title: Ottawa Panel Evidence-Based Clinical Practice Guidelines for Foot Care in the Management of Juvenile Idiopathic Arthritis.
abstract: To create evidence-based guidelines evaluating foot care interventions for the management of juvenile idiopathic arthritis (JIA).
  
  
  
  An electronic literature search of the following databases from database inception to May 2015 was conducted: MEDLINE (Ovid), EMBASE (Ovid), Cochrane CENTRAL, and clinicaltrials.gov.
  
  
  
  The Ottawa Panel selection criteria targeted studies that assessed foot care or foot orthotic interventions for the management of JIA in those aged 0 to ≤18 years. The Physiotherapy Evidence Database scale was used to evaluate study quality, of which only high-quality studies were included (score, ≥5). A total of 362 records were screened, resulting in 3 full-text articles and 1 additional citation containing supplementary information included for the analysis.
  
  
  
  Two reviewers independently extracted study data (intervention, comparator, outcome, time period, study design) from the included studies by using standardized data extraction forms. Directed by Cochrane Collaboration methodology, the statistical analysis produced figures and graphs representing the strength of intervention outcomes and their corresponding grades (A, B, C+, C, C-, D+, D, D-). Clinical significance was achieved when an improvement of ≥30% between the intervention and control groups was present, whereas P>.05 indicated statistical significance. An expert panel Delphi consensus (≥80%) was required for the endorsement of recommendations.
  
  
  
  All included studies were of high quality and analyzed the effects of multidisciplinary foot care, customized foot orthotics, and shoe inserts for the management of JIA. Custom-made foot orthotics and prefabricated shoe inserts displayed the greatest improvement in pain intensity, activity limitation, foot pain, and disability reduction (grades A, C+).
  
  
  
  The use of customized foot orthotics and prefabricated shoe inserts seems to be a good choice for managing foot pain and function in JIA.
authors.affiliation: Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: Lucie.Brosseau@uottawa.ca.
authors.forename: Lucie
authors.initials: L
authors.lastname: Brosseau
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Toupin-April
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Methods Center, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Wells
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Smith
authors.affiliation: Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
authors.forename: Arlanna G
authors.initials: AG
authors.lastname: Pugh
authors.affiliation: Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Stinson
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Ciarán M
authors.initials: CM
authors.lastname: Duffy
authors.affiliation: Faculty of Health Sciences, School of Nursing Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Wendy
authors.initials: W
authors.lastname: Gifford
authors.affiliation: Clinical Epidemiology Program, Ottawa Methods Center, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Moher
authors.affiliation: Musculoskeletal Division, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.affiliation: Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Cavallo
authors.affiliation: Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Gino
authors.initials: G
authors.lastname: De Angelis
authors.affiliation: Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Laurianne
authors.initials: L
authors.lastname: Loew
authors.affiliation: Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Prinon
authors.initials: P
authors.lastname: Rahman
authors.affiliation: Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: Marcotte
authors.affiliation: Interdisciplinary School of Health Sciences, Faculty of Health Sciences, Ottawa, Ontario, Canada.
authors.forename: Jade
authors.initials: J
authors.lastname: Taki
authors.affiliation: Faculty of Health Sciences, School of Nursing Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jacinthe
authors.initials: J
authors.lastname: Bisaillon
authors.affiliation: Physiotherapy Program, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Judy
authors.initials: J
authors.lastname: King
authors.affiliation: Faculty of Health and Medicine - Health Precinct, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Coda
authors.affiliation: School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Lanarkshire, United Kingdom.
authors.forename: Gordon J
authors.initials: GJ
authors.lastname: Hendry
authors.affiliation: Podiatry Clinic of Outaouais, Hospital Boulevard, Gatineau, Québec, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Gauvreau
authors.affiliation: Hayles Foot and Ankle Clinic, Ottawa, Ontario, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Hayles
authors.affiliation: Hayles Foot and Ankle Clinic, Ottawa, Ontario, Canada.
authors.forename: Kay
authors.initials: K
authors.lastname: Hayles
authors.affiliation: Department of Pediatrics and Medicine, University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Feldman
authors.affiliation: Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada.
authors.forename: Glen P
authors.initials: GP
authors.lastname: Kenny
authors.affiliation: Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada.
authors.forename: Jing Xian
authors.initials: JX
authors.lastname: Li
authors.affiliation: School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Briggs
authors.affiliation: Occupational Therapy Program, Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Rose
authors.initials: R
authors.lastname: Martini
authors.affiliation: School of Public Health, Option Epidemiology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Debbie Ehrmann
authors.initials: DE
authors.lastname: Feldman
authors.affiliation: Physiotherapy Program, Department of Rehabilitation, Pavillon Ferdinand-Vandry, Université Laval, Québec, Quebec, Canada.
authors.forename: Désirée B
authors.initials: DB
authors.lastname: Maltais
authors.affiliation: School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Tupper
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bigford
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Marg
authors.initials: M
authors.lastname: Bisch
mesh_terms: D001171:Arthritis, Juvenile / Q000534:rehabilitation*; D003697:Delphi Technique; D055317:Evidence-Based Practice; D061826:Foot Orthoses; D006801:Humans; D059408:Pain Management / Q000379:methods*; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D012775:Shoes
keywords: Arthritis, juvenile; Orthotic devices; Pediatrics; Physical therapy modalities; Podiatry; Rehabilitation; Rheumatology