الفهرس 
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Abstract
Healthcare professionals are attentive to problems of hand functioning but tend to overlook or pay little attention to problems involving the feet in spite of the high prevalence of feet involvement in (RA) is recorded, as 9 out of 10 patients reporting foot pain during the course of the disease
Foot orthoses play a crucial role in the rehabilitation management of patients with RA. They are used to decrease pain and inflammation, improve function, and correct biomechanical malalignment.
Our study aimed to compare the effect of total contact custom-made versus over-the-counter insoles on pain and foot functionality.
This study included RA 30 patients, were divided randomly into two groups:15 patients applied 15 pairs of custom-made soft total contact insoles (TCI) made by orthotist according to the planter pressure assessment and foot template design, 15 patients were using 15 pairs of a flat (OTC) insole made of silicone.
All patients underwent history taking and relevant clinical and laboratory testing.
All patients underwent static and dynamic planter pressure assessment of both feet.
Pain assessment by (VAS) and (LEFS) scoring for foot function before and after using insoles was done for all patients.
A statistically significant difference was found in the VAS (P value <0.001) after using insoles, there was a significant improvement in foot pain in both groups. However, it is observed that CM foot orthoses produced significantly greater improvement of VAS than OTC insoles.
In (OTC) group, Increased number of patients with mild pain from (13.3%) to (53.3%) after intervention with a significant P-value< 0.01, and a decrease in number of patients with moderate pain (from (73.3%) to (46.7%) and patients with severe pain (from (13.3%) to (0.00%) was observed after intervention.
While in the (CM) group, Increased number of patients with mild pain from (13.3%) to (100%) after intervention, a decrease in number of patients with moderate pain (from (80%) to (0.00%) with P-value< 0.01 and patients with severe pain (from (6.7%) to (0.00%) in after intervention.
Also, found statistically significant improvement in (LEFS) score (P value<0.00) “improved lower limb functionality” in both groups after using the insoles, slightly higher in (CM) group more than (OTC) group.
No significant difference was found in foot functionality between the two groups post intervention.
Although price for TCI might not be suitable for some patients, yet the long-term use of TCI can be beneficial (Georgoudis & Aggourakis, 2015).