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Forefoot damage, pain and pressure in RA

Discussion in 'General Issues and Discussion Forum' started by Hylton Menz, Nov 15, 2005.

  1. Hylton Menz

    Hylton Menz Guest


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    Advance access from Rheumatology:

    Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics

    M. van der Leeden, M. Steultjens, J. H. M. Dekker, A. P. A. Prins, and J. Dekker

    Objective. To assess (i) the relationship between forefoot joint damage and foot function (expressed as gait and pressure parameters), (ii) the relationship between foot function and pain, and (iii) the relationship between foot function and disability in patients with foot complaints secondary to rheumatoid arthritis (RA).

    Methods. Sixty-two patients with RA-related foot complaints were included. Measurements of joint damage, gait characteristics, plantar pressure, pain and disability were obtained. Data were analysed using descriptive and correlational techniques.

    Results. Joint damage on radiographs of the forefoot correlated significantly with forefoot pressure (r = 0.296, P = 0.020). Further investigation of the metatarsophalangeal joints (MTPs) showed joint damage to correlate significantly with peak pressure and pressure-time integral (PTI) of MTP1 and MTP4. A significant correlation between PTI under the forefoot and barefoot pain was found (r = 0.290, P = 0.022). Gait parameters (total contact time and the duration of heel loading) and disability, measured with the Foot Function Index, were significantly correlated (r = 0.315, P = 0.013 and r = 0.266, P = 0.037, respectively).

    Conclusion. Forefoot joint damage in the rheumatoid foot is related to increased pressure under the forefoot, especially pressure under the first and fourth MTP joints. High forefoot pressure is associated with pain during barefoot walking. A prolonged stance phase and delayed heel lift are related to disability in daily activities.​
     
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    Articles:
    1
    Rheumatoid arthritis gait impairment

    Kinematic adaptation of locomotor pattern in rheumatoid arthritis patients with forefoot impairment.
    Laroche D, Ornetti P, Thomas E, Ballay Y, Maillefert JF, Pozzo T.
    INSERM-ERM 207 Motricite & Plasticite, Universite de Bourgogne, BP 27877, 21078, Dijon Cedex, France, davy.laroche@u-bourgogne.fr.
    Exp Brain Res. 2006 Aug 17
     
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    NewsBot The Admin that posts the news.

    Articles:
    1
    Forefoot pathology in rheumatoid arthritis identified with ultrasound may not localise to areas of highest pressure: cohort observations at baseline and twelve months.
    Bowen CJ, Culliford D, Allen R, Beacroft J, Gay A, Hooper L, Burridge J, Edwards CJ, Arden NK.
    J Foot Ankle Res. 2011 Nov 23;4(1):25.
     
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