TY - JOUR
T1 - Orthoses Alter In Vivo Segmental Foot Kinematics During Walking in Patients With Midfoot Arthritis
AU - Rao, Smita
AU - Baumhauer, Judith F.
AU - Tome, Josh
AU - Nawoczenski, Deborah A.
N1 - Funding Information:
Supported by the Arthritis Foundation (Upstate New York Chapter Grant, Postdoctoral Fellowship Award) and the American Orthopedic Foot and Ankle Society Research Grant and Wrymark Inc.
Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2010/4
Y1 - 2010/4
N2 - Rao S, Baumhauer JF, Tome J, Nawoczenski DA. Orthoses alter in vivo segmental foot kinematics during walking in patients with midfoot arthritis. Objective: To assess the effect of a 4-week intervention with a full-length carbon graphite (FL) orthosis on pain and function in patients with midfoot arthritis, and to identify alterations in in vivo foot kinematics accompanying FL use in patients with midfoot arthritis. These results have immediate application for enhancing patient care through effective orthotic recommendations. Design: Experimental laboratory study supplemented by a case series. Setting: University based clinical research laboratory. Participants: Patients (n=30) with midfoot arthritis and age-, sex-, and body mass index-matched control subjects (n=20). Intervention: Four-week intervention with FL orthoses. Main Outcome Measures: Pain and function were assessed using the Foot Function Index-Revised (FFI-R). In vivo foot kinematics were quantified as peak and total range of calcaneal eversion, forefoot abduction, first metatarsal plantarflexion, and first metatarsophalangeal joint dorsiflexion during walking in 2 conditions: with FL orthoses and with shoes only. A paired t test and repeated-measures analysis of variance were used to assess statistical significance (α=.05) of change in FFI-R score and in vivo foot kinematics, respectively. Results: Significant improvements in pain and function, discerned as lower FFI-R scores (P<.001), were noted after the 4-week intervention with FL orthoses. During walking, FL orthosis use resulted in decreased first metatarsophalangeal joint dorsiflexion (P=.024) and first metatarsal plantarflexion range of motion (P=.038), compared with the shoe-only condition. Conclusions: Orthotic intervention emphasizing a "stiffening" strategy of the first metatarsal and first metatarsophalangeal joint may be valuable in patients with midfoot arthritis and early degenerative changes.
AB - Rao S, Baumhauer JF, Tome J, Nawoczenski DA. Orthoses alter in vivo segmental foot kinematics during walking in patients with midfoot arthritis. Objective: To assess the effect of a 4-week intervention with a full-length carbon graphite (FL) orthosis on pain and function in patients with midfoot arthritis, and to identify alterations in in vivo foot kinematics accompanying FL use in patients with midfoot arthritis. These results have immediate application for enhancing patient care through effective orthotic recommendations. Design: Experimental laboratory study supplemented by a case series. Setting: University based clinical research laboratory. Participants: Patients (n=30) with midfoot arthritis and age-, sex-, and body mass index-matched control subjects (n=20). Intervention: Four-week intervention with FL orthoses. Main Outcome Measures: Pain and function were assessed using the Foot Function Index-Revised (FFI-R). In vivo foot kinematics were quantified as peak and total range of calcaneal eversion, forefoot abduction, first metatarsal plantarflexion, and first metatarsophalangeal joint dorsiflexion during walking in 2 conditions: with FL orthoses and with shoes only. A paired t test and repeated-measures analysis of variance were used to assess statistical significance (α=.05) of change in FFI-R score and in vivo foot kinematics, respectively. Results: Significant improvements in pain and function, discerned as lower FFI-R scores (P<.001), were noted after the 4-week intervention with FL orthoses. During walking, FL orthosis use resulted in decreased first metatarsophalangeal joint dorsiflexion (P=.024) and first metatarsal plantarflexion range of motion (P=.038), compared with the shoe-only condition. Conclusions: Orthotic intervention emphasizing a "stiffening" strategy of the first metatarsal and first metatarsophalangeal joint may be valuable in patients with midfoot arthritis and early degenerative changes.
KW - Arthritis
KW - Orthotic devices
KW - Rehabilitation
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U2 - 10.1016/j.apmr.2009.11.027
DO - 10.1016/j.apmr.2009.11.027
M3 - Article
C2 - 20382295
AN - SCOPUS:77950482111
SN - 0003-9993
VL - 91
SP - 608
EP - 614
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 4
ER -