Purpose of Research
The research carried out by Shrader and Siegel (2003) was done to describe a patient with rheumatoid arthritis (RA) and functional hallux limitus (FHL) and discuss the management of these conditions with the help of footwear, foot orthoses, shoe modifications, and patient education.
Tests and Measurements
Tests and measurements in the scenario included evaluation of pain level and its impact on the patient’s quality of life, the assessment of posture and alignment, range of motion, muscle performance, and footwear. The measurements were done using palpations, visual observation, foot inspection, and foot radiographs.
Intervention
As interventions for the condition, the patient was provided with modified therapeutic footwear, ankle stirrup brace, and foot orthoses. Additionally, the patient was given an appropriate education. The reassessment and adjustment of the footwear and equipment took 4 visits; during the last one, plantar pressure was measured and the patient reported the absence of pain.
Patient Safety
Since the given condition affects the patient’s gait, it is important to check that they are equipped for moving around in different spaces without a risk of falling and suffering an injury. It may be necessary to advise the patient to avoid certain surfaces or rely on an assistant at certain times of the day.
Conditions for Stopping an Intervention
The interventions for this case included therapeutic footwear of different kinds. Such intervention should be stopped if during an assessment it turns out that the footwear causes pain or dislocates the joints in the patient’s foot making the condition worse.
Conditions for Contacting a Physical Therapist
FHL itself is a complex condition that is also quite rare; it requires a careful and well-informed approach from the start. Additionally, the footwear and its adjustments are expected to make the patient feel better; however, if they seem to aggravate the condition, this is a reason for contacting a physical therapist.
Reference
Shrader JA, Siegel KL. Nonoperative management of functional hallux limitus in a patient with rheumatoid arthritis. Phys Ther. 2003; 83(6): 831-843.