Skip to main content

Advertisement

Log in

Foot health in patients with rheumatoid arthritis—a scoping review

  • Review on Pathology
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Rheumatoid arthritis affects joints and can cause significant impairments in daily life. The foot is often the first site of symptoms and foot problems are strongly related to RA. The aim of this review was, therefore, to describe foot health in patients with rheumatoid arthritis and to identify how patients perform foot self-care. With this knowledge interventions to support foot health and functional ability in RA patients can be developed. The design of the review was a scoping review. A systematic literature search of three electronic databases, MEDLINE, CINAHL and Embase, was conducted in June 2016. The search yielded 1205 studies, of which 32 were selected for the review. The data were analysed by means of content analysis. Foot problems in RA patients are prevalent and impair their daily activities. Foot pain and foot structural deformities were the most prevalent problems. RA patients have difficulties caring their own feet and in finding proper footwear. Many different instruments were used to measure different aspects of foot health. Patients with RA have a high prevalence of foot and ankle problems. These foot problems are a major burden to patients themselves. RA patients’ ability to self-care ability can be diminished, since RA also affects joints in the hands. In future cross-cultural validation studies are needed to ensure psychometrically sound instrumentation. Methods to alleviate foot pain and to prevent foot problems in RA patients need to be developed and tested.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

*Article included in the review

  1. van Gestel AM, Prevoo ML, van’t Hof MA, van Rijswijk MH, van de Putte LB, van Riel PL (1996) Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis. Comparison with the preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism Criteria. Arthritis Rheum 39:34–40

    Article  PubMed  Google Scholar 

  2. Hawker G (1997) Update on the epidemiology of the rheumatic diseases. Curr Opin Rheumatol 9:90–94

    Article  CAS  PubMed  Google Scholar 

  3. Young A, Dixey J, Cox N, Davies P, Devlin J, Emery P, Gallivan S, Gough A, James D, Prouse P, Williams P, Winfield J (2000) How does functional disability in early rheumatoid arthritis (RA) affect patients and their lives? Results of 5 years of follow-up in 732 patients from the early RA Study (ERAS). Rheumatology 39:603–611

    Article  CAS  PubMed  Google Scholar 

  4. van der Leeden M, Steultjens MP, Ursum J, Dahmen R, Roorda LD, Schaardenburg DV, Dekker J (2008) Prevalence and course of forefoot impairments and walking disability in the first eight years of rheumatoid arthritis. Arthritis Rheum 59:1596–1602

    Article  PubMed  Google Scholar 

  5. van der Leeden M, Steultjens M, Dekker JH, Prins AP, Dekker J (2006) Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics. Rheumatology 45:465–469*

  6. Laroche D, Ornetti P, Thomas E, Ballay Y, Maillefert JF, Pozzo T (2007) Kinematic adaptation of locomotor pattern in rheumatoid arthritis patients with forefoot impairment. Exp Brain Res 176:85–97

    Article  PubMed  Google Scholar 

  7. Semple R, Turner DE, Helliwell PS, Woodburn J (2007) Regionalised centre of pressure analysis in patients with rheumatoid arthritis. Clin Biomech (Bristol, Avon) 22:127–129

    Article  Google Scholar 

  8. Grondal L, Tengstrand B, Nordmark B, Wretenberg P, Stark A (2008) The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1000 RA patients. Acta Orthop 79:257–261*

  9. Helfand AE (2006) Public health and podiatric medicine: Principles and practice, 2nd edn. American Public Health Association, Washington, DC

    Google Scholar 

  10. Michelson J, Easley M, Wigley FM, Hellmann D (1994) Foot and ankle problems in rheumatoid arthritis. Foot Ankle Int 15:608–613*

  11. Rao S, Riskowski J, Hannan MT (2012) Musculoskeletal conditions of the foot and ankle: assessments and treatment options. Best Pract Res Clin Rheumatol 26:345–368

    Article  PubMed  PubMed Central  Google Scholar 

  12. Balint GP, Korda J, Hangody L, Balint P (2003) Foot and ankle disorders. Best Pract Res Clin Rheumatol 17:87–111

    Article  PubMed  Google Scholar 

  13. Otter SJ, Lucas K, Springett K, Moore A, Davies K, Cheek L, Young A, Walker-Bone K (2010) Foot pain in rheumatoid arthritis prevalence, risk factors and management: an epidemiological study. Clin Rheumatol 29:255–271

