Functional Impairments Characterizing Mild, Moderate, and Severe Hallux Valgus

Abstract

Objective. Hallux valgus (HV) has been linked to functional disability and increased risk of falls, but mechanisms underpinning functional disability are unclear. This study investigated functional performance, muscle strength, and plantar pressures in adults with mild, moderate, and severe HV compared to controls, while considering the influence of foot pain. Methods. Sixty adults with HV (classified as mild, moderate, and severe on dorsalplantar radiographs) and 30 controls participated. Measures included hallux plantar flexion and abduction strength, walking performance, postural sway, and forefoot plantar pressures. Multivariate analysis of covariance and pairwise comparisons (P < 0.05 after Bonferroni adjustment) were used to investigate differences between groups, adjusting for age, sex, body mass index, and foot pain. Results. Hallux plantar flexion and abduction strength were significantly reduced in those with moderate (mean differences: plantar flexion ؊45.8 N, abduction ؊12.3 N; P < 0.001) and severe HV (plantar flexion ؊50.1 N; P < 0.001, abduction ؊11.2 N; P ‫؍‬ 0.01) compared to controls. A significant reduction in hallux peak pressure and pressure-time integral was evident in moderate (peak pressure ؊90.8 kPa; P < 0.001) and severe HV (peak pressure ؊106.2 kPa; P < 0.001) compared to controls. Those with severe HV also demonstrated increased mediolateral postural sway in single leg stance compared to controls (3.5 cm; P ‫؍‬ 0.01). Conclusion. Moderate to severe HV is associated with reduced hallux plantar pressures and strength measures, while relatively normal function compared to controls was found in those with mild deformity. Greater understanding of specific functional deficits associated with different stages of HV will help inform clinical management and future research.

Quality of Life Impact Related to Foot Health in a Sample of Older People with Hallux Valgus

“…The FPDI includes subscales for pain (score range 0 -10) and function (score range 0 -20), with higher scores indicating more pain or self-reported functional disability. We performed our study using the validated FHSQ, and the concurrent validity between these two approaches has not yet been determined [46].…”

Effects of Foot Deformities on Gait, Balance and Functional Mobility in Older Women

“…Likely, according to the study there is no difference between mild, moderate and severe hallux valgus groups in terms of gait performance. 18 According to our results, static and dynamic outcomes of balance tests weren't variable between the groups. Despite considerable differences in measurement techniques used in the literature, we found similar findings to previous studies about balance outcomes.…”

“…While the differences in anteroposterior sway did not reach statistical significance in the study, individuals with mild hallux valgus displayed greater mediolateral sway compared to the moderate hallux valgus group. 18 Also outcomes of functional mobility tests didn't differ in the groups. Comparative one study between the groups with and without deformity was conducted by Spink and colleagues (2011) are consistent with our results.…”

“…We divided the total deformity score into 3 groups for comparison: 1-8 points (mild deformity), 9-16 points (moderate deformity) and 17-24 points (severe deformity). [17][18][19][20] In the present study, we conducted practical demonstrations of all tests for the participants. Also at least one trial test is applied by participants before formal test.…”

“…[13][14][15] We contacted poor studies that investigated older women and effects of foot deformity regarding to severity. 15,17,18 Also, effects of foot deformities on gait, balance and functional mobility isn't clear according to literature. [13][14][15][16] Therefore, the aim of this study to investigate the effects of foot deformities (i.e., pes planus/cavus, hallux valgus, hallux limitus/rigidus, claw toe, hammer toe, overlapping toes, transverse arch drop, pes valgus/varus) regarding to severity on gait, balance and functional mobility in nursing home residing older women.…”