Gait changes in individuals with bilateral hallux valgus reduce first metatarsophalangeal loading but increase knee abductor moments

Shih, Kao-Shang; Chien, Hsiung–Fei; Lu, Tung‐Wu; Chang, Chi‐Fon; Kuo, Ching-Ming

doi:10.1016/j.gaitpost.2014.02.011

Cited by 29 publications

(30 citation statements)

References 29 publications

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“…The current study first revealed that a frontal plane knee alignment was independently associated with the hallux valgus angle, which is comparable to a subsample of knees with a K/L grade ≥2, and this relationship became stronger in varus-aligned knees. Although the current study cannot elucidate the mechanism to explain the relationship between knee alignment and hallux valgus angles, several studies showed that patients with hallux valgus have an altered foot pressure pattern during gait in patients with medial knee OA [49–52]. The AAA was correlated with the coronal location of the center of pressure, [51] and realignment of the knee following TKA results in a foot pressure pattern, particularly in the hallux [53].…”

Section: Discussionmentioning

confidence: 96%

Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis

Ohi

Iijima

Aoyama

et al. 2017

BMC Musculoskelet Disord

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BackgroundTo examine the association of radiographic frontal plane knee alignment with three-dimensional foot posture in patients with medial knee osteoarthritis (OA).MethodsParticipants in orthopedic clinics with Kellgren/Lawrence (K/L) grade ≥1 (88 patients and 88 knees; age, 61–91 years; 65.9% female) were enrolled. An anteroposterior radiographic view was used to assess the anatomical axis angle (AAA) after subtracting a sex-specific correction factor. The three-dimensional foot posture was also evaluated.ResultsMultiple regression analyses showed that increased corrected AAA (i.e., valgus direction) was independently associated with a decrease in the hallux valgus angle (regression coefficient: −0.40 per degree, 95% confidence interval [CI]: −0.72, −0.09; P = 0.013) and increase in the pronation angle of the calcaneus relative to floor (regression coefficient: 0.33 per degree, 95% CI: 0.10, 0.56; P = 0.005) adjusted for age, sex, and body mass index. The relationship between the corrected AAA and hallux valgus angle strengthened (regression coefficient: −0.60 per degree, 95% CI: −1.08, −0.13; P = 0.014) in varus-aligned knees examined separately (63 knees). The other foot postures (navicular height, navicular height/foot length, and rearfoot angle) were not significantly associated with corrected AAA.ConclusionsRadiographic frontal plane knee alignment was associated with hallux valgus angle and calcaneus angle relative to the floor in patients with medial knee OA, particularly in varus-aligned knees. These results indicate a connection between altered frontal knee alignment and foot posture, which may be helpful in understanding the pathogenesis of altered foot posture observed in patients with knee OA.

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Section: Discussionmentioning

confidence: 96%

Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis

Ohi

Iijima

Aoyama

et al. 2017

BMC Musculoskelet Disord

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“…Hallux valgus (HV) alters the alignment of the first metatarsophalangeal joint 4,23 and affects a large number of older adults. 26 While HV does not change the general gait pattern, 6,10,22,30 it causes pain and an imbalance of muscle forces at the forefoot, 1 has been linked to falls 25 in the older population, and changes the plantar pressure on the foot. Surgical intervention reduces pain caused by the deformity.…”

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confidence: 99%

Pilot Study of a 3-Dimensional Method for Analysis of Pronation of the First Metatarsal of Hallux Valgus Patients

Campbell

Miller

Williams³

et al. 2018

Foot Ankle Int.

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“…A lower MLE indicates higher walking stability; in other words, a repetitive pattern of the ankle joints is observed during walking. When wearing high heels, the length of the ankle's periosteum is reduced, whereas the size and stiffness of the Achilles tendon are increased [ 34 ]. This reduces the range of movement of the ankle during high-heeled walking [ 17 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Quantifying the Dynamic Stability of Gait Patterns in People with Hallux Valgus

Park

Kang

Jeon

et al. 2021

Applied Bionics and Biomechanics

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Hallux valgus (HV), which is mainly caused by the wearing of narrow-width and high-heeled shoes, disrupts gait behavior because it deforms lower limb joints. There is limited information regarding the relationship between the foot disease HV and lower limb joints. Previous studies evaluating abnormal gait patterns caused by deformity used spatiotemporal parameters; however, they failed to characterize the overall gait dynamics. To address this issue, this study is aimed at characterizing the gait stability of patients with HV and examining the joints that are critically affected by HV. To assess complex gait dynamics, we quantified the potential changes in gait stability by using the maximum Lyapunov exponent (MLE). Angular displacements of the ankle, knee, and hip in the sagittal plane during walking were investigated to calculate the MLE for gait stability based on foot conditions (i.e., barefoot, flat shoes, and high heels). During walking, a large MLE ( P < 0.05 ) was noted for the knee joints of subjects with HV, relative to the other lower limb joints. HV appears to have the most critical effect on the knee joints during walking. Ankle movement exhibited higher dynamic stability than the other joint movements of the lower limb ( P < 0.05 ). The type of shoe used in the experiment showed no significant dependence with gait stability and joint movement ( P > 0.05 ). Quantitative assessments of dynamic stability using the MLE may help clinicians assess the overall gait dynamics of HV patients and other people suffering from gait disturbances.

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Gait changes in individuals with bilateral hallux valgus reduce first metatarsophalangeal loading but increase knee abductor moments

Cited by 29 publications

References 29 publications

Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis

Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis

Pilot Study of a 3-Dimensional Method for Analysis of Pronation of the First Metatarsal of Hallux Valgus Patients

Quantifying the Dynamic Stability of Gait Patterns in People with Hallux Valgus

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