Metatarsalgia and rheumatoid arthritis--a randomized, single blind, sequential trial comparing 2 types of foot orthoses and supportive shoes.
OBJECTIVE
To compare the effects of semi-rigid and soft orthoses worn in supportive shoes, and supportive shoes worn alone, on metatarsal phalangeal (MTP) joint pain. MTP joint synovitis, and lower extremity function in patients with rheumatoid arthritis.


METHODS
Twenty-eight subjects referred to occupational therapy received in random order 3 interventions for 12 week trials, separated by 2 week washouts. A crossover design compared effectiveness of interventions.


RESULTS
Twenty-four subjects completed the study. A reduction in mean pain scores from baseline to final visits showed that semi-rigid orthoses had a highly significant effect on pain. Soft orthoses did not show a significant effect on pain from baseline to final visit, nor did shoes worn alone. None of the interventions had a significant effect on synovitis or function.


CONCLUSIONS
Semi-rigid orthoses worn in supportive shoes were an effective treatment for metatarsalgia. Supportive shoes worn alone or worn with soft orthoses did not provide pain relief for metatarsalgia.
Occupational Therapy Department, Vancouver Hospital and Health Science Centre, British Columbia, Canada.
A C
AC
Chalmers
C
C
Busby
J
J
Goyert
B
B
Porter
M
M
Schulzer
D000328:Adult; D018771:Arthralgia / Q000209:etiology / Q000628:therapy*; D001172:Arthritis, Rheumatoid / Q000503:physiopathology* / Q000628:therapy*; D019538:Health Care Surveys; D006801:Humans; D008683:Metatarsophalangeal Joint / Q000473:pathology* / Q000503:physiopathology*; D009989:Orthotic Devices; D010147:Pain Measurement; D020127:Recovery of Function; D012775:Shoes; D016896:Treatment Outcome