Researchers investigate effectiveness of prefab orthotics

17 June 2015

Researchers investigate effectiveness of prefab orthotics

Researchers have been awarded £200,000 by the Dr William M. Scholl Podiatric Research and Development Fund to investigate the effectiveness of prefabricated foot orthotics to treat problems associated with rheumatoid arthritis.

The study, which is being carried out by the University of East London’s Dr Kellie Gibson in collaboration with researchers from Glasgow Caledonian University (GCU), aims to address a lack of knowledge on prefabricated orthotics and provide the NHS with robust evidence on clinical outcomes, patient satisfaction and cost effectiveness.

Rheumatoid Arthritis (RA) affects an estimated 645,000 people in the UK, most of whom will develop foot and ankle problems over the course of their disease.

Standard treatment for this is through the use of foot orthotics which may help to redistribute load from weight bearing sites and maintain arch shape.

Foot orthotics are manufactured via two different approaches: the more traditional approach of customising the orthotics according to the patient’s specifications; and prefabricated versions which are cheaper to make and easier to mass produce.

Previous research suggests that customised versions result in an approximately 25% reduction in foot pain and disability compared with no treatment. However, there is conflicting evidence as to whether or not prefabricated versions provide the same benefits.  

The randomised controlled study of prefabricated versus customised foot orthoses for people with rheumatoid arthritis will evaluate the clinical and cost effectiveness of prefabricated foot orthoses, as compared to customised versions by evaluating foot pain and disability outcomes using questionnaires. 

The research will also allow deeper exploration of patient opinions, perceptions, and experiences of orthotic therapy through a series of interviews and satisfaction questionnaires.

Dr Gibson said: “This research should provide clinically-relevant evidence, enhancing the knowledge base and treatment pathways for the use of foot orthotics within the NHS. This research is based on early rheumatoid arthritis patients as they a have a high prevalence of foot disease and pain.”

The GCU team comprises Professor Jim Woodburn, Professor Martijn Steultjens and Dr Gordon Hendry.

Dr Hendry said: “The FOCOS-RA trial will provide definitive evidence of the comparative effectiveness of customised versus prefabricated foot orthoses for people who have foot pain related to their rheumatoid arthritis. The evaluation of cost-effectiveness of these interventions will address a significant gap in current knowledge which will help to inform clinical practice in future.”


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