Article

OBJECTIVES: To evaluate the effectiveness of multidisciplinary foot-care, and to
evaluate the methodological considerations of a trial of multidisciplinary care
in juvenile idiopathic arthritis. SUBJECTS : Children / adolescents with juvenile idio-pathic
arthritis and inflammatory joint disease affecting the foot/ankle. METHODS: Standard medical care was compared with a 12 month program of multidisciplinary
foot-care informed by musculoskeletal ultrasound.
This program was centred on
strict disease control through rigorous examination and interventions delivered
by a team comprised of a paediatric rheumatologist, podiatrist, physiotherapist
and musculoskeletal ultrasonographer. Patients were assessed on foot impairment
and disability scores using the Juvenile Arthritis Foot Disability Index.
RESULTS: Forty-four participants, aged 3-17 years were randomly assigned to
receive the experimental (n = 21) or usual care (n = 23) interventions. There was
an overall improvement in levels of foot related impairments in both groups over
12 months. Between-group differences in change scores for the Juvenile Arthritis
Foot Disability Index were not statistically significant at 6 or 12 month follow-ups. CONCLUSION: The integrated multidisciplinary foot care interventions
described in this trial were safe, but did not improve foot impairment levels
relative to usual care.
This trial identified several methodological challenges
including recruitment/retention, difficulties with outcome tools and potential confounders.

Langue : ANGLAIS