Kinematic changes of the foot and ankle in patients with systemic rheumatoid arthritis and forefoot deformity.

Minimal published data exist characterizing the effect of rheumatoid arthritis of the forefoot (RA) on multi-segmental gait kinematics. The purpose of this study was to examine specific changes in segmental foot motion in patients with RA as compared to persons without foot/ankle pathology. This was a cross-sectional, descriptive study consisting of 22 preoperative adult patients (29 feet) diagnosed with RA and 25 adult patients with no known foot pathology (Control). All RA patients were evaluated by the same orthopaedic surgeon. This group consisted of 20 women and 2 men with a mean age of 54 years (range, 17-76 years). The Control cohort consisted of 13 men and 12 women with a mean age of 41 years (range, 27-73 years). Foot and ankle motion data for the RA population were obtained using a 15-camera Vicon Motion Analysis System (Vicon Motion Systems, Inc., Lake Forest, CA). Anterior-posterior, lateral, and modified coronal radiographic views were obtained to relate marker position to underlying bony anatomy. Temporal and three-dimensional kinematic parameters were obtained via the 4-segment Milwaukee Foot Model. Quantitative comparisons of range of motion values during the seven phases of gait were made between RA and Control ankles using unpaired nonparametric methods. The RA group showed significant differences (p < 0.001) as compared to Controls with prolonged stance time, shortened stride length, increased cadence, and a walking speed that was 80% of Control. Overall, kinematic data in the RA cohort showed significant differences (p < 0.001) in motion for tibial, hindfoot, and forefoot motion as compared to Controls. The effect of RA on segmental foot motion is poorly understood. This study characterized the effect that RA has on motion about the foot and ankle during gait, providing insight into this pathology to improve quantitative assessment, treatment planning, and rehabilitative care.

Khazzam M ，Long JT ，Marks RM ，Harris GF ... -  《JOURNAL OF ORTHOPAEDIC RESEARCH》

Pes planovalgus in RA: a descriptive and analytical study of foot function determined by gait analysis.

Turner DE ，Woodburn J ，Helliwell PS ，Cornwall MW ，Emery P ... -  《-》

Foot and ankle kinematics in patients with posterior tibial tendon dysfunction.

Ness ME ，Long J ，Marks R ，Harris G ... -  《-》

Quantitative characterization of gait kinematics in patients with hallux rigidus using the Milwaukee foot model.

The purpose of this study was to provide a quantitative analysis of the changes that occur in the foot and ankle during the gait of patients with hallux rigidus. Using a 15-camera Vicon Motion Analysis System, gait analysis was conducted on a population of 22 patients with hallux rigidus and compared to that of 25 healthy ambulators. Weight-bearing radiographs were measured to index marker positions to underlying bony anatomy. The Milwaukee Foot Model was used to perform three-dimensional analysis of dynamic foot and ankle motion, and temporal-spatial parameters were also calculated. Values were compared to controls using unpaired parametric methods (Student t-test, p < 0.002). The hallux rigidus population showed significant alterations in gait patterns as compared to controls in various planes in all segments (hallux, forefoot, hindfoot, and tibia) of the foot and ankle, particularly in the range of motion of the hallux and the forefoot. Prolonged stance phase was also observed. As reports regarding the quantitative study of the multisegment foot and ankle are limited, this study was useful in providing characterization of gait patterns in patients with hallux rigidus.

Canseco K ，Long J ，Marks R ，Khazzam M ，Harris G ... -  《-》

Changes in 3D joint kinematics support the continuous use of orthoses in the management of painful rearfoot deformity in rheumatoid arthritis.

Woodburn J ，Helliwell PS ，Barker S 《JOURNAL OF RHEUMATOLOGY》