Comparison of in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and matched asymptomatic control subjects

Rao, Smita<sup>1,2</sup>; Baumhauer, Judith F.<sup>3</sup>; Tome, Josh<sup>2</sup>; Nawoczenski, Deborah A.<sup>2</sup>

Affiliations

¹Department of Physical Therapy, New York University, NY 10012, United States

²Department of Orthopedics, University of Rochester Medical Center, Rochester, NY, United States

³Center for Foot and Ankle Research, Department of Physical Therapy, Ithaca College–Rochester Center, Rochester, NY, United States

Abstract and keywords

The purpose of this study was to compare in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and asymptomatic control subjects. Segmental foot motion during walking and step descent was assessed using a multi-segment foot model in 30 patients with midfoot arthritis and 20 age, gender and BMI matched controls. Peak and total range of motion (ROM), referenced to subtalar neutral, were examined for each of the following dependent variables: 1st metatarso-phalangeal (MTP1) dorsiflexion, 1st metatarsal (MT1) plantarflexion, ankle dorsiflexion, calcaneal eversion and forefoot abduction. The results showed that, compared to level walking, step descent required greater MTP1 dorsiflexion (p<0.01), MPT1 plantarflexion (p<0.01), ankle dorsiflexion (p<0.01), calcaneus eversion (p=0.03) and forefoot abduction (p=0.01), in all subjects. In addition, step descent also necessitated greater MTP1 dorsiflexion (p<0.01), ankle dorsiflexion (p<0.01) and forefoot abduction (p=0.02) excursion compared to walking. Patients with midfoot arthritis responded differently to the step task compared to control subjects in terms of MT1 and calcaneus eversion excursion. During walking, patients with midfoot arthritis showed significantly less MT1 plantarflexion excursion compared to control subjects (p=0.03). However, during step descent, both groups showed similar MT1 plantarflexion excursion. During walking, patients with midfoot arthritis showed similar calcaneus eversion excursion compared to control subjects. However, during step descent, patients with midfoot arthritis showed significantly greater calcaneus eversion excursion compared to control subjects (p=0.03). Independently or in combination, these motions may contribute to articular stress and consequently to symptoms in patients with midfoot arthritis.

Keywords: Arthritis; Midfoot; Multi-segment foot model

Links

DOI: 10.1016/j.jbiomech.2009.02.006

PubMed: 19409567

WoS: 000266737700014

History

Accepted: 2009-02-17

Cited Works (7)

Year	Entry
1982	Hardcastle PH, Reschauer R, Kutscha-Lissberg E, Schoffmann W. Injuries to the tarsometatarsal joint: incidence, classification and treatment. J Bone Joint Surg. 1982;64B(3):349-356.
2008	Yu J, Cheung JT-M, Fan Y, Zhang Y, Leung AK-L, Zhang M. Development of a finite element model of female foot for high-heeled shoe design. Clin Biomech (Bristol, Avon). 2008;23(suppl 1):S31-S38.
1997	Cavanagh PR, Morag E, Boulton AJM, Young MJ, Deffner KT, Pammer SE. The relationship of static foot structure to dynamic foot function. J Biomech. March 1997;30(3):243-250.
2001	Richter M, Wippermann B, Krettek C, Schratt HE, Hufner T, Thermann H. Fractures and fracture dislocations of the midfoot: occurrence, causes and long-term results. Foot Ankle Int. 2001;22(5):392-398.
1987	Arntz CT, Hansen ST Jr. Dislocations and fracture dislocations of the tarsometatarsal joints. Orthop Clin North Am. 1987;18(1):105-114.
1986	Myerson MS, Fisher RT, Burgess AR, Kenzora JE. Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Foot Ankle. 1986;6(5):225-242.
2002	Teng AL, Pinzur MS, Lomasney L, Mahoney L, Harvey R. Functional outcome following anatomic restoration of tarsal-metatarsal fracture dislocation. Foot Ankle Int. 2002;23(10):922-926.

Cited By (4)

Year	Entry
2016	Huh J, Gross CE, DeOrio JK. Subtalar, Chopart, and Lisfranc joint degeneration. In: Valderrabano V, Easley M, eds. Foot and Ankle Sports Orthopaedics. Cham, Switzerland: Springer International Publishing; 2016:329-340.
2012	Bishop C, Paul G, Thewlis D. Recommendations for the reporting of foot and ankle models. J Biomech. August 31, 2012;45(13):2185-2194.
2014	Kelly LA. In-Vivo Function of Human Plantar Intrinsic Foot Muscles [PhD thesis]. Brisbane, Australia: University of Queensland; 2014.
2021	Kessler SE. The Spring in Your Step: The Role of Muscles and Elastic Connective Tissue Within the Foot [PhD thesis]. Brisbane, Australia: University of Queensland; 2021.