Custom-made foot orthotics reduce pain and increase walking speed, activity and functional ability levels in children with juvenile idiopathic arthritis (JIA) according to a study reported in the May 2005 Journal of Rheumatology.
Researchers at Children’s Hospital and Health Center, San Diego have determined that custom-made orthotics “should become a standard part of the overall medical treatment for children with foot and/or ankle arthritis.”
Dr. Mary Powell, of Children’s Hospital and Health Center, San Diego, and colleagues examined the clinical efficacy of custom-made semirigid foot orthotics with shock-absorbing posts in 40 children with JIA that affected the feet and ankles.
Children were randomized to wear custom-made orthotics, off-the-shelf flat neoprene shoe inserts, or supportive athletic shoes with medial longitudinal arch support and shock-absorbing soles, according to the report.
Compared with the other two groups, children in the orthotics group had significant improvements in overall pain, walking speed, activity limitations, foot pain and disability levels. Clinically meaningful improvements in child health-related quality of life were reported by both children and parents.
No significant effects on any of the measures were observed in either the off-the-shelf inserts or the supportive athletic shoe groups, except a reduction in pain in the latter.
“No objective changes were documented in the tender and swollen foot joint count from the baseline measures to the 3 month follow-up examination,” Dr. Powell’s team writes. “The children still had active arthritis and no discernible differences were noted between the groups even though clinical changes were noted.”
The researchers conclude that custom-made orthotics “should become a standard part of the overall medical treatment for children with foot and/or ankle arthritis.” It should also be covered by insurance, they add.
J Rheumatol 2005;32:943-950.