the RA patients. In comparison with age- and sex-matched controls, the patients with early RA walked slower (1.05 m/s Vs 1.30 m/s) and had a longer double-support phase (19.3% Vs 15.8%). In terminal stance, the heel rise angle was reduced in the patients in comparison with normal (-78.9° Vs -85.7°). Medial arch height was lower and peak eversion in stance greater in the RA patients. The peak ankle plantarflexion power profile was lower in the patients in comparison with the controls (3.4 W/kg Vs 4.6 W/kg). Pressure analysis indicated that the RA patients had a reduced lesser toe contact area (7.6 cm2 Vs 8.1 cm2), elevated peak forefoot pressure (672 kPa Vs 553 kPa) and a larger mid-foot contact area (24.6 cm2 Vs 19.4 cm2).

CONCLUSION

Analysis detected small but clinically important changes in foot function in a small cohort of RA patients with disease duration <2 years. These were accompanied by active joint disease and impairment and disability.

Item Type: Article
Copyright, Publisher and Additional Information: © 2006 Turner et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Institution: The University of Leeds
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Musculoskeletal Disease (Leeds)
Depositing User: Sherpa Assistant
Date Deposited: 26 Jan 2007
Last Modified: 08 Jun 2014 17:12
Published Version: http://www.biomedcentral.com/1471-2474/7/102
Status: Published
Publisher: BioMed Central
Refereed: Yes
Identification Number: 10.1186/1471-2474-7-102
URI: http://eprints.whiterose.ac.uk/id/eprint/1928

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