ABSTRACT
Foot and ankle problems are common complications in rheumatoid arthritis disease. Gait pattern such as normal foot and ankle rocker is impaired in patients with rheumatoid arthritis. Rocker sole as an external shoe modification is commonly prescribed in this pathology. The aim of this study was to investigate the effect of rocker shoe on vertical ground reaction force parameters during walking in patients with rheumatoid arthritis. Sixteen female participants with rheumatoid arthritis were recruited in this study. All patients were prepared with a pair of high-top, heel-to-toe rocker shoe and were asked to wear the shoes for one month. Ground reaction force parameters including peak forces and peak force times were evaluated in the first session, and after seven days and thirty days follow up were carried on. First maximal vertical force was significantly increased with rocker shoe compared to barefoot after 7 days follow up. Walking with rocker shoe reduced the minimal vertical force after 7 days. The second maximal vertical force showed to be statistically lower with rocker shoe than barefoot after 7 and 30 days. Furthermore, stance time decreased with rocker shoe after one month. Results of this study revealed that vertical ground reaction force parameters changed in rheumatoid arthritis patients with heel-to-toe rocker shoe, both immediately and after one month follow up. This might suggest the effectiveness of rocker shoes in improving gait in rheumatoid arthritis patients
ABSTRACT
Posterior corneal elevation changes are keys to early diagnosis of corneal ectasia after keratorefractive surgery, so it is important to use an accurate method for measuring posterior corneal elevation. The purpose of this study is investigating posterior corneal elevation changes with Pentacam[HR] on patients underwent photorefractive keratectomy. In this clinical trial and prospective study, Pentacam was used to evaluate changes in posterior corneal elevation before and after photorefractive keratectomy in 32 eyes of 16 patients. Posterior corneal elevation defined by maximum elevation before and after surgery and posterior corneal displacement defined by maximum difference in posterior elevation before and after surgery in the central 4mm zone. SPSS for windows [version 17] was used for data analysis and Paired T test was used for statistical analysis. The mean age of patients was 25.17 +/- 7.11 years and the mean of equivalent sphere was - 3.75 +/- 1.14 diopters. After photorefractive keratectomy, mean posterior corneal displacement was - 0.84 +/- 3.53 micrometers and mean posterior corneal elevation before and after surgery was 5.38 +/- 4.12 and 4.31 +/- 5.05 micrometers respectively [p=0.108]. There was no statistically significant difference in posterior corneal elevation values between before and after photorefractive keratectomy and no case of corneal ectasia with Pentacam, that was contrary to results obtained with Orbscan in previous studies. Our study suggests that Pentacam can show more accurate values of posterior corneal elevation in comparison to Orbscan. More studies must be performed to verify our conclusion