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Table 1 Guidelines and recommendations for foot related non-pharmacological interventions in early rheumatoid arthritis.

From: Looking through the 'window of opportunity': is there a new paradigm of podiatry care on the horizon in earlyrheumatoid arthritis?

  Scottish Intercollegiate Guidelines Network Management of early rheumatoid arthritis [69] Clinical practice guidelines for the use of non-pharmacological treatments in early rheumatoid arthritis [37] British Society for Rheumatology and British Health Professionals in Rheumatology Guideline for the management of rheumatoid arthritis (the first 2 years) [70] European League Against Rheumatism recommendations for the management of early arthritis [71] Multidisciplinary guidelines for the management of early rheumatoid arthritis [72]
Multidisciplinary team care Podiatry is part of the multidisciplinary team   Podiatry is part of the multidisciplinary team
Full-time dedicated podiatrist specialising in rheumatology is essential
  Podiatry is part of the multidisciplinary team
Access to foot health care 'Good practice' to offer all patients with early RA a podiatry referral   Access to podiatry should be available according to patient need
Podiatry services should provide specific and dedicated service for diagnosis, assessment and management of foot problems associated with RA
Timely intervention for acute problems is important
  Foot care can relieve pain, maintain function and improve quality of life
Foot Health Assessment/Review   Metatarsal pain and/or foot alignment abnormalities should be looked for regularly Annual foot review/assessment is recommended for patients at risk of developing serious complications in order to detect problems early
Appropriate lower limb assessment for vascular and neurological status is needed
Assessment of lower limb mechanics and foot pressures should occur
  Annual foot review is recommended for patients at risk of developing complications
Orthoses/Insoles/Splints Some evidence for the efficacy of foot orthoses for comfort, and stride speed and length Appropriate insoles should be prescribed if needed Orthoses are an important and effective intervention in RA Use of orthoses has shown short term relief of pain only, rather than an effect on disease activity. Joint protection included-orthoses not specifically mentioned
Therapeutic footwear Appropriate footwear for comfort, mobility, and stability is well recognised in clinical practice but little available evidence   There should be a provision of specialist footwear if needed