Conservative podiatric management in rheumatoid arthritis: a literature review of evidence and gaps
Bibliographic record
Abstract
Background: Foot problems are highly prevalent in rheumatoid arthritis (RA) and contribute to pain, disability, and reduced quality of life. Conservative podiatric interventions, including foot orthoses (FO) and foot health education (FHE), can improve foot functionality and reduce pain. However, podiatrists remain underrepresented in rheumatology care teams and their role is often absent from clinical guidelines. This review aimed to evaluate the evidence for conservative podiatric interventions in RA and highlight their impact on patient care. Methods A literature search was performed in PubMed Central (PMC), Scopus, Web of Science, CINAHL, MEDLINE, and ScienceDirect. Eligible designs included randomized controlled trials (RCTs), quasi-experimental studies, cohort and case-control studies, cross-sectional studies and surveys. Methodological quality and levels of evidence were assessed using the Canadian Task Force on Preventive Health Care (CTFPHC) criteria. Results 12 studies were included. RCTs demonstrated that foot orthoses reduce pain and positively influence gait biomechanics. Quasi-experimental and cohort studies reported benefits in plantar pressure distribution and mobility. Callus debridement showed short-term pain reduction, while patient education studies identified persistent gaps in knowledge, delivery, and referral pathways. Cross-sectional studies confirmed the high prevalence of foot deformities and disability, with limited or inconsistent podiatry access across services. Conclusions Conservative podiatric interventions and FHE are effective and essential in RA management, improving function and quality of life. Despite this, podiatry remains inconsistently integrated within rheumatology care. Strengthening referral pathways and conducting further high-quality research are necessary steps to ensure foot health is recognized as a core element of multidisciplinary RA management.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".