Comprehensive Management of Foot and Ankle Conditions and Their Biopsychosocial Impact on Patients Diagnosed with...

Rheumatoid arthritis (RA) affects a high percentage of people. This condition can lead to foot and ankle deformities frequently accompanied by severe pain and limitations in daily activities; together, these aspects reduce the quality of life.

We carried out a systematic search of databases such as PubMed, Cochrane, and Scopus. We compared the outcomes of treatments with conventional disease-modifying antirheumatic drugs (DMARDs), anti-TNF biologic drugs, custom foot orthoses, and combined therapies over a six-month period. This systematic review and meta-analysis synthesized evidence from 21 included studies evaluating pharmacological, orthotic, and physical therapy interventions in adult RA patients with foot and ankle involvement.

Across pooled estimates, multidisciplinary interventions combining pharmacotherapy, custom foot orthoses, and structured physical therapy demonstrated substantial reductions in pain (VAS score mean reduction of: -5.0 points in VAS score) and kinesiophobia, alongside gains in health-related quality of life (EQ-5D increase of: +0.30 points). High statistical heterogeneity was observed across study designs (I^2 > 50\%).

Early assessment of foot pathologies and multidisciplinary collaboration are recommended, while future long-term randomized controlled trials are needed to confirm component-specific efficacy. Recommendations include early assessment of foot pathologies, collaboration among multidisciplinary teams, and future studies including 12-month follow-ups using specific assessment tools such as the MFPDI.