    Article  PubMed  Google Scholar 

  14. Borman P, Ayhan F, Tuncay F, Sahin M (2012) Foot problems in a group of patients with rheumatoid arthritis: an unmet need for foot care. Open Rheumatol J 6: 290–295. doi:10.2174/1874312901206010290 (Epub 2012 Oct 4)*

  15. Marques WV, Cruz VA, Rego J, Silva NA (2016) The impact of comorbidities on the physical function in patients with rheumatoid arthritis. Rev Bras Reumatol 56:14–21

    Article  Google Scholar 

  16. Wickman AM, Pinzur MS, Kadanoff R, Juknelis D (2004) Health-related quality of life for patients with rheumatoid arthritis foot involvement. Foot Ankle Int 25:19–26

    Article  PubMed  Google Scholar 

  17. Wan SW, He HG, Mak A, Lahiri M, Luo N, Cheung PP, Wang W (2016) Health-related quality of life and its predictors among patients with rheumatoid arthritis. Appl Nurs Res 30: 176–183. doi:10.1016/j.apnr.2015.07.004 (Epub 2015 Aug 3)

    Article  PubMed  Google Scholar 

  18. <bib id="bib18">Forestier R, Andre-Vert J, Guillez P, Coudeyre E, Lefevre-Colau MM, Combe B, Mayoux-Benhamou MA (2009) Non-drug treatment (excluding surgery) in rheumatoid arthritis: clinical practice guidelines. Joint Bone Spine 76:691–698

    Article  PubMed  Google Scholar 

  19. Farrow SJ, Kingsley GH, Scott DL (2005) Interventions for foot disease in rheumatoid arthritis: a systematic review. Arthritis Rheum 53:593–602

    Article  CAS  PubMed  Google Scholar 

  20. Grant MJ, Booth A (2009) A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J 26:91–108

    Article  PubMed  Google Scholar 

  21. Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG (2010) CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 340:c869. doi:10.1136/bmj.c869

    Article  PubMed  PubMed Central  Google Scholar 

  22. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2008) The strengthening the reporting of observational studies in epidemiology (STROBE)statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349

    Article  Google Scholar 

  23. Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19:349–357

    Article  PubMed  Google Scholar 

  24. González-Fernández ML, Valor L, Morales-Lozano R, Hernández-Flórez D, López-Longo FJ, Martínez D, González CM, Monteagudo I, Martínez-Barrio J, Garrido J, Naredo E (2016) To what extent is foot pain related to biomechanical changes and ultrasound-detected abnormalities in rheumatoid arthritis? Clin Exp Rheumatol 34:480–488*

  25. Kerry RM, Holt GM, Stockley I (1994) The foot in chronic rheumatoid arthritis: a continuing problem. Foot (Edinb) 4:201–203*

  26. Bagherzadeh Cham M, Ghasemi MS, Forogh B, Sanjari MA, Zabihi Yeganeh M, Eshraghi A (2014) Effect of rocker shoes on pain, disability and activity limitation in patients with rheumatoid arthritis. Prosthet Orthot Int 38:310–315*

  27. O’Connell PG, Lohmann Siegel K, Kepple TM, Stanhope SJ, Gerber LH (1998) Forefoot deformity, pain, and mobility in rheumatoid and nonarthritic subjects. J Rheumatol 25:1681–1686*

  28. Dahmen R, Buijsmann S, Siemonsma PC, Boers M, Lankhorst GJ, Roorda LD (2014) Use and effects of custom-made therapeutic footwear on lower-extremity-related pain and activity limitations in patients with rheumatoid arthritis: a prospective observational study of a cohort. J Rehabil Med 46:561–567*

  29. Rome K, Gow PJ, Dalbeth N, Chapman JM (2009) Clinical audit of foot problems in patients with rheumatoid arthritis treated at Counties Manukau District Health Board, Auckland, New Zealand. J Foot Ankle Res 2:16. doi:10.1186/1757-1146-2-16*

