Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics
Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics
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DOI：
10.1093/rheumatology/kei186
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发表时间：
2006-04-01
期刊：
影响因子：
5.5
通讯作者：
Dekker, J
中科院分区：
文献类型：
--
作者：
van der Leeden, M;Steultjens, M;Dekker, J
目标。评估(I)前足关节损害与足功能(以步态和压力参数表示)之间的关系，(Ii)足功能与疼痛的关系，以及(Iii)继发于类风湿关节炎(RA)的足部主诉患者足功能与残疾的关系。62名患有类风湿性关节炎相关足部疾病的患者纳入研究。测量关节损伤、步态特征、足底压力、疼痛和残疾。数据分析采用描述性和关联性技术。前足关节损伤与前足压力呈显著正相关(r=0.296，P=0.020)。对跖趾关节(MTP)的进一步研究表明，关节损伤与MTP1和MTP4的峰值压力和压力-时间积分(PTI)显著相关。前足底疼痛指数与赤足疼痛呈显著正相关(r=0.290，P=0.022)。步态参数(总接触时间和脚跟负重时间)与足功能指数测定的残疾程度显著相关(分别为r=0.315，P=0.013和r=0.266，P=0.037)。类风湿性足的前足关节损伤与前足下压力增加有关，尤其是第一和第四个MTP关节下的压力。前脚压力大与赤脚行走时的疼痛有关。站立阶段延长和脚跟抬起延迟与日常活动中的残疾有关。
Objective. To assess (i) the relationship between forefoot joint damage and foot function (expressed as gait and pressure parameters), (ii) the relationship between foot function and pain, and (iii) the relationship between foot function and disability in patients with foot complaints secondary to rheumatoid arthritis (RA).Methods. Sixty-two patients with RA-related foot complaints were included. Measurements of joint damage, gait characteristics, plantar pressure, pain and disability were obtained. Data were analysed using descriptive and correlational techniques.Results. Joint damage on radiographs of the forefoot correlated significantly with forefoot pressure (r = 0.296, P = 0.020). Further investigation of the metatarsophalangeal joints (MTPs) showed joint damage to correlate significantly with peak pressure and pressure-time integral (PTI) of MTP1 and MTP4. A significant correlation between PTI under the forefoot and barefoot pain was found (r = 0.290, P = 0.022). Gait parameters (total contact time and the duration of heel loading) and disability, measured with the Foot Function Index, were significantly correlated (r = 0.315, P = 0.013 and r = 0.266, P = 0.037, respectively).Conclusion. Forefoot joint damage in the rheumatoid foot is related to increased pressure under the forefoot, especially pressure under the first and fourth MTP joints. High forefoot pressure is associated with pain during barefoot walking. A prolonged stance phase and delayed heel lift are related to disability in daily activities.