Faculty Collaboration Database

Kinematic changes of the foot and ankle in patients with systemic rheumatoid arthritis and forefoot deformity. J Orthop Res 2007 Mar;25(3):319-29

Date

12/05/2006

Pubmed ID

17143899

DOI

10.1002/jor.20312

Scopus ID

2-s2.0-33947413176 (requires institutional sign-in at Scopus site)   67 Citations

Abstract

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.

Author List

Khazzam M, Long JT, Marks RM, Harris GF

Author

Gerald Harris PhD Director in the Orthopaedic Research Engineering Center (OREC) department at Marquette University

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Ankle
Arthritis, Rheumatoid
Biomechanical Phenomena
Cross-Sectional Studies
Female
Foot Deformities, Acquired
Forefoot, Human
Gait
Humans
Male
Middle Aged
Range of Motion, Articular