  30. Rojas-Villarraga A, Bayone J, Zuluaga N, Mejia S, Hincapie ME, Anaya JM (2009) The impact of rheumatoid foot on disability in Colombian patients with rheumatoid arthritis. BMC Musculoskelet Disord 10:67. doi:10.1186/1471-2474-10-67*

  31. Waller R, Manuel P, Williamson L (2012) The Swindon Foot and Ankle Questionnaire: Is a Picture worth of thousand words? ISRN Rheumatol 2012:105479. doi:10.5402/2012/105479 (Epub 2012 Sep 26)*

  32. Brenton-Rule A, Dalbeth N, Menz HB, Bassett S, Rome K (2016) Foot and ankle characteristics associated with falls in adults with established rheumatoid arthritis: a cross-sectional study. BMC Musculoskelet Disord Jan 13(17):22. doi:10.1186/s12891-016-0888-z*

  33. Douglas KMJ, Ladoyanni E, Treharne GJ, Hale ED, Erb N, Kitas GD (2006) Cutaneous abnormalities in rheumatoid arthritis compared with non-inflammatory rheumatic conditions. Ann Rheum Dis 65:1341–1345*

  34. Siddle HJ, Firth J, Waxman R, Nelson EA, Helliwell PS (2012) A case series to describe the clinical characteristics of foot ulceration in patients with rheumatoid arthritis. Clin Rheumatol 31:541–545*

  35. Warenczak A, Lisinski P, Huber J (2014) Importance of the functional examination in lower extremities in patients with rheumatoid arthritis. Acta Bioeng Biomech 16:103–110*

  36. van der Leeden M, Steultjens M, Dekker JH, Prins AP, Dekker J (2007) The relationship of disease duration to foot function, pain and disability in rheumatoid arthritis patients with foot complaints. Clin Exp Rheumatol 25:275–280*

  37. Morpeth T, Brenton-Rule A, Carroll M, Frecklington M, Rome K (2016) Fear of falling and foot pain, impairment and disability in rheumatoid arthritis: a case-control study. Clin Rheumatol 35:887–991*

  38. Semple R, Newcombe LW, Finlayson GL, Hutchinson CR, Forlow JH, Woodburn J (2009) The FOOTSTEPS self-management foot care program: are rheumatoid arthritis patients physically able to participate? Musculoskeletal Care 7:57–65*

  39. Williams AE, Graham AS (2012) ‘My feet—visible, but ignored…’ A qualitative study of foot care for people with rheumatoid arthritis. Clin Rehabil 26:952–959*

  40. Hendry GJ, Gibson KA, Pile K, Taylor L, Toit VD, Burns J, Rome K (2013) “They just scraped off the calluses”: a mixed methods exploration of foot care access and provision for people with rheumatoid arthritis in south-western Sydney, Australia. J Foot Ankle Res 6:34. doi:10.1186/1757-1146-6-34*

  41. Williams AE, Nester CJ, Ravey MI (2007) Rheumatoid arthritis patients’ experiences of wearing therapeutic footwear—a qualitative investigation. BMC Musculoskelet Disord 8:104. doi:10.1186/1471-2474-8-104*

  42. Silvester RN, Williams AE, Dalbeth N, Rome K (2010) ‘Choosing shoes’: a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid patients. J Foot Ankle Res 3:24 doi:10.1186/1757-1146-3-24*

  43. Naidoo S, Anderson S, Mills J, Parsons S, Breeden S, Bevan E, Edwards C, Otter S (2011) “I could cry, the amount of shoes I can’t get into”: a qualitative exploration of the factors that influence retail footwear selection in women with rheumatoid arthritis. J Foot Ankle Res 4:21. doi:10.1186/1757-1146-4-21*

  44. Park C, Craxford AD (1981) Surgical footwear in rheumatoid arthritis—a patient acceptability study. Prosthet Orthot Int 5:33–36*

  45. Williams AE, Nester CJ, Ravey MI, Kottink A, Klapsing M-G (2010) Women’s experiences of wearing therapeutic footwear in three European countries. J Foot Ankle Res 3:23. doi:10.1186/1757-1146-3-23*

  46. Williams AE, Rome K, Nester CJ (2007) A clinical trial of specialist footwear for patients with rheumatoid arthritis. Rheumatology 46:302–307*

