Juvenile Idiopathic Arthritis (JIA) refers to a heterogeneous group of inflammatory arthritis occurring in children which leads to increased production of synovial fluid and effusion into affected joints. This causes decreased muscle strength and compromises bone health.
A major symptom of the disease is joint pain followed by disability, gait abnormalities, foot deformities and fatigue. Subclinical inflammation is also frequently observed in the foot and ankle of patients with this condition.
In order to obtain a more detailed understanding of the kinematic changes that take place in juvenile idiopathic arthritis, Merker et al. studied the kinematic and kinetic data of eleven patients with at least one affected ankle joint and fixed pes planovalgus.
The authors observed that the hindfoot/tibia motion in these individuals shifted towards excessive eversion and the forefoot/hindfoot motion shifted towards supination in static and walking condition.
This information could prove valuable in the formulation of an exercise regimen and in the designing of custom orthotic insoles to help prevent joint destruction and achieve successful rehabilitative outcomes.
The efficacy of an exercise programme with jumps was explored in detail by Sandstedt et al. to assess its impact on muscle strength, physical fitness and well-being of 54 children and adolescents with juvenile idiopathic arthritis.
The 12-week fitness programme was designed to include rope skipping and muscle strength training exercises and was required to be performed at home at least three times a week.
An increase in muscle strength in hip and knee extensors was observed at the end of the programme and was maintained in knee extensors at follow-up. There was no increase in pain during the study and the programme was found to be well tolerated by patients.
MASS4D® customised foot orthotics can serve as an adjunct to such a programme particularly as a pain-management device to provide relief to the patient from pain in the lower limbs, improve ambulation and restore optimal foot functionality.
By improving gait patterns and reducing abnormal movements of the foot, patients with juvenile idiopathic arthritis have a better defence from developing foot deformities which can significantly inhibit their walking capabilities.
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Repetitive plantarflexion can lead to pain and mechanical limitation in the posterior ankle joint which is known as posterior ankle impingement syndrome. This pathology commonly occurs in ballet dancers and football players.