Plantar pressures and first MPJ pain

NewsBot · Jan 2, 2016

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Are Pressure Time Integral and Cumulative Plantar Stress Related to 1st Metatarsophalangeal Joint Pain: The Multicenter Osteoarthritis Study
Smita Rao et al
Arthritis Care & Research; Accepted Article

Objective. To examine the relationship between plantar stress over a step, cumulative plantar stress over a day and 1st metatarsophalangeal (MTP) joint pain among older adults.

Methods. Plantar stress and 1st MTP pain were assessed within the Multicenter Osteoarthritis Study (MOST). All included participants were asked if they had pain, aching or stiffness at the 1st MTP joint on most days for the past 30 days. Pressure time integral (PTI) was quantified as participants walked on a pedobarograph, and mean steps per day were obtained using an accelerometer. Cumulative plantar stress was calculated as the product of regional PTI and mean steps per day. Quintiles of hallucal and 2nd metatarsal PTI and cumulative plantar stress were generated. The relationship between predictors and the odds ratio of 1st MTP pain was assessed using a logistic regression model.

Results. Feet in the quintile with the lowest hallux PTI had 2.14 times increased odds of 1st MTP pain (95% confidence interval [95% CI]:1.42-3.25, p<0.01). Feet in the quintile with the lowest 2nd metatarsal PTI had 1.50 times increased odds of 1st MTP pain (95% CI:1.01-2.23, p=0.042). Cumulative plantar stress was unassociated with 1st MTP pain.

Conclusion. Lower PTI was modestly associated with increased prevalence of frequent 1st MTP pain at both the hallux and 2nd metatarsal. Lower plantar loading may indicate the presence of an antalgic gait strategy and may reflect an attempt at pain avoidance. The lack of association with cumulative plantar stress may suggest that they do not limit their walking as a pain-avoidance mechanism
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NewsBot · Nov 8, 2017

Centre of Pressure Characteristics during Walking in Individuals with and without First Metatarsophalangeal Joint Osteoarthritis
Hylton Menz et al
ARHP Concurrent Abstract Session November 7, 2017

Background/Purpose: Osteoarthritis of the first metatarsophalangeal joint (1st MTPJ OA) is a common and disabling condition characterised by symptoms of joint pain and stiffness, formation of a dorsal exostosis, and progressive reduction in range of motion of 1st MTPJ dorsiflexion. Because the 1st MTPJ plays an important role in transferring the body’s centre of mass over the foot during the propulsive phase of gait, individuals with 1st MTPJ OA frequently adopt an apropulsive walking pattern. The objective of this study was to compare centre of pressure characteristics during walking in individuals with and without 1st MTPJ OA, in order to provide insights into alterations in foot function associated with this condition.

Methods: Twenty people with 1st MTPJ OA and 20 asymptomatic controls matched for age, sex and body mass index underwent gait analysis using the emed®-x400 plantar pressure system (Novel GmbH, Germany). Average and maximum centre of pressure velocity and lateral-medial force index during loading, midstance, terminal stance and preswing were compared between the groups, adjusting for contact time.

Results: During the preswing phase of gait, maximum centre of pressure velocity was significantly slower in individuals with 1st MTPJ OA (0.78 ± 0.19 vs 1.13 ± 0.36 m/sec; p=0.003), and both average and maximum lateral-medial force indices were significantly higher in individuals with 1st MTPJ OA (0.98 ± 0.14 vs 0.82 ± 0.13; p<0.001 and 1.37 ± 0.29 vs 1.15 ± 0.15; p=0.008, respectively). See Figures 1 and 2. Non-weightbearing 1st MTPJ dorsiflexion range of motion was significantly associated with maximum centre of pressure velocity (r=0.54, p<0.001) and average lateral-medial force index (r=-0.44, p=0.004) during preswing.

Conclusion: These findings suggest that individuals with 1st MTPJ OA may generate less forward momentum when walking due to a lateral transfer of force during propulsion, possibly due to decreased range of 1st MTPJ dorsiflexion.
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NewsBot · Apr 27, 2018

Centre of pressure characteristics during walking in individuals with and without first metatarsophalangeal joint osteoarthritis
Hylton B. Menz et al
Gait and Posture; Article in Press

Highlights
•CoP characteristics were compared between individuals with and without 1st MTPJ OA.
•Individuals with 1 st MTPJ OA demonstrate slower CoP velocity during propulsion.
•Individuals with 1 st MTPJ OA demonstrate higher lateral force generation.
•Decreased 1st MTPJ range of motion was associated with these CoP characteristics
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Objective
: The objective of this study was to compare centre of pressure characteristics during walking in individuals with and without first metatarsophalangeal joint osteoarthritis (1st MTPJ OA), in order to provide insights into alterations in foot function associated with this condition.

Methods
Twenty people with 1st MTPJ OA and 20 asymptomatic controls matched for age, sex and body mass index underwent gait analysis using the emed®-x400 plantar pressure system (Novel GmbH, Germany). Average and maximum centre of pressure velocity and lateral-medial force index during loading, midstance, terminal stance and preswing were compared between the groups.

Results
During the preswing phase of gait, maximum centre of pressure velocity was significantly slower in individuals with 1st MTPJ OA (0.78 ± 0.19 vs 1.13 ± 0.36 m/sec; p = 0.003), and both average and maximum lateral-medial force indices were significantly higher in individuals with 1st MTPJ OA (0.98 ± 0.14 vs 0.82 ± 0.13; p < 0.001 and 1.37 ± 0.29 vs 1.15 ± 0.15; p = 0.008, respectively). Non-weightbearing 1st MTPJ dorsiflexion range of motion was significantly associated with maximum centre of pressure velocity (r = 0.54, p < 0.001) and average lateral-medial force index (r = −0.44, p = 0.004) during preswing.

Conclusions
Individuals with 1st MTPJ OA exhibit significant differences in centre of pressure characteristics during propulsion, possibly due to decreased range of available 1st MTPJ dorsiflexion.
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