University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, UK, University of South Australia, Adelaide, South Australia.
University of Leeds, NIHR Leeds Biomedical Research Centre, and Leeds Community Healthcare NHS Trust, Leeds, UK.
Arthritis Care Res (Hoboken). 2021 Jun;73(6):772-780. doi: 10.1002/acr.24182.
To compare foot and leg muscle strength in people with symptomatic midfoot osteoarthritis (OA) with asymptomatic controls, and to determine the association between muscle strength, foot pain, and disability.
Participants with symptomatic midfoot OA and asymptomatic controls were recruited for this cross-sectional study from general practices and community health clinics. The maximum isometric muscle strength of the ankle plantarflexors, dorsiflexors, invertors and evertors, and the hallux and lesser toe plantarflexors was measured using hand-held dynamometry. Self-reported foot pain and foot-related disability were assessed with the Manchester Foot Pain and Disability Index. Differences in muscle strength were compared between groups. Multivariable regression was used to determine the association between muscle strength, foot pain, and disability after adjusting for covariates.
People with midfoot OA (n = 52) exhibited strength deficits in all muscle groups, ranging from 19% (dorsiflexors) to 30% (invertors) relative to the control group (n = 36), with effect sizes of 0.6-1.1 (P < 0.001). In those with midfoot OA, ankle invertor muscle strength was negatively and independently associated with foot pain (β = -0.026 [95% confidence interval (95% CI) -0.051, -0.001]; P = 0.045). Invertor muscle strength was negatively associated with foot-related disability, although not after adjustment for depressive symptoms (β = -0.023 [95% CI -0.063, 0.017]; P = 0.250).
People with symptomatic midfoot OA demonstrate weakness in the foot and leg muscles compared to asymptomatic controls. Preliminary indications from this study suggest that strengthening of the foot and leg muscles may offer potential to reduce pain and improve function in people with midfoot OA.
比较有症状的中足骨关节炎（OA）患者与无症状对照者的足部和腿部肌肉力量，并确定肌肉力量、足部疼痛和残疾之间的关系。
这项横断面研究从普通诊所和社区健康诊所招募了有症状的中足 OA 患者和无症状对照者。使用手持测力计测量踝关节跖屈肌、背屈肌、内翻肌和外翻肌以及大脚趾和小趾跖屈肌的最大等长肌肉力量。使用曼彻斯特足部疼痛和残疾指数评估足部疼痛和足部相关残疾的自我报告情况。比较两组之间的肌肉力量差异。在调整协变量后，使用多变量回归来确定肌肉力量、足部疼痛和残疾之间的关系。
与对照组（n = 36）相比，患有中足 OA 的患者（n = 52）所有肌肉群的力量均出现不足，范围从 19%（背屈肌）到 30%（内翻肌），效应大小为 0.6-1.1（P < 0.001）。在患有中足 OA 的患者中，踝关节内翻肌力量与足部疼痛呈负相关且独立相关（β = -0.026 [95%置信区间（95%CI）-0.051，-0.001]；P = 0.045）。内翻肌力量与足部相关残疾呈负相关，但在调整抑郁症状后则不然（β = -0.023 [95%CI -0.063，0.017]；P = 0.250）。
与无症状对照者相比，有症状的中足 OA 患者的足部和腿部肌肉较弱。这项研究的初步结果表明，加强足部和腿部肌肉可能有潜力减轻中足 OA 患者的疼痛并改善其功能。
