Telfer Scott, Baeten Elien, Gibson Kellie S, Steultjens Martijn P, Turner Deborah E, Woodburn James, Hendry Gordon J
Institute for Applied Health Research, Glasgow Caledonian University, UK; Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, USA.
Life Sciences Department, Thomas More Kempen, Belgium.
Clin Biomech (Bristol). 2014 Nov;29(9):1027-31. doi: 10.1016/j.clinbiomech.2014.08.009. Epub 2014 Aug 27.
Altered foot function is common in individuals with rheumatoid arthritis. Plantar pressure distributions during gait are regularly assessed in this patient group; however, the association between frequently reported magnitude-based pressure variables and clinical outcomes has not been clearly established. Recently, a novel approach to the analysis of plantar pressure distributions throughout stance phase, the dynamic plantar loading index, has been proposed. This study aimed to assess the utility of this index for measuring foot function in individuals with rheumatoid arthritis.
Barefoot plantar pressures during gait were measured in 63 patients with rheumatoid arthritis and 51 matched controls. Additionally, 15 individuals with rheumatoid arthritis had in-shoe plantar pressures measured whilst walking in standardized footwear for two conditions: shoes-only; and shoes with prescribed custom foot orthoses. The dynamic plantar loading index was determined for all participants and conditions. Patient and control groups were compared for significant differences as were the shod and orthosis conditions.
The patient group was found to have a mean index of 0.19, significantly lower than the control group's index of 0.32 (p>0.001, 95% CI [0.054, 0.197]). No significant differences were found between the shoe-only and shoe plus orthosis conditions. The loading index was found to correlate with clinical measures of structural deformity.
The dynamic plantar loading index may be a useful tool for researchers and clinicians looking to objectively assess dynamic foot function in patients with rheumatoid arthritis; however, it may be unresponsive to changes caused by orthotic interventions in this patient group.
类风湿关节炎患者足部功能改变较为常见。该患者群体在步态过程中的足底压力分布常被评估；然而，频繁报告的基于大小的压力变量与临床结局之间的关联尚未明确确立。最近，一种分析整个站立期足底压力分布的新方法——动态足底负荷指数被提出。本研究旨在评估该指数在测量类风湿关节炎患者足部功能方面的效用。
对63例类风湿关节炎患者和51例匹配的对照组进行了步态过程中的赤足足底压力测量。此外，15例类风湿关节炎患者在穿着标准化鞋具行走时测量了鞋内足底压力，包括两种情况：仅穿鞋子；以及穿配有定制足部矫形器的鞋子。确定了所有参与者和所有情况下的动态足底负荷指数。比较了患者组和对照组之间的显著差异，以及穿鞋和穿矫形器两种情况之间的差异。
发现患者组的平均指数为0.19，显著低于对照组的指数0.32（p>0.001，95%CI[0.054，0.197]）。仅穿鞋子和穿鞋子加矫形器两种情况之间未发现显著差异。发现负荷指数与结构畸形的临床指标相关。
动态足底负荷指数可能是研究人员和临床医生客观评估类风湿关节炎患者动态足部功能的有用工具；然而，在该患者群体中，它可能对矫形干预引起的变化不敏感。
