Foot orthoses in children with juvenile idiopathic arthritis: a randomised controlled trial

• Published in: Archives of disease in childhood Vol. 99; no. 7; pp. 649 - 651
• Main Authors: Coda, Andrea, Fowlie, Peter W, Davidson, Joyce E, Walsh, Jo, Carline, Tom, Santos, Derek
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group 01.07.2014; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Adolescent; Arthritis; Arthritis, Juvenile - psychology; Arthritis, Juvenile - therapy; Biological and medical sciences; Care and treatment; Child; Child Health; Clinical trials; Data Analysis; Diseases of the osteoarticular system; Drug Therapy; Fear of Success; Female; Foot Orthoses; General aspects; Humans; Hypotheses; Inflammatory joint diseases; Juvenile arthritis; Male; Medical sciences; Miscellaneous; Orthopaedic equipment; Orthopedic appliances; Orthopedic equipment and supplies; Orthotic Devices; Pain; Pain - psychology; Pain Management - methods; Pain Measurement; Parents; Pediatrics; Potential Dropouts; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of life; Quality of Life - psychology; Questionnaires; Rheumatology; Statistical Analysis; Surveys and Questionnaires; Treatment Outcome; United Kingdom > UK; Human; Pediatrics; Chronic; Diseases of the osteoarticular system; Juvenile rheumatoid arthritis; Clinical trial; Controlled therapeutic trial; Inflammatory joint disease; Child; Randomized controlled trial; Public health; Foot
• DOI: 10.1136/archdischild-2013-305166
• ISSN: 0003-9888

Introduction There is limited evidence supporting the podiatric treatment of children with juvenile idiopathic arthritis (JIA). This multicentre randomised controlled trial aimed to determine whether preformed foot orthoses (FOs) impacted on pain and quality of life (QoL) in children with JIA. Methods Eligible children were randomised to receive either ‘fitted’ FOs with customised chair-side corrections or ‘control’ FOs made without corrections. Changes in pain and QoL were measured using a visual analogue scale and Paediatric Quality of Life questionnaire, respectively. JIA children were assessed at baseline, 3 months and 6 months. Results 60 children were recruited. 179 out of a possible 180 assessments (99.4%) were completed. A statistically significant greater difference in pain reduction (baseline—6 months) was seen between the two groups favouring fitted FOs (p=0.029). The reduction in pain in the fitted FOs group was clinically important (8 mm). Significant differences in QoL favouring fitted FOs were also identified as measured by the children and independently by their parents/carers. Conclusions Fitted FOs may reduce pain and improve QoL in selected children with JIA. Trial registration number NCT02001844.