VERSAILLES, FRANCE — Custom-made foot orthoses produced immediate and significant benefits for juvenile idiopathic arthritis patients, according to the results of a study conducted in Stockholm.
Youngsters with cavovarus foot position showed the most pronounced improvements when they began wearing the device, investigator Marie André reported in a poster at the 12th European Pediatric Rheumatology Congress.
Children with oligoarthritis and polyarthritis had better results than those with enthesitis-related arthritis, according to Ms. André of Astrid Lindgren Children's Hospital at Karolinska University Hospital, and her colleagues.
“We know children need to be physically active,” she said in an interview at the meeting. “If you give them orthoses, there may be pain relief and … improvements in balance, and then maybe they can be more physically active.”
The youngsters, aged 8–17 years, performed five standardized capacity tests with and without orthoses: standing, jumping, running, climbing stairs, and walking 200 meters at their own pace. The researchers recorded walking and running times, and assessed balance capacity. With each test, the children rated their pain on a visual analog scale.
The most pronounced improvements were in balance and in pain scores while running. For each measure, 34 children had better results with their orthoses while 5 saw no change, and 9 fared worse.
Many children did significantly better on the timed walking test (31 improved, 3 unchanged, 14 worse). Pain scores were significantly improved when the children were standing (26 better, 14 unchanged, 8 worse), and climbing stairs (27 better, 10 unchanged, 11 worse).
The differences in pain while jumping and walking were not significant, however. Likewise, while 19 children had better running times with orthoses, 16 saw no change, and 13 performed worse.
“In this study we looked at improvement in immediate effects, but orthoses are a long-term treatment, and we are planning a long-term study, too,” she said.