Ottawa Panel Evidence-Based Clinical Practice Guidelines for Foot Care in the Management of Juvenile Idiopathic Arthritis

Lucie Brosseau; Karine Toupin-April; George Wells; Christine A Smith; Arlanna G Pugh; Jennifer N Stinson; Ciarán M Duffy; Wendy Gifford; David Moher; Catherine Sherrington; Sabrina Cavallo; Gino De Angelis; Laurianne Loew; Prinon Rahman; Rachel Marcotte; Jade Taki; Jacinthe Bisaillon; Judy King; Andrea Coda; Gordon J Hendry; Julie Gauvreau; Martin Hayles; Kay Hayles; Brian Feldman; Glen P Kenny; Jing Xian Li; Andrew M Briggs; Rose Martini; Debbie Ehrmann Feldman; Désirée B Maltais; Susan Tupper; Sarah Bigford; Marg Bisch

doi:10.1016/j.apmr.2015.11.011

Ottawa Panel Evidence-Based Clinical Practice Guidelines for Foot Care in the Management of Juvenile Idiopathic Arthritis

Arch Phys Med Rehabil. 2016 Jul;97(7):1163-1181.e14. doi: 10.1016/j.apmr.2015.11.011. Epub 2015 Dec 18.

Authors

Lucie Brosseau¹, Karine Toupin-April², George Wells³, Christine A Smith⁴, Arlanna G Pugh⁵, Jennifer N Stinson⁶, Ciarán M Duffy⁷, Wendy Gifford⁸, David Moher⁹, Catherine Sherrington¹⁰, Sabrina Cavallo¹¹, Gino De Angelis¹¹, Laurianne Loew¹¹, Prinon Rahman¹², Rachel Marcotte¹³, Jade Taki¹⁴, Jacinthe Bisaillon⁸, Judy King¹⁵, Andrea Coda¹⁶, Gordon J Hendry¹⁷, Julie Gauvreau¹⁸, Martin Hayles¹⁹, Kay Hayles¹⁹, Brian Feldman²⁰, Glen P Kenny¹³, Jing Xian Li¹³, Andrew M Briggs²¹, Rose Martini²², Debbie Ehrmann Feldman²³, Désirée B Maltais²⁴, Susan Tupper²⁵, Sarah Bigford²⁶, Marg Bisch²⁶

Affiliations

¹ Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: Lucie.Brosseau@uottawa.ca.
² Department of Pediatrics, Faculty of Medicine, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
³ Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Methods Center, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
⁴ Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁵ Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
⁶ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
⁸ Faculty of Health Sciences, School of Nursing Sciences, University of Ottawa, Ottawa, Ontario, Canada.
⁹ Clinical Epidemiology Program, Ottawa Methods Center, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
¹⁰ Musculoskeletal Division, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
¹¹ Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
¹² Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
¹³ Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada.
¹⁴ Interdisciplinary School of Health Sciences, Faculty of Health Sciences, Ottawa, Ontario, Canada.
¹⁵ Physiotherapy Program, University of Ottawa, Ottawa, Ontario, Canada.
¹⁶ Faculty of Health and Medicine - Health Precinct, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia.
¹⁷ School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Lanarkshire, United Kingdom.
¹⁸ Podiatry Clinic of Outaouais, Hospital Boulevard, Gatineau, Québec, Canada.
¹⁹ Hayles Foot and Ankle Clinic, Ottawa, Ontario, Canada.
²⁰ Department of Pediatrics and Medicine, University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children, Toronto, Ontario, Canada.
²¹ School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
²² Occupational Therapy Program, Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
²³ School of Public Health, Option Epidemiology, University of Montreal, Montreal, Quebec, Canada.
²⁴ Physiotherapy Program, Department of Rehabilitation, Pavillon Ferdinand-Vandry, Université Laval, Québec, Quebec, Canada.
²⁵ School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
²⁶ Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

PMID: 26707409
DOI: 10.1016/j.apmr.2015.11.011

Abstract

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.

Keywords: Arthritis, juvenile; Orthotic devices; Pediatrics; Physical therapy modalities; Podiatry; Rehabilitation; Rheumatology.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Arthritis, Juvenile / rehabilitation*
Delphi Technique
Evidence-Based Practice
Foot Orthoses*
Humans
Pain Management / methods*
Physical Therapy Modalities*
Randomized Controlled Trials as Topic
Shoes