Changes in load bearing in the rheumatoid foot.

Abstract

suMMARY A study of peak force exerted under areas of the foot was made in 27 patients with rheumatoid disease and in 30 normal persons. Patients were found to exert considerably less force under their toes and under the first metatarsal head and more force under the 3 outer metatarsal heads. It was possible to correlate these changes with increasing clinical and radiological severity.In normal walking the centre of gravity of loading begins in the proximal part of the heel, passes over the medial side of the midfoot on to the second metatarsal head, and ends at the lateral border of the great toe (Fig. 1). Although the highest loads are exerted on the heel, it is the forefoot that is involved for the greater part of the foot contact time (Dhanendran and Hutton, in preparation). The variations in the load distribution under the normal foot are now established, and since the foot is a common site of pain and deformity in rheumatoid arthritis, we decided to try to correlate the changes in loading with clinical and radiological disease.Barrett (1976) in a qualitative study found that there was high pressure under the second and third metatarsal heads in rheumatoid arthritis. We have tried to quantify the force distribution under the feet of patients and controls of similar age and weight. We hope that the results presented here will aid in the treatment of these patients.

Foot function after subtalar distraction bone-block arthrodesis

“…Diagram showing the regions of interest for pedobarographic analysis according to Sharma et al 20 (RF, rearfoot; MF, midfoot; MT, metatarsals; and D, toes). important clinical parameters are summarised in Table II.…”

“…Five consecutive measurements were obtained for both feet. Eight regions of interest of the footprint were defined according to Sharma et al, 20 namely rearfoot, midfoot, first metatarsal head, second metatarsal head, third to fifth metatarsal head, first toe, second toe, and lesser toes (Fig. 4).…”

Arthrodesis versus Mayo resection

“…37,46,47 Numerous methods have been used to measure loading of the foot. 8,[16][17][18][19][20]24,33,37,42 To minimise errors in measurement, we preferred not to divide the footprint into small areas.…”

Foot Pressure Studies in the Assessment of Forefoot Arthroplasty in the Rheumatoid Foot

“…9 ) , Sharma et a1. 16, indicated reduced toe and first metatarsal head loading and increased loading of the lateral three metatarsal heads relative to a control population. Collis and Jayson" used silicon semiconductor strain gauges and found a wide variation in dynamic pressure distribution under the forefoot in rheumatoid feet.…”