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痛风和无症状高尿酸血症患者赤足行走时的时空步态参数和足底压力分布:与血清尿酸盐浓度正常的健康个体比较

Spatiotemporal gait parameters and plantar pressure distribution during barefoot walking in people with gout and asymptomatic hyperuricemia: comparison with healthy individuals with normal serum urate concentrations.

作者信息

Stewart Sarah, Dalbeth Nicola, Vandal Alain C, Rome Keith

机构信息

Department of Podiatry, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142 New Zealand.

Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand ; Department of Rheumatology, Auckland District Health Board, P.O. Box 92189, Auckland, New Zealand.

出版信息

J Foot Ankle Res. 2016 Apr 30;9:15. doi: 10.1186/s13047-016-0147-4. eCollection 2016.

Abstract

BACKGROUND

To identify spatiotemporal gait parameters and plantar pressure distribution during barefoot walking in people with gout and people with asymptomatic hyperuricemia by comparing them to healthy individuals with normal serum urate concentrations.

METHODS

Eighty-seven participants were included: 24 with gout, 29 with asymptomatic hyperuricemia and 34 age- and sex-matched normouricemic control participants. Spatiotemporal parameters of gait were assessed during level barefoot walking using a GAITRite® walkway. Peak plantar pressure and pressure time integrals were recorded using a TekScan MatScan®. Results were adjusted for age and body mass index.

RESULTS

Compared to normouricemic control participants, participants with gout demonstrated increased step time (P = 0.022) and stance time (P = 0.022), and reduced velocity (P = 0.050). Participants with gout also walked with decreased peak pressure at the heel (P = 0.012) and hallux (P = 0.036) and increased peak pressure (P < 0.001) and pressure time integrals (P = 0.005) at the midfoot. Compared to normouricemic control participants, participants with asymptomatic hyperuricemia demonstrated increased support base (P = 0.002), double support time (P < 0.001) and cadence (P = 0.028) and reduced swing time (P = 0.019) and single support time (P = 0.020) as well as increased pressure at the midfoot (P = 0.013), first metatarsal (P = 0.015) and second metatarsal (P = 0.007).

CONCLUSION

During barefoot walking, people with gout walk slower with plantar pressure patterns suggestive of apropulsive and antalgic gait strategies. Individuals with asymptomatic hyperuricemia also demonstrate altered barefoot gait patterns when compared to normouricemic control participants. Clinicians may consider dynamic gait outcomes when assessing and managing foot and lower limb related pain and disability in individuals with gout and asymptomatic hyperuricemia.

摘要

背景

通过将痛风患者和无症状高尿酸血症患者与血清尿酸浓度正常的健康个体进行比较,确定他们在赤足行走过程中的时空步态参数和足底压力分布。

方法

纳入87名参与者:24名痛风患者、29名无症状高尿酸血症患者以及34名年龄和性别匹配的血尿酸正常的对照参与者。使用GAITRite®步道评估在水平赤足行走过程中的时空步态参数。使用TekScan MatScan®记录足底峰值压力和压力时间积分。结果根据年龄和体重指数进行了调整。

结果

与血尿酸正常的对照参与者相比,痛风患者的步长时间(P = 0.022)和站立时间(P = 0.022)增加,速度降低(P = 0.050)。痛风患者行走时足跟(P = 0.012)和拇趾(P = 0.036)的峰值压力降低,而足中部的峰值压力(P < 0.001)和压力时间积分(P = 0.005)增加。与血尿酸正常的对照参与者相比,无症状高尿酸血症患者的支撑面(P = 0.002)、双支撑时间(P < 0.001)和步频(P = 0.028)增加,摆动时间(P = 0.019)和单支撑时间(P = 0.020)减少,同时足中部(P = 0.013)、第一跖骨(P = 0.015)和第二跖骨(P = 0.007)的压力增加。

结论

在赤足行走过程中,痛风患者行走速度较慢,足底压力模式提示推进性和止痛步态策略。与血尿酸正常的对照参与者相比,无症状高尿酸血症患者也表现出改变的赤足步态模式。临床医生在评估和管理痛风和无症状高尿酸血症患者的足部及下肢相关疼痛和残疾时,可能需要考虑动态步态结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dc2/4851792/561cfd333016/13047_2016_147_Fig1_HTML.jpg

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