Forefoot pathology in relation to plantar pressure distribution in patients with rheumatoid arthritis: A cross-sectional study in the Amsterdam Foot cohort

A. P. M. Konings-Pijnappels, M. Tenten-Diepenmaat, R. Dahmen, S. K. Verberne, J. Dekker, J. W. R. Twisk, L. D. Roorda, M. van der Leeden

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: In patients with rheumatoid arthritis (RA), both high and low forefoot plantar pressures have been reported. Better understanding of pathology in the forefoot associated with altered pressure distribution in patients with RA could help to better formulate and specify goals for treatment with foot orthoses or therapeutic footwear. Objectives: To investigate the association of plantar pressure with disease activity and deformity in the forefoot in patients with rheumatoid arthritis and forefoot symptoms. Methods: A cross sectional study, using data of 172 patients with rheumatoid arthritis and forefoot symptoms, was conducted. Peak pressure (PP) and pressure time integral (PTI) in the forefoot were measured with a pressure platform. Forefoot deformity was assessed using the Platto score. Forefoot disease activity was defined as swelling and/or pain assessed by palpation of the metatarsophalangeal joints. The forefoot was divided in a medial, central and lateral region, in which the following conditions could be present: 1) no pathology, 2) disease activity, 3) deformity or 4) disease activity and deformity. A multilevel analysis was performed using condition per forefoot region as independent variable and PP or PTI in the corresponding region as dependent variable. Results: Statistically significant higher plantar pressures were found in forefoot regions with deformities (RR 1.2, CI 1.1-1.3, P<0.0001), compared to forefoot regions without forefoot pathology. No significant differences in plantar pressures were found when solely forefoot disease activity was present in forefoot regions. Significance: Forefoot deformities are related to higher plantar pressures measured in the corresponding forefoot regions. The absence of an association between local disease activity and plantar pressure might be explained by the low prevalence of metatarsophalangeal joint pain or swelling. Future research with sensitive imaging measures to detect disease activity is recommended to reveal the effect of forefoot disease activity on plantar pressure.
Original languageEnglish
Pages (from-to)317-322
Number of pages6
JournalGait and Posture
Volume68
Early online date12 Dec 2018
DOIs
Publication statusPublished - 2019

Cite this

@article{5823bec0971f4286a3d8982b04c8e637,
title = "Forefoot pathology in relation to plantar pressure distribution in patients with rheumatoid arthritis: A cross-sectional study in the Amsterdam Foot cohort",
abstract = "Background: In patients with rheumatoid arthritis (RA), both high and low forefoot plantar pressures have been reported. Better understanding of pathology in the forefoot associated with altered pressure distribution in patients with RA could help to better formulate and specify goals for treatment with foot orthoses or therapeutic footwear. Objectives: To investigate the association of plantar pressure with disease activity and deformity in the forefoot in patients with rheumatoid arthritis and forefoot symptoms. Methods: A cross sectional study, using data of 172 patients with rheumatoid arthritis and forefoot symptoms, was conducted. Peak pressure (PP) and pressure time integral (PTI) in the forefoot were measured with a pressure platform. Forefoot deformity was assessed using the Platto score. Forefoot disease activity was defined as swelling and/or pain assessed by palpation of the metatarsophalangeal joints. The forefoot was divided in a medial, central and lateral region, in which the following conditions could be present: 1) no pathology, 2) disease activity, 3) deformity or 4) disease activity and deformity. A multilevel analysis was performed using condition per forefoot region as independent variable and PP or PTI in the corresponding region as dependent variable. Results: Statistically significant higher plantar pressures were found in forefoot regions with deformities (RR 1.2, CI 1.1-1.3, P<0.0001), compared to forefoot regions without forefoot pathology. No significant differences in plantar pressures were found when solely forefoot disease activity was present in forefoot regions. Significance: Forefoot deformities are related to higher plantar pressures measured in the corresponding forefoot regions. The absence of an association between local disease activity and plantar pressure might be explained by the low prevalence of metatarsophalangeal joint pain or swelling. Future research with sensitive imaging measures to detect disease activity is recommended to reveal the effect of forefoot disease activity on plantar pressure.",
author = "Konings-Pijnappels, {A. P. M.} and M. Tenten-Diepenmaat and R. Dahmen and Verberne, {S. K.} and J. Dekker and Twisk, {J. W. R.} and Roorda, {L. D.} and {van der Leeden}, M.",
note = "Copyright {\circledC} 2018. Published by Elsevier B.V.",
year = "2019",
doi = "10.1016/j.gaitpost.2018.12.015",
language = "English",
volume = "68",
pages = "317--322",
journal = "Gait and Posture",
issn = "0966-6362",
publisher = "Elsevier",

}

Forefoot pathology in relation to plantar pressure distribution in patients with rheumatoid arthritis : A cross-sectional study in the Amsterdam Foot cohort. / Konings-Pijnappels, A. P. M.; Tenten-Diepenmaat, M.; Dahmen, R.; Verberne, S. K.; Dekker, J.; Twisk, J. W. R.; Roorda, L. D.; van der Leeden, M.

