Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands.
Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
J Foot Ankle Res. 2024 Sep;17(3):e12041. doi: 10.1002/jfa2.12041.
Hindfoot varus deformity is common in people with unilateral upper motor neuron syndrome (UMNS) and can be dynamic or persistent. The aims of this study were (1) to gain insight into plantar pressure characteristics of people with chronic UMNS in relation to hindfoot varus and (2) to propose a quantitative outcome measure, based on plantar pressure, for the scientific evaluation of surgical interventions.
In this retrospective study, a cohort comprising plantar pressure data of 49 people with UMNS (22 "no hindfoot varus", 18 "dynamic hindfoot varus", and 9 "persistent hindfoot varus"), and 586 healthy controls was analyzed. As an indication of plantigrade foot contact, the ratio between the plantar contact area of the affected and the non-affected foot was calculated. To investigate spatial and temporal aspects of plantar pressure, normalized plantar pressure patterns and center of pressure trajectories were computed.
People with UMNS had lower plantar pressure area ratios compared to healthy controls. Additionally, increased plantar pressure underneath the lateral foot was found in people with a persistent hindfoot varus. Center of pressure trajectories were more lateral during the first 26% of the stance phase in people with a dynamic hindfoot varus and during the first 82% of the stance phase in people with a persistent hindfoot varus compared to healthy controls.
Spatial and temporal differences in plantar pressure were found in people with dynamic or persistent hindfoot varus deformity. We propose to primarily use the medio-lateral center of pressure trajectory as outcome measure for the scientific evaluation of surgical interventions targeting hindfoot varus.
足后足内翻畸形在单侧上运动神经元综合征（UMNS）患者中很常见，且可能是动态的或持续性的。本研究的目的是（1）深入了解慢性 UMNS 患者的足底压力特征与后足内翻的关系，以及（2）提出一种基于足底压力的定量结果测量方法，用于科学评估手术干预。
在这项回顾性研究中，分析了一个由 49 名 UMNS 患者（22 名“无后足内翻”、18 名“动态后足内翻”和 9 名“持续性后足内翻”）和 586 名健康对照者的足底压力数据组成的队列。为了指示跖骨足接触，计算了受累脚和非受累脚的足底接触面积比。为了研究足底压力的空间和时间方面，计算了归一化的足底压力模式和压力中心轨迹。
与健康对照组相比，UMNS 患者的足底压力面积比更低。此外，在持续性后足内翻患者中，发现外侧足部的足底压力增加。与健康对照组相比，在动态后足内翻患者中，在支撑相的前 26%期间，压力中心轨迹更偏向外侧，在持续性后足内翻患者中，在支撑相的前 82%期间，压力中心轨迹更偏向外侧。
在有动态或持续性后足内翻畸形的患者中发现了足底压力的空间和时间差异。我们建议主要使用中-外侧压力中心轨迹作为针对后足内翻的手术干预的科学评估的结果测量方法。
