Article

Hallux valgus (HV) is one of the most common deformities in podiatric
and orthopedic practice.
Plantar pressure technology has been widely used in
studying the pressure distribution in HV patients for better assessment to plan
interventions. However, previous studies produced an array of controversial
findings and most of them only focused on the forefoot. METHODS: We examined the
dynamic changes of foot pressure of the whole foot with a large-sample
investigation (229 patients and 35 controls). Foot pain, which has been largely
neglected previously, was used to group the participants. RESULTS: Compared to
healthy controls, patients had significantly higher loading of the first and
second metatarsals, where the transverse arch usually collapses, and
significantly less loading of the hallux. Moreover, forces in most regions
reached their maximum late, indicating a slow build-up of loading. Patients
shortened the loading duration on their forefoot, loaded more on the medial foot
starting from early foot contact, and delayed the medial-to-lateral load
transition. Notably, nearly all these changes were more pronounced in patients
with pain. CONCLUSIONS: Biomechanical changes in HV patients are not only caused
by physical deformity but also by modified neural control strategies, possibly to
alleviate discomfort and to accommodate the foot deformity. Our results suggest
that dynamic evaluation of the whole foot and consideration of foot pain are
necessary for the functional assessment of foot pressure in HV patients. The foot
balance changes have important clinical implications.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

Langue : ANGLAIS