Article

OBJECTIVE: To create evidence-based guidelines evaluating foot care interventions
for the management of juvenile idiopathic arthritis (JIA).
DATA SOURCES: An
electronic literature search of the following databases from database inception
to May 2015 was conducted: MEDLINE (Ovid), EMBASE (Ovid), Cochrane CENTRAL, and
clinicaltrials.gov. STUDY SELECTION: The Ottawa Panel selection criteria targeted
studies that assessed foot care or foot orthotic interventions for the management
of JIA in those aged 0 to </=18 years. The Physiotherapy Evidence Database scale
was used to evaluate study quality, of which only high-quality studies were
included (score, >/=5). A total of 362 records were screened, resulting in 3
full-text articles and 1 additional citation containing supplementary information
included for the analysis. DATA EXTRACTION: Two reviewers independently extracted
study data (intervention, comparator, outcome, time period, study design) from
the included studies by using standardized data extraction forms. Directed by
Cochrane Collaboration methodology, the statistical analysis produced figures and
graphs representing the strength of intervention outcomes and their corresponding
grades (A, B, C+, C, C-, D+, D, D-). Clinical significance was achieved when an
improvement of >/=30% between the intervention and control groups was present,
whereas P>.05 indicated statistical significance. An expert panel Delphi
consensus (>/=80%) was required for the endorsement of recommendations. DATA
SYNTHESIS: All included studies were of high quality and analyzed the effects of
multidisciplinary foot care, customized foot orthotics, and shoe inserts for the
management of JIA. Custom-made foot orthotics and prefabricated shoe inserts
displayed the greatest improvement in pain intensity, activity limitation, foot
pain, and disability reduction (grades A, C+). CONCLUSIONS: The use of customized
foot orthotics and prefabricated shoe inserts seems to be a good choice for
managing foot pain and function in JIA.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS