Table 2.
Recommendations
| Chiropody recommendations and GRADE (Annex 1) | |
| Chiropodies are recommended for the removal of hyperkeratotic (helomas and thylomas) and nail lesions | Very low |
| Chiropodies should be completed with orthopaedic treatments or orthopaedic footwear | Very low |
| Footwear recommendations and GRADE (Annex 2) | |
| Standardized therapeutic footwear benefits patients with RA by reducing pain and improving physical functionality, compared to store-bought footwear | High |
| Standardized therapeutic footwear provides benefits in foot functionality (reducing plantar pressure), foot pain, physical functionality, and quality of life | High |
| Foot orthoses recommendations and GRADE (Annex 3) | |
| Foot orthoses optimize the biomechanics and function of the foot, providing cushioning and unloading the structures of the foot | High |
| Foot orthoses reduce foot pain, improve physical function and quality of life | High |
| Custom foot orthoses reduce foot pain and functionality, balance, and quality of life | High |
| Surgical recommendations and GRADE (Annex 4) | |
| Total ankle arthroplasty is recommended for patients with RA | Very low |
| Arthrodesis of the 1st metatarsophalangeal joint and arthroplasty of the 2nd to 5th metatarsal heads are recommended | Very low |
| Scarf’s technique is positive in short-term correction of hallux abductus valgus | Very low |
| Self-care recommendations and GRADE (Annex 5) | |
| It is recommended to work with patients on the limiting factors for self-care with all the factors involved in the care of patients with RA | Very low |
| Ulcer management recommendations and GRADE (Annex 6) | |
| Care of skin ulcers, such as vascular ulcers with a high risk of infection, is recommended | Very low |
| Physical therapy recommendations and GRADE | |
| Moderate physical exercise with limited supervision is advisable as long as intensity, frequency and appropriate duration is respected | Expert opinion |
| Supervised in-office physical exercise has positive effects on quality of life, physical functioning, and pain | Expert opinion |
| Injections recommendations and GRADE (Annex 7) | |
| Corticosteroid injection with previous ultrasound information improves stiffness and physical function results compared to infiltration with clinical and radiographic data alone | Moderate evidence |
| Corticosteroid injection with clinical and radiographic data alone is capable of improving pain and, to a lesser extent, stiffness and physical function | Moderate evidence |
| In patients with ankle arthritis, an injection of triamcinolone hexacetonide corticosteroid is effective in reducing pain and inflammation | Low evidence |
| In patients with RA and tendinitis of the foot, an injection of corticosteroids together with a podiatric-orthotic program is effective in terms of pain, function and ultrasound (Doppler) | Moderate evidence |