The impact of rheumatoid foot on disability in Colombian patients with rheumatoid arthritis.
BACKGROUND
Alterations in the feet of patients with rheumatoid arthritis (RA) are a cause of disability in this population. The purpose of this research was to evaluate the impact that foot impairment has on the patients' global quality of life (QOL) based on validated scales and its relationship to disease activity.


METHODS
This was a cross-sectional study in which 95 patients with RA were enrolled. A complete physical examination, including a full foot assessment, was done. The Spanish versions of the Health Assessment Questionnaire (HAQ) Disability Index and of the Disease Activity Score (DAS 28) were administered. A logistic regression model was used to analyze data and obtain adjusted odds ratios (AORs).


RESULTS
Foot deformities were observed in 78 (82%) of the patients; hallux valgus (65%), medial longitudinal arch flattening (42%), claw toe (lesser toes) (39%), dorsiflexion restriction (tibiotalar) (34%), cock-up toe (lesser toes) (25%), and transverse arch flattening (25%) were the most frequent. In the logistic regression analysis (adjusted for age, gender and duration of disease), forefoot movement pain, subtalar movement pain, tibiotalar movement pain and plantarflexion restriction (tibiotalar) were strongly associated with disease activity and disability. The positive squeeze test was significantly associated with disability risk (AOR = 6,3; 95% CI, 1.28-30.96; P = 0,02); hallux valgus, and dorsiflexion restriction (tibiotalar) were associated with disease activity.


CONCLUSIONS
Foot abnormalities are associated with active joint disease and disability in RA. Foot examinations provide complementary information related to the disability as an indirect measurement of quality of life and activity of disease in daily practice.
Rojas-Villarraga
Adriana
A
Center for Autoimmune Diseases Research (CREA), Corporación para Investigaciones Biológicas, Universidad del Rosario, Medellin, Colombia. adrirojas@gmail.com
Bayona
Javier
J
Zuluaga
Natalia
N
Mejia
Santiago
S
Hincapie
Maria-Eugenia
ME
Anaya
Juan-Manuel
JM
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D003105:Colombia / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005528:Foot / Q000473:pathology / Q000503:physiopathology; D005531:Foot Deformities, Acquired / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D033023:Foot Joints / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010808:Physical Examination; D015995:Prevalence; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult