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Plantar Pressures in Rheumatoid Arthritis Using Prefabricated Metatarsal Padding

Lorraine Jackson, BSc(Hons) ^*, Jodi Binning, MSc  and Julia Potter, PhD 

^* Southampton City PCT, Podiatry Services, Central Health Clinic, Southampton, England. Ms. Jackson is now with the NHS Direct Hampshire & Isle of Wight, Hedge End, Southampton, England.
New Generation Project, Southampton General Hospital, Southampton, England.
Podiatry Research Group, University of Southampton, Highfield, Southampton, England.

Corresponding author: Lorraine Jackson, BSc(Hons), NHS Direct Hampshire & Isle of Wight, Strawberry Fields, Berrywood Business Village, Tollbar Way, Hedge End, Southampton, Hampshire SO30 2UN, England.

Abstract

We sought to determine whether one of two prefabricated insole designs could better manage high forefoot plantar pressures in patients with rheumatoid arthritis. Ten subjects with rheumatoid arthritis who experienced pain with shod weightbearing were studied by using a plantar pressure measurement system. Two insole designs and a shoe-only control condition were randomly tested in repeated trials. Dome- and bar-shaped metatarsal pads made of latex foam were incorporated into full-length insoles made of urethane. Significant reductions in mean peak plantar pressures over the central metatarsals were noted when using the insole and dome pad design (12% [33 kPa]) and the insole and bar pad design (21% [58 kPa]) compared with the shoe-only condition. A prefabricated insole design incorporating a bar metatarsal pad is recommended to manage high forefoot plantar pressures in patients with rheumatoid arthritis. (J Am Podiatr Med Assoc 94(3): 239-245, 2004)

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