  47. Woodburn J, Helliwell P (1997) Foot problems in rheumatology. Br J Rheumatol 36:932–933

    Article  CAS  PubMed  Google Scholar 

  48. van der Heijde DM, van’t Hof MA, van Riel PL, Theunisse LA, Lubberts EW, van Leeuwen MA, van Rijswijk MH, van de Putte LB (1990) Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis 49:916–920

    Article  PubMed  PubMed Central  Google Scholar 

  49. van der Heijde DM, van’t Hof MA, van Riel PL, Theunisse LA, Lubberts EW, van Leeuwen MA, van Rijswijk MH, van de Putte LB (1992) Validity of single variables and composite indices for measuring disease activity in rheumatoid arthritis. Ann Rheum Dis 51:177–181

    Article  PubMed  PubMed Central  Google Scholar 

  50. Bakker MF, Jacobs JW, Kruize AA, van der Veen MJ, Van Booma-Frankfort C, Vreugdenhil SA, Bijlsma JW, Lafeber FP, Welsing PM (2012) Misclassification of disease activity when assessing individual patients with early rheumatoid arthritis using disease activity indices that do not include joints of feet. Ann Rheum Dis 71:830–835

    Article  PubMed  Google Scholar 

  51. Budiman-Mak E, Conrad KJ, Roach KE (1991) The foot function index: a measure of foot pain and disability. J Clin Epidemiol 44:561–570*

  52. Bennet PJ, Patterson C, Wearing S, Baglioni T (1998) Development and validation of a questionnaire designed to measure foot-health status. J Am Podiatr Med Assoc 88:419–428

    Article  Google Scholar 

  53. Graham A, Hammond A, Williams A (2011) Therapeutic foot health education for patients with rheumatoid arthritis: a narrative review. Musculoskeletal Care 9:141–151

    PubMed  Google Scholar 

  54. Goodacre LJ, Candy FJ (2011) ‘If I didn’t have RA I wouldn’t give them house room’: the relationship between RA, footwear and clothing choices. Rheumatology 50:513–517

    Article  PubMed  Google Scholar 

  55. Subirana M, Sola I, Garcia JM, Gich I, Urrutia G (2005) A nursing qualitative systematic review required MEDLINE and CINAHL for study identification. J Clin Epidemiol 58:20–25

    Article  PubMed  Google Scholar 

  56. Rathbone J, Carter M, Hoffmann T, Glasziou P (2016) A comparison of the performance of seven key bibliographic databases in identifying all relevant systematic reviews of interventions for hypertension. Syst Rev 5:27. doi:10.1186/s13643-016-0197-5

    Article  PubMed  PubMed Central  Google Scholar 

  57. Slobogean GP, Verma A, Giustini D, Slobogean BL, Mulpuri K (2009) MEDLINE, EMBASE, and Cochrane index most primary studies but not abstracts included in orthopedic meta-analyses. J Clin Epidemiol 62:1261–1267

    Article  PubMed  Google Scholar 

  58. Lohkamp M, Burrow G, McCarron T, Maclaren W, Granat M (2006) The prevalence of disabling foot pain in patients with early rheumatoid arthritis. Foot (Edinb) 16:201–207*

  59. Pourtier-Piotte C, Pereira B, Soubrier M, Thomas E, Gerbaud L, Coudevre E (2015) French validation of the foot function index (FFI). Ann Phys Rehabil Med 58:276–282*

  60. Fransen M, Edmonds J (1997) Off-the-shelf orthopedic footwear for people with rheumatoid arthritis. Arthritis Care Res 10:250–256*

  61. Brenton-Rule A, D’Almeida S, Bassett S, Carroll M, Dalbeth N, Rome K (2014) The effects of sandals on postural stability in patients with rheumatoid arthritis: an exploratory study. Clin Biomech 29:350–353*

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Minna Stolt.

Ethics declarations

Conflict of interest

Authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stolt, M., Suhonen, R. & Leino-Kilpi, H. Foot health in patients with rheumatoid arthritis—a scoping review. Rheumatol Int 37, 1413–1422 (2017). https://doi.org/10.1007/s00296-017-3699-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-017-3699-0

Keywords

Navigation