The nature, extent and functional impact of foot problems in established rheumatoid arthritis
Date
2009-11-10T10:48:36Z
Authors
Gosai, Hema
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Abstract
Introduction
Foot involvement is common in rheumatoid arthritis (RA). Foot pain, instability and
deformity affect ambulation and impacts on health-related quality of life. The aim of this
study was to determine the nature, extent and functional impact of rheumatoid foot
problems in established RA.
Patients and Methods
One hundred RA patients were studied. Functional status was evaluated using the modified
Health Assessment Questionnaire (mHAQ) and Foot Health Status Questionnaire (FHSQ).
Foot deformity and footwear suitability was assessed using the Foot Problems Survey (FP
Survey) and Footwear Suitability Scale (FWS Scale).
Results
In this predominantly female group of 95%, with a mean (± SD) disease duration of 12.2
(7.9) and moderate functional disability [mHAQ: 1.3 (0.6)], the FP Survey showed all
patients had one or more foot deformity. Foot function was impaired with a mean (± SD)
FHSQ score of 41.3 (12.4) and the FWS Scale showed that 93% wore unsuitable footwear.
A strong correlation was observed of the global FHSQ (r=-0.5489, p<0.0001), its pain
domain (r=-0.472, p<0.0001) and foot function domain (r=-0.599, p<0.0001), with the
global mHAQ score. Despite the high frequency of foot problems observed only 27% had
visited a podiatrist.
Conclusion
In conclusion foot problems and foot function disability is common in Black South African
patients with established RA. Furthermore the strong correlation between mHAQ and
FHSQ showed that foot functional disability was a major driver of overall functional
disability in RA.
Description
M.Sc.(Med.), Faculty of Health Sciences, University of the Witwatersrand, 2009
Keywords
foot problems, rheumatoid arthritis