Abstract：
Children with juvenile idiopathic arthritis (JIA) can experience significant physical impairment of the lower extremity. Prolonged joint disease and symptoms may cause gait alterations such as reduced walking speed and increased plantar pressures in diseased areas of their feet. There is limited robust clinical trials investigating the effect of non-invasive mechanical therapies such as foot orthoses (FOs) on improving gait parameters in children with JIA.
Are customised preformed FOs effective in improving gait parameters in children with JIA?
A multicentre, parallel design, single-blinded randomised clinical trial was used to assess the gait impacts of customised preformed FOs on children with JIA. Children with a diagnosis of JIA, exhibiting lower limb symptoms and aged 5-18 were eligible. The trial group received a low-density full length, Slimflex Simple device which was customised chair side and the control group received a sham device. Peak pressure and pressure time integrals were used as the main gait outcomes and were measured using portable Tekscan gait analysis technology at baseline, 3 and 6 months. Differences at each follow-up were assessed using the Wilcoxon rank sum test.
66 participants were recruited. Customised preformed FOs were effective in altering plantar pressures in children with JIA versus a control device. Reductions of peak pressures and pressure time integrals in the heel, forefoot and 5th metatarsophalangeal joint were statistically significant in favour of the trial group. This was associated with statistically significant increased midfoot contact with the trial device at baseline, 3 and 6-month data collections. The trial intervention was safe and well accepted by participants, which is reflected in the high retention rate (92%).
Clinicians may prescribe customised preformed FOs in children with JIA to deflect pressure from painful joints and redistribute from high pressure areas such as the rearfoot and forefoot.
Are customised preformed FOs effective in improving gait parameters in children with JIA?
A multicentre, parallel design, single-blinded randomised clinical trial was used to assess the gait impacts of customised preformed FOs on children with JIA. Children with a diagnosis of JIA, exhibiting lower limb symptoms and aged 5-18 were eligible. The trial group received a low-density full length, Slimflex Simple device which was customised chair side and the control group received a sham device. Peak pressure and pressure time integrals were used as the main gait outcomes and were measured using portable Tekscan gait analysis technology at baseline, 3 and 6 months. Differences at each follow-up were assessed using the Wilcoxon rank sum test.
66 participants were recruited. Customised preformed FOs were effective in altering plantar pressures in children with JIA versus a control device. Reductions of peak pressures and pressure time integrals in the heel, forefoot and 5th metatarsophalangeal joint were statistically significant in favour of the trial group. This was associated with statistically significant increased midfoot contact with the trial device at baseline, 3 and 6-month data collections. The trial intervention was safe and well accepted by participants, which is reflected in the high retention rate (92%).
Clinicians may prescribe customised preformed FOs in children with JIA to deflect pressure from painful joints and redistribute from high pressure areas such as the rearfoot and forefoot.
摘要：
患有青少年特发性关节炎（JIA）的儿童可能会经历下肢的显着身体损伤。长时间的关节疾病和症状可能会导致步态改变，例如步行速度降低和脚部患病区域的足底压力增加。研究非侵入性机械疗法如足矫形器（FOs）对改善JIA儿童步态参数的影响的可靠临床试验有限。
定制的预制FOs在改善JIA儿童的步态参数方面是否有效？
多中心，并行设计,我们采用单盲随机临床试验评估定制预制FOs对JIA患儿的步态影响.诊断为JIA的儿童，表现出下肢症状和5-18岁是合格的。试验组接受了低密度全长，SlimflexSimple设备是定制的椅子侧，对照组接受了假设备。使用峰值压力和压力时间积分作为主要步态结果，并在基线时使用便携式Tekscan步态分析技术进行测量，3和6个月。使用Wilcoxon秩和检验评估每次随访的差异。
招募了66名参与者。与控制设备相比，定制的预制FOs可有效改变JIA儿童的足底压力。鞋跟峰值压力和压力时间积分的降低，前足和第5跖趾关节对试验组具有统计学意义.这与基线时与试验装置的中足接触显著增加相关，3和6个月的数据收集。试验干预是安全的，被参与者接受，这反映在高保留率(92%)。
临床医生可以在JIA儿童中开出定制的预制FOs，以转移疼痛关节的压力，并从后足和前足等高压区域重新分配。
定制的预制FOs在改善JIA儿童的步态参数方面是否有效？
多中心，并行设计,我们采用单盲随机临床试验评估定制预制FOs对JIA患儿的步态影响.诊断为JIA的儿童，表现出下肢症状和5-18岁是合格的。试验组接受了低密度全长，SlimflexSimple设备是定制的椅子侧，对照组接受了假设备。使用峰值压力和压力时间积分作为主要步态结果，并在基线时使用便携式Tekscan步态分析技术进行测量，3和6个月。使用Wilcoxon秩和检验评估每次随访的差异。
招募了66名参与者。与控制设备相比，定制的预制FOs可有效改变JIA儿童的足底压力。鞋跟峰值压力和压力时间积分的降低，前足和第5跖趾关节对试验组具有统计学意义.这与基线时与试验装置的中足接触显著增加相关，3和6个月的数据收集。试验干预是安全的，被参与者接受，这反映在高保留率(92%)。
临床医生可以在JIA儿童中开出定制的预制FOs，以转移疼痛关节的压力，并从后足和前足等高压区域重新分配。
