The Effects of Custom-made Foot Orthoses on Foot Pain, Foot Function, Gait Function and Freeliving Walking Activities in Psoriatic Arthritis (PsA) Patients: a Pre-experimental Trial
Bibliographic record
Abstract
Abstract Introduction: Foot involvement is a major concern in psoriatic arthritis (PsA) as it can lead to severe levels of foot pain and disability as well as reduced mobility and quality of life. Previous studies have shown moderate efficacy in reducing foot pain and disability in rheumatoid arthritis patients with the use of custom-made foot orthoses (CFO). However, evidence on the efficacy of CFO in PsA patients is lacking.Objectives: Explore the effects of CFO on foot function, foot and lower limb pain, gait function, and freeliving walking activities (FWA) in PsA patients.Methods: A Pre-experimental study including 20 PsA patients (mean age: 54.10 ± 9.06 y and disease duration: 11.53 ± 10.22 y), was conducted. All the participants received and wore CFO for a 7-week period. Foot and lower limb pain and foot function were measured before and after the intervention using the numerical rating scale (NRS) and the foot function index (FFI). Gait function was assessed from gait spatiotemporal parameters (STPs) extracted during a 10-meter walk test with an gait analysis system (Mobility Lab). Freeliving walking activities (step count, freeliving cadence, time spent in different ambulatory physical activities (APA)) were recorded over 7 days using accelerometer data collected from an instrumented sock worn during waking hours.Results: PsA patients reported severe baseline levels of foot pain (54.46 ± 14.58 %) and disability (46.65 ± 16.14%) on the FFI. Statistically and clinically significant improvements with large effect sizes (Cohen’s effect size > 1, p<0.005) in foot pain and foot function were observed after 7 weeks of CFO use. A significant correlation (r=-0.64, p<0.01) between CFO wear time after the adaption period and foot function on the FFI at 7 weeks was observed. However, no significant changes were demonstrated for gait STP nor for free-living walking activities after 7 weeks of CFO use.Conclusion: Results support the clinical and biomechanical plausibility of using CFO with PsA patients to reduce pain and improve foot function. Larger and controlled studies are needed to confirm these findings and a multidisciplinary approach including the prescription of exercise therapy and physiotherapy in combination with CFO could be relevant to improve STP and promote APA in PsA patients.Study registration: ClinicalTrials.gov, NCT05075343, Retrospectively registered on 29 September 2021.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".