Department of Nutrition and Movement Sciences, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands.
Department of Nutrition and Movement Sciences, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands; Department of Orthopaedic Surgery, Maastricht University Medical Centre+, Postbus 5800, 6202 AZ, Maastricht, the Netherlands.
Gait Posture. 2021 Feb;84:273-279. doi: 10.1016/j.gaitpost.2020.12.017. Epub 2020 Dec 25.
Previous research showed that hallux rigidus (HR) affects foot and ankle kinematics during gait. It is unclear if HR affects lower limb kinematics as well.
Does HR affect lower limb kinematics, and if so, is gait deviation correlated with patient-reported outcome?
This was a retrospective case-control study, including 15 HR patients and 15 healthy controls who underwent three-dimensional gait analysis by using the Plug-in Gait lower body model. The Gait Profile Score (GPS), a gait index score describing gait deviation and composed out of nine Gait Variable Scores (GVS), and intersegmental range of motion of lower limb joints were assessed. Patient-reported outcome was assessed with the Foot Function Index (FFI) and Manchester-Oxford Foot Questionnaire (MOXFQ). Data were analysed with Student t-tests and Spearman rank correlations.
HR significantly affects gait, reflected by a higher GPS in HR subjects as compared to healthy controls. Gait deviation was seen in ankle flexion (GVS) and to a lesser extent in pelvic rotation (GVS). Interestingly, these differences were not detected when lower limb kinematics were evaluated by comparing the intersegmental ranges of motion of these joints. Positive correlations were present between patient-reported outcomes and GPS, especially functional subdomains, were positively correlated with GPS and GVS.
This study demonstrated that HR, next to foot kinematics, additionally affects lower limb kinematics evaluated with an objective gait index score, i.e. GPS. The positive correlation between the GPS and patient-reported outcome can be seen as the first step in defining whether objectively measured gait indices can be used in considering surgery since most of the benefit of surgery will be expected in the patients with most gait deviation.
先前的研究表明，拇僵硬（HR）会影响步态中的足和踝关节运动学。目前尚不清楚 HR 是否也会影响下肢运动学。
HR 是否会影响下肢运动学，如果是，那么步态偏差是否与患者报告的结果相关？
这是一项回顾性病例对照研究，包括 15 例 HR 患者和 15 例健康对照者，他们通过使用 Plug-in Gait 下肢模型进行三维步态分析。步态指标评分（GPS）是一种描述步态偏差的步态指标评分，由九个步态变量评分（GVS）组成，以及下肢关节的节段间活动范围。患者报告的结果通过足功能指数（FFI）和曼彻斯特-牛津足部问卷（MOXFQ）进行评估。数据采用学生 t 检验和 Spearman 秩相关进行分析。
HR 显著影响步态，表现在 HR 患者的 GPS 高于健康对照组。在踝关节屈曲（GVS）和骨盆旋转（GVS）方面观察到步态偏差。有趣的是，当通过比较这些关节的节段间运动范围来评估下肢运动学时，并没有发现这些差异。患者报告的结果与 GPS 之间存在正相关，尤其是功能子域，与 GPS 和 GVS 呈正相关。
这项研究表明，除了足部运动学之外，HR 还会影响下肢运动学，通过客观的步态指标评分（即 GPS）进行评估。GPS 与患者报告的结果之间的正相关性可以看作是定义客观测量的步态指标是否可以用于考虑手术的第一步，因为手术的大部分益处预计将在步态偏差最大的患者中体现。
