Plantar pressures determinants in mild Hallux Valgus

Nova, Alfonso Martínez; Sánchez-Rodríguez, Raquel; Pérez-Soriano, Pedro; Llana-Belloch, Salvador; Leal-Muro, Alejo; Pedrera‐Zamorano, Juan D.

doi:10.1016/j.gaitpost.2010.06.015

Cited by 81 publications

(76 citation statements)

References 9 publications

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“…Recent studies of plantar loading have been limited by relatively small samples (~ 300 participants) [14,16]. Thus, the current study with over 3000 participants with information on multiple foot disorders may offer insights into the associations of HV that smaller studies cannot.…”

Section: Discussionmentioning

confidence: 99%

Hallux valgus and plantar pressure loading: the Framingham foot study

Galica

Hagedorn

Dufour

et al. 2013

Journal of Foot and Ankle Research

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BackgroundHallux valgus (HV), a common structural foot deformity, can cause foot pain and lead to limited mobility. The purpose of this study was to evaluate differences in plantar pressure and force during gait by HV status in a large population-based cohort of men and women.MethodsA trained examiner performed a validated physical examination on participants’ feet and recorded the presence of hallux valgus and other specific foot disorders. Each foot was classified into one of four mutually exclusive groups based on the foot examination. Foot groups were: (i) HV only, (ii) HV and at least one additional foot disorder (FD), (iii) no HV but at least one other FD, and (iv) neither HV nor FD (referent). Biomechanical data for both feet were collected using Tekscan Matscan. Foot posture during quiet standing, using modified arch index (MAI), and foot function during gait, using center of pressure excursion index (CPEI), were calculated per foot. Further, walking scans were masked into eight sub-regions using Novel Automask, and peak pressure and maximum force exerted in each region were calculated.ResultsThere were 3205 participants, contributing 6393 feet with complete foot exam data and valid biomechanical measurements. Participants with HV had lower hallucal loading and higher forces at lesser toes as well as higher MAI and lower CPEI values compared to the referent. Participants with HV and other FDs were also noted to have aberrant rearfoot forces and pressures.ConclusionsThese results suggest that HV alters foot loading patterns and pressure profiles. Future work should investigate how these changes affect the risk of other foot and lower extremity ailments.

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Section: Discussionmentioning

confidence: 99%

Hallux valgus and plantar pressure loading: the Framingham foot study

Galica

Hagedorn

Dufour

et al. 2013

Journal of Foot and Ankle Research

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“…Galica et al [10] tried to evaluate the plantar pressure and force of HV feet in a large population-based cohort, but they did not further classify the subjects according to different manifestation, which in fact might bring misinterpretation because different symptoms might couple with different or even contradictory loading patterns [11–14]. Wen et al [13] divided the HV patients into pain and asymptomatic groups and investigated their difference in loading pattern with normal foot.…”

Section: Introductionmentioning

confidence: 99%

Loading pattern of postoperative hallux valgus feet with and without transfer metatarsalgia: a case control study

et al. 2017

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BackgroundPostoperative transfer metatarsalgia is a common complication after hallux valgus surgeries. Shortening of the first metatarsal is traditionally thought to be the primary cause of it. However, we speculate the abnormal loading pattern during gait is the real reason. This study is to determine specific differences in the loading patterns between reconstructive hallux valgus (HV) feet with and without postoperative transfer metatarsalgia, so as to find risky loading characteristics of this complication.MethodsThirty feet with postoperative transfer metatarsalgia were recruited as pain group, while another 30 postoperative feet without pain as controls. All participants were asked to walk barefoot at self-selected speed through a plantar force measuring plate (Rs-Scan Inc.) for three times. Certain plantar load variables were recorded or calculated, and their differences between two groups were compared.ResultsFor pain group, the maximum plantar force and force time integral of the first metatarsal decrease significantly; the force time integral of the central rays (second plus third metatarsal) does not significantly differ with that in the controls, but their cumulative load percentage to the whole foot is higher. In pain group, the time point when central rays reached their peak force during the push-off is significantly later than that in controls. And the regional instant load percentage at this moment presented significantly higher for central rays, while significantly lower for the first metatarsal and the hallux compared to the controls.ConclusionsFor hallux valgus feet with postoperative metatarsalgia, the load function of the first metatarsal is obviously impaired. But for central rays, indicative difference is not reflected in either peak or cumulative load during the gait cycle, but in the instant load distribution when central rays reach their peak load. So we can conclude that whether the remaining regions can adequately share certain load during walking, especially around the time metatarsalgia often occurs, plays an unnegligible role. So surgeons should pay more attention to reconstruct a foot where load can be evenly distributed.

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“…It is plausible that altered forefoot structure in feet with HV may affect muscle function, which in turn may impact on gait parameters, specifically the smooth transfer of body weight required for efficient toe-off (8). Unfortunately, the findings of gait studies using plantar pressure analysis have been inconsistent, with some reporting increased (9 -11), decreased (12), or unchanged (13) pressures under the medial forefoot in HV compared to controls. None of these studies have accounted for different levels of HV severity, and only 2 have considered the presence of foot pain (11,14).…”

Section: Introductionmentioning

confidence: 99%

Functional Impairments Characterizing Mild, Moderate, and Severe Hallux Valgus

Hurn

Vicenzino

Smith

2014

Arthritis Care & Research

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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.

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Plantar pressures determinants in mild Hallux Valgus

Cited by 81 publications

References 9 publications

Hallux valgus and plantar pressure loading: the Framingham foot study

Hallux valgus and plantar pressure loading: the Framingham foot study

Loading pattern of postoperative hallux valgus feet with and without transfer metatarsalgia: a case control study

Functional Impairments Characterizing Mild, Moderate, and Severe Hallux Valgus

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