In: Gait and Posture, Vol. 68, 2019, p. 317-322.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Forefoot pathology in relation to plantar pressure distribution in patients with rheumatoid arthritis

T2 - A cross-sectional study in the Amsterdam Foot cohort

AU - Konings-Pijnappels, A. P. M.

AU - Tenten-Diepenmaat, M.

AU - Dahmen, R.

AU - Verberne, S. K.

AU - Dekker, J.

AU - Twisk, J. W. R.

AU - Roorda, L. D.

AU - van der Leeden, M.

N1 - Copyright © 2018. Published by Elsevier B.V.

PY - 2019

Y1 - 2019

N2 - Background: In patients with rheumatoid arthritis (RA), both high and low forefoot plantar pressures have been reported. Better understanding of pathology in the forefoot associated with altered pressure distribution in patients with RA could help to better formulate and specify goals for treatment with foot orthoses or therapeutic footwear. Objectives: To investigate the association of plantar pressure with disease activity and deformity in the forefoot in patients with rheumatoid arthritis and forefoot symptoms. Methods: A cross sectional study, using data of 172 patients with rheumatoid arthritis and forefoot symptoms, was conducted. Peak pressure (PP) and pressure time integral (PTI) in the forefoot were measured with a pressure platform. Forefoot deformity was assessed using the Platto score. Forefoot disease activity was defined as swelling and/or pain assessed by palpation of the metatarsophalangeal joints. The forefoot was divided in a medial, central and lateral region, in which the following conditions could be present: 1) no pathology, 2) disease activity, 3) deformity or 4) disease activity and deformity. A multilevel analysis was performed using condition per forefoot region as independent variable and PP or PTI in the corresponding region as dependent variable. Results: Statistically significant higher plantar pressures were found in forefoot regions with deformities (RR 1.2, CI 1.1-1.3, P<0.0001), compared to forefoot regions without forefoot pathology. No significant differences in plantar pressures were found when solely forefoot disease activity was present in forefoot regions. Significance: Forefoot deformities are related to higher plantar pressures measured in the corresponding forefoot regions. The absence of an association between local disease activity and plantar pressure might be explained by the low prevalence of metatarsophalangeal joint pain or swelling. Future research with sensitive imaging measures to detect disease activity is recommended to reveal the effect of forefoot disease activity on plantar pressure.

AB - Background: In patients with rheumatoid arthritis (RA), both high and low forefoot plantar pressures have been reported. Better understanding of pathology in the forefoot associated with altered pressure distribution in patients with RA could help to better formulate and specify goals for treatment with foot orthoses or therapeutic footwear. Objectives: To investigate the association of plantar pressure with disease activity and deformity in the forefoot in patients with rheumatoid arthritis and forefoot symptoms. Methods: A cross sectional study, using data of 172 patients with rheumatoid arthritis and forefoot symptoms, was conducted. Peak pressure (PP) and pressure time integral (PTI) in the forefoot were measured with a pressure platform. Forefoot deformity was assessed using the Platto score. Forefoot disease activity was defined as swelling and/or pain assessed by palpation of the metatarsophalangeal joints. The forefoot was divided in a medial, central and lateral region, in which the following conditions could be present: 1) no pathology, 2) disease activity, 3) deformity or 4) disease activity and deformity. A multilevel analysis was performed using condition per forefoot region as independent variable and PP or PTI in the corresponding region as dependent variable. Results: Statistically significant higher plantar pressures were found in forefoot regions with deformities (RR 1.2, CI 1.1-1.3, P<0.0001), compared to forefoot regions without forefoot pathology. No significant differences in plantar pressures were found when solely forefoot disease activity was present in forefoot regions. Significance: Forefoot deformities are related to higher plantar pressures measured in the corresponding forefoot regions. The absence of an association between local disease activity and plantar pressure might be explained by the low prevalence of metatarsophalangeal joint pain or swelling. Future research with sensitive imaging measures to detect disease activity is recommended to reveal the effect of forefoot disease activity on plantar pressure.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85058364050&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30566899

U2 - 10.1016/j.gaitpost.2018.12.015

DO - 10.1016/j.gaitpost.2018.12.015

M3 - Article

VL - 68

SP - 317

EP - 322

JO - Gait and Posture

JF - Gait and Posture

SN - 0966-6362

ER -