Plantar pressures in people with midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot

Lithgow, Merridy J.; Buldt, Andrew K.; Munteanu, Shannon E.; Marshall, Michelle; Thomas, Martin J.; Peat, George; Roddy, Edward; Menz, Hylton B.

Abstract

Background
Midfoot osteoarthritis (OA) is a common condition, however its aetiology is not well understood. Understanding how plantar pressures differ between people with and without midfoot OA may provide insight into the aetiology and how best to manage this condition.

Research question
To compare plantar pressures between people with and without symptomatic radiographic midfoot OA.

Methods
This was a cross-sectional study of adults aged ≥50 years registered with four UK general practices who reported foot pain in the past year. Symptomatic radiographic midfoot OA was defined as midfoot pain in the last four weeks, combined with radiographic OA in one or more midfoot joints. Cases were matched 1:1 for sex and age (± 5 years) to asymptomatic controls. Peak plantar pressure and maximum force in 10 regions of the foot were determined using a pressure platform (RSscan International, Olen, Belgium) and compared between the groups using independent samples t-tests and effect sizes (Cohen’s d).

Results
We included 61 midfoot OA cases (mean age 67.0, SD 8.1, 31 males, 30 females) and matched these to 61 controls (mean age 66.0, SD 7.9). Midfoot OA cases displayed greater force (d=0.79, medium effect size, p=<0.001) and pressure at the midfoot (d=0.70, medium effect size, p=<0.001), greater force at the fourth metatarsophalangeal (MTP) joint (d=0.28, small effect size, p=0.13), and fifth MTP joint (d=0.37, small effect size, p=0.10) and greater pressure at the fifth MTP joint (d=0.34, small effect size, p=0.13). They also displayed lower force (d=0.40, small effect size, p=0.02) and pressure at the hallux (d=0.50, medium effect size, p=<0.001) and lower force (d=0.54, medium effect size, p=<0.001) and pressure at the lesser toes (d=0.48, small effect size, p=<0.001) compared with controls.

Significance
Midfoot OA appears associated with lowering of the medial longitudinal arch, greater lateral push off and less propulsion at toe off. Longitudinal studies are needed to establish causal relationships.

Citation

Lithgow, M. J., Buldt, A. K., Munteanu, S. E., Marshall, M., Thomas, M. J., Peat, G., Roddy, E., & Menz, H. B. (2024). Plantar pressures in people with midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot. Gait & Posture, 108, 243-249. https://doi.org/10.1016/j.gaitpost.2023.12.008

• Journal Article Type: Article
• Acceptance Date: Dec 8, 2023
• Online Publication Date: Dec 12, 2023
• Publication Date: 2024-02
• Deposit Date: Feb 26, 2024
• Journal: Gait & Posture
• Print ISSN: 0966-6362
• Electronic ISSN: 1879-2219
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 108
• Pages: 243-249
• DOI: https://doi.org/10.1016/j.gaitpost.2023.12.008
• Public URL: https://keele-repository.worktribe.com/output/669234
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0966636223015138?via%3Dihub