Effect of rocker shoes on pain, disability and activity limitation in patients with rheumatoid arthritis

Background: Rheumatoid arthritis is a chronic inflammatory joint disease which affects the joints and soft tissues of the foot and ankle. Rocker shoes may be prescribed for the symptomatic foot in rheumatoid arthritis; however, there is a limited evidence base to support the use of rocker shoes in these patients. Objectives: The aim of this study was to evaluate the effectiveness of heel-to-toe rocker shoes on pain, disability, and activity limitation in patients with rheumatoid arthritis. Study design: Clinical trial. Methods: Seventeen female patients with rheumatoid arthritis of 1 year or more duration, disease activity score of less than 2.6, and foot and ankle pain were recruited. Heel-to-toe rocker shoe was made according to each patient’s foot size. All the patients were evaluated immediately, 7 and 30 days after their first visit. Foot Function Index values were recorded at each appointment. Results: With the use of rocker shoes, Foot Function Index values decreased in all subscales. This reduction was noted in the first visit and was maintained throughout the trials. Conclusion: Rocker shoe can improve pain, disability, and activity limitation in patients with rheumatoid foot pain. All the subjects reported improved comfort levels. Clinical relevance The results of this study showed that high-top, heel-to-toe rocker shoe with wide toe box was effective at reducing foot and ankle pain. It was also regarded as comfortable and acceptable footwear by the patients with rheumatoid foot problems.

[1]  N. Chockalingam,et al.  Evaluation of lower limb electromyographic activity when using unstable shoes for the first time: A pilot quasi control trial , 2013, Prosthetics and orthotics international.

[2]  S. Hutchins,et al.  Effects of the heel-to-toe rocker sole on walking in able-bodied persons , 2013, Prosthetics and orthotics international.

[3]  P Bowker,et al.  The biomechanics and clinical efficacy of footwear adapted with rocker profiles--evidence in the literature. , 2009, Foot.

[4]  Nam Soon Cho,et al.  Randomized controlled trial for clinical effects of varying types of insoles combined with specialized shoes in patients with rheumatoid arthritis of the foot , 2009 .

[5]  P. Helliwell,et al.  Methodological considerations for a randomised controlled trial of podiatry care in rheumatoid arthritis: lessons from an exploratory trial , 2007, BMC musculoskeletal disorders.

[6]  C. Nester,et al.  Rheumatoid arthritis patients' experiences of wearing therapeutic footwear - A qualitative investigation , 2007, BMC musculoskeletal disorders.

[7]  S. An,et al.  EFFECT OF ROCKER HEEL ANGLE OF WALKING SHOE ON GAIT MECHANICS AND MUSCLE ACTIVITY , 2007 .

[8]  G F Harris,et al.  Biomechanical implications of the negative heel rocker sole shoe: gait kinematics and kinetics. , 2006, Gait & posture.

[9]  S. Collins,et al.  The advantages of a rolling foot in human walking , 2006, Journal of Experimental Biology.

[10]  C. Nester,et al.  A clinical trial of specialist footwear for patients with rheumatoid arthritis. , 2006, Rheumatology.

[11]  T Pozzo,et al.  Effects of loss of metatarsophalangeal joint mobility on gait in rheumatoid arthritis patients. , 2006, Rheumatology.

[12]  J. Dekker,et al.  Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics. , 2006, Rheumatology.

[13]  M. Bonnin,et al.  Footwear for the rheumatoid foot and ankle , 2005, Médecine et Chirurgie du Pied.

[14]  A. Williams,et al.  Meeting the challenge for foot health in rheumatic diseases , 2004 .

[15]  P. Hannonen,et al.  Pain and joint mobility explain individual subdimensions of the health assessment questionnaire (HAQ) disability index in patients with rheumatoid arthritis , 2004, Annals of the rheumatic diseases.

[16]  G. Harris,et al.  Biomechanics of the toe-only rocker sole shoe: gait kinematics and kinetics , 2003, Proceedings of the 25th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE Cat. No.03CH37439).

[17]  N. Bek,et al.  Outcome of Orthoses Intervention in the Rheumatoid Foot , 2003, Foot & ankle international.

[18]  J. Louwerens,et al.  The influence of shoe design on plantar pressures in neuropathic feet. , 2003, Diabetes care.

[19]  P. Helliwell,et al.  Three-dimensional kinematics at the ankle joint complex in rheumatoid arthritis patients with painful valgus deformity of the rearfoot. , 2002, Rheumatology.

[20]  J. Listing,et al.  Loss of physical independence in rheumatoid arthritis: interview data from a representative sample of patients in rheumatologic care. , 2000, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[21]  J. Shrader,et al.  Nonsurgical management of the foot and ankle affected by rheumatoid arthritis. , 1999, The Journal of orthopaedic and sports physical therapy.

[22]  T. Bach,et al.  novel Award First Prize Paper. Orthotic management of plantar pressure and pain in rheumatoid arthritis. , 1999, Clinical biomechanics.

[23]  A. MacSween,et al.  The effect of custom moulded ethyl vinyl acetate foot orthoses on the gait of patients with rheumatoid arthritis , 1999 .

[24]  M. Krogsgaard,et al.  Patient compliance and effect of orthopaedic shoes , 1999, Prosthetics and orthotics international.

[25]  J. Grifka Shoes and insoles for patients with rheumatoid foot disease. , 1997, Clinical orthopaedics and related research.

[26]  R. Mann,et al.  Management of the foot and ankle in rheumatoid arthritis. , 1996, Rheumatic diseases clinics of North America.

[27]  J. Michelson,et al.  Foot and Ankle Problems in Rheumatoid Arthritis , 1994, Foot & ankle international.

[28]  G. J. Gouw,et al.  Athletic footwear affects balance in men. , 1994, British journal of sports medicine.

[29]  M. Liang,et al.  The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. , 1988, Arthritis and rheumatism.

[30]  J. Perry,et al.  Walking patterns of healthy subjects wearing rocker shoes. , 1985, Physical therapy.

[31]  P. Dimonte,et al.  Pathomechanics, gait deviations, and treatment of the rheumatoid foot: a clinical report. , 1982, Physical therapy.

[32]  A. D. Craxford,et al.  Surgical footwear in rheumatoid arthritis—a patient acceptability study , 1981, Prosthetics and orthotics international.

[33]  E. Vidigal,et al.  The foot in chronic rheumatoid arthritis. , 1975, Annals of the rheumatic diseases.

[34]  B. Nigg,et al.  Effect of an unstable shoe construction on lower extremity gait characteristics. , 2006, Clinical biomechanics.

[35]  Gerald F Harris,et al.  Effect of rocker soles on plantar pressures. , 2004, Archives of physical medicine and rehabilitation.

[36]  G F Harris,et al.  Biomechanics of the double rocker sole shoe: gait kinematics and kinetics. , 2004, Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference.

[37]  D. Hedeker,et al.  Impacts of foot orthoses on pain and disability in rheumatoid arthritics. , 1996, Journal of clinical epidemiology.

[38]  K. Roach,et al.  The Foot Function Index: a measure of foot pain and disability. , 1991, Journal of clinical epidemiology.