Researchers investigate innovative gait rehabilitation for people with rheumatoid arthritis

Posted on 13 July 2017

Keele University is part of a research team awarded a £1.8m grant to examine the effectiveness of a new way of improving and maintaining walking ability in people who suffer from the painful and disabling symptoms of early rheumatoid arthritis.

Rheumatoid arthritis is a chronic autoimmune disease that attacks multiple joints throughout the body. More than 90% of people with rheumatoid arthritis develop symptoms in the foot and ankle, with resulting difficulties in walking.

Keele University’s NIHR Professor Nadine Foster and Dr Sam Hider are part of the team working on the initial development of the gait rehabilitation that will be used in the clinical trial. Working with the Research Institute for Primary Care and Health Sciences, Keele Clinical Trials Unit and the Haywood hospital in Staffordshire, the Keele team are part of the full clinical trial to test the effectiveness of gait rehabilitation in early rheumatoid arthritis patients.
Consultant Rheumatologist, Dr Sam Hider explained:

“This investigation will test whether gait rehabilitation using a walking circuit combined with behavioural approaches, will help to improve the physical function of people with early rheumatoid arthritis.”

During the first two years of diagnosis, patients with rheumatoid arthritis usually receive medication to control inflammation and may be referred for physiotherapy and/or podiatry for foot stretching and strengthening exercises and insoles. While some patients improve, many continue to suffer from foot pain, walking difficulties and problems performing daily activities.

Dr Hider continued:
“Treatments for rheumatoid arthritis that focus on the foot are quite limited, so this new trial will help to develop this under-researched area. Although lots of drug treatments are available, we hope to use an exercise-based intervention alongside existing therapies to improve mobility in patients.”

Dr Hider and Professor Foster will work alongside partners at Glasgow Caledonian University - Professor Martijn Steultjens and Dr Gordon Hendry, researchers in musculoskeletal health, will lead the investigation - along with King’s College London, Salford University, and the University of Glasgow.

The research team will use new gait rehabilitation techniques to help people walk with improved posture, balance and stability. Gait rehabilitation has been proven to help people suffering from the effects on mobility of neurological conditions such as stroke, multiple sclerosis, and Parkinson’s disease.

This new five-year study, funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, will establish whether the gait rehabilitation results in any additional benefits compared to usual treatment alone in a randomised trial.

The GREAT study (Gait Rehabilitation in Early Arthritis Trial) will take the form of an initial feasibility study involving patients from NHS regions in England and Scotland to fine-tune the gait rehabilitation intervention package and to identify the best way to measure its effectiveness, followed by a large trial to investigate whether gait rehabilitation adds benefits to usual care and to establish whether or not gait rehabilitation should be offered to all people with early rheumatoid arthritis.

NIHR Professor Foster, Director of the Clinical Trials Unit at Keele University, commented: “We are very pleased to be part of this new trial, and developing new treatments for rheumatoid arthritis. We are looking forward to working with our colleagues and patients to further develop the rehabilitation intervention and to then establish whether it is effective in improving patients’ lives.”