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The foot as a barrier in patients with early rheumatoid arthritis - an interview study among Swedish women and men.
Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health.
School of Health Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.
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2017 (English)In: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: Foot impairments are related to reduced mobility and participation restrictions in daily activities in patients with established rheumatoid arthritis (RA). The new biological medications are effective and reduce disease activity, but not disability to the same extent. Foot impairments are assumed to be related to participation restrictions also in patients with early RA, diagnosed after the introduction of biological medications. The knowledge of foot impairments needs to be more explored after the introduction of biological disease-modifying drugs (bDMARDs). The aim of this study was to explore the patients' perspective of foot impairments related to early RA.

METHODS: The sample included 59 patients (20-63 years) who were interviewed about participation dilemmas in daily life using the Critical Incident Technique. The interviews were audio-recorded and transcribed. Data related to foot impairments were extracted and analyzed thematically. A research partner validated the analysis. The study was approved by the Regional Ethics Committee.

RESULTS: Patients with early RA described a variety of participation restrictions related to foot impairments: 1) foot hindrances in domestic life, 2) foot impairments influencing work, 3) leisure activities restricted by one's feet 4) struggling to be mobile 5) foot impairments as an early sign of rheumatic disease.

CONCLUSION: There is a need to focus on foot impairments related to early RA, and for health care professionals to understand these signs. A suggestion for future research is to conduct a longitudinal follow-up of foot impairment related to medication, disease activity and disability in patients diagnosed after the introduction of bDMARDs. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017.
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Rheumatology and Autoimmunity
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URN: urn:nbn:se:liu:diva-144021DOI: 10.1002/acr.23486PubMedID: 29195001OAI: oai:DiVA.org:liu-144021DiVA: diva2:1170439
Available from: 2018-01-03 Created: 2018-01-03 Last updated: 2018-01-25

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Björk, MathildaThyberg, IngridValtersson, EvaSverker, Annette
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Division of Occupational TherapyFaculty of Medicine and Health SciencesDepartment of RheumatologyDivision of Neuro and Inflammation ScienceDepartment of Medical and Health SciencesDepartment of Activity and HealthSocial WorkFaculty of Arts and SciencesDivision of Community Medicine
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Arthritis care & research
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