Plantar foot pressures are not related to disease activity in rheumatoid arthritis
Plantar foot pressures are not related to disease activity in rheumatoid arthritis
Background: foot pressures are elevated within the RA foot, particularly under the
forefoot. Recent evidence has linked joint damage, as measured by radiological
erosion scores, to increased plantar forefoot pressures. However, it is not clear
whether plantar forefoot pressures in RA are also related to inflammatory disease
activity. The objective of this study was to investigate relationships between
forefoot pressures and disease activity (DAS28) in a sample of RA patients.
Methods: a cross sectional study design was used in which patients with RA (ACR
criteria) were investigated for plantar foot pressures. Foot pressure measurements
were recorded by an FScan In-shoe system, (Tekscan Inc. USA) according to
standard protocol. Average foot pressures were calculated for the entire plantar
foot area, and the third step was selected for analysis. The outcome variables
(identified in Table 1) for both left and right feet were recorded. The data was split
into groups according to DAS28 scores(identified in table 1) to define RA disease
activity.
Results: 149 patients (119 female and 30 male) with RA (34 seronegative, 114
seropositive and 1 unidentified) completed the study: mean age 59.3 (SD 12.5)
years, weight 73.3 (14.9) Kg, disease duration 12.28 (10.3) years. The mean ESR
was 23.3 (19.2), CRP 12.5 (18.1), DAS28 scores 3.9 (1.3). Foot pressure and
footstep time variables are reported in table 1. Using analysis of variance no
significant differences between DAS28 groups were found for any of the foot
pressure variables (Peak pressure L p¼0.410, R p¼0.412; Time of peak pressure
L p¼0.094, R p¼0.075; Total footstep time L p¼0.165, R p¼0.459; Force-time
integral L p¼0.441, R p¼0.961; Mean force L p¼0.867, R p¼0.452). However, a
test for trend showed there was a borderline association between DAS28 group
and time of peak pressure (left p¼0.014; right p¼0.058) and that this was
independent of age (left ¼0.063 p¼0.01;, right ¼0.043, p¼0.058).
Conclusions: data from this study suggest that patients with higher disease
activity may have longer times of peak pressures. Since longer times of peak
pressures in diabetes patients have been linked to secondary mechanical damage,
it is recommended that further investigations into the importance of temporal and
spatial foot pressures in RA patients with high disease activity is undertaken.
Disclosures: A.G. received funding from Arthritis Research Campaign for a
research intern for the duration of the study. C.B., L.H., C.J.E., D.C. and N.K.A.
have declared no conflicts of interest
332-[i129]
Gay, Anita
bfa22423-d2b8-4715-9a8e-10809ddd8a19
Bowen, Catherine J.
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Hooper, Lindsey
95256156-ce8c-4e7c-b04d-b6e459232441
Edwards, Christopher J.
dcb27fec-75ea-4575-a844-3588bcf14106
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
April 2009
Gay, Anita
bfa22423-d2b8-4715-9a8e-10809ddd8a19
Bowen, Catherine J.
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Hooper, Lindsey
95256156-ce8c-4e7c-b04d-b6e459232441
Edwards, Christopher J.
dcb27fec-75ea-4575-a844-3588bcf14106
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Gay, Anita, Bowen, Catherine J., Hooper, Lindsey, Edwards, Christopher J. and Arden, Nigel K.
(2009)
Plantar foot pressures are not related to disease activity in rheumatoid arthritis.
Rheumatology, 48 (Supplement 1), .
(doi:10.1093/rheumatology/kep739).
Abstract
Background: foot pressures are elevated within the RA foot, particularly under the
forefoot. Recent evidence has linked joint damage, as measured by radiological
erosion scores, to increased plantar forefoot pressures. However, it is not clear
whether plantar forefoot pressures in RA are also related to inflammatory disease
activity. The objective of this study was to investigate relationships between
forefoot pressures and disease activity (DAS28) in a sample of RA patients.
Methods: a cross sectional study design was used in which patients with RA (ACR
criteria) were investigated for plantar foot pressures. Foot pressure measurements
were recorded by an FScan In-shoe system, (Tekscan Inc. USA) according to
standard protocol. Average foot pressures were calculated for the entire plantar
foot area, and the third step was selected for analysis. The outcome variables
(identified in Table 1) for both left and right feet were recorded. The data was split
into groups according to DAS28 scores(identified in table 1) to define RA disease
activity.
Results: 149 patients (119 female and 30 male) with RA (34 seronegative, 114
seropositive and 1 unidentified) completed the study: mean age 59.3 (SD 12.5)
years, weight 73.3 (14.9) Kg, disease duration 12.28 (10.3) years. The mean ESR
was 23.3 (19.2), CRP 12.5 (18.1), DAS28 scores 3.9 (1.3). Foot pressure and
footstep time variables are reported in table 1. Using analysis of variance no
significant differences between DAS28 groups were found for any of the foot
pressure variables (Peak pressure L p¼0.410, R p¼0.412; Time of peak pressure
L p¼0.094, R p¼0.075; Total footstep time L p¼0.165, R p¼0.459; Force-time
integral L p¼0.441, R p¼0.961; Mean force L p¼0.867, R p¼0.452). However, a
test for trend showed there was a borderline association between DAS28 group
and time of peak pressure (left p¼0.014; right p¼0.058) and that this was
independent of age (left ¼0.063 p¼0.01;, right ¼0.043, p¼0.058).
Conclusions: data from this study suggest that patients with higher disease
activity may have longer times of peak pressures. Since longer times of peak
pressures in diabetes patients have been linked to secondary mechanical damage,
it is recommended that further investigations into the importance of temporal and
spatial foot pressures in RA patients with high disease activity is undertaken.
Disclosures: A.G. received funding from Arthritis Research Campaign for a
research intern for the duration of the study. C.B., L.H., C.J.E., D.C. and N.K.A.
have declared no conflicts of interest
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More information
Published date: April 2009
Additional Information:
Proceedings of Rheumatology '09, Glasgow, UK, 28 Apr-01 May 2009
Organisations:
Medicine, Health Sciences
Identifiers
Local EPrints ID: 72586
URI: http://eprints.soton.ac.uk/id/eprint/72586
ISSN: 1462-0324
PURE UUID: 54826d98-5d39-4048-adb3-3ad886c3d112
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Date deposited: 19 Feb 2010
Last modified: 14 Mar 2024 02:53
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Author:
Anita Gay
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