Constraints on variation of weight-shifting by foot during walking in adolescents with valgus alignment of hallux

Abstract

Purpose: Etiology of hallux valgus (HV) remains unclear and effective treatments and prophylaxis for this condition are lacking and conclusions of researches concerning HV are inconsistent. Recognition of the function-structure interrelation in foot at the early stage of valgus alignment of first metatarsophalangeus joint (1stMTPJ) would help explain the etiology of HV. Methods: The frequency of weight-shifting patterns during walking and the body mass index (BMI) were assessed relative to goniometric measurements of the 1stMTPJ angle in adolescents. Weight-shifting patterns were identified with a plantar pressure analysis, performed with the Gaitline-Maxline Distance method. Results: As the 1stMTPJ angle widened, the frequency distributions of identified weight-shifting patterns became increasingly lopsided, due to the favoring or disfavoring of one pattern at the expense of the other. The two sexes showed opposite trends in the weight-shifting patterns that were favored/disfavored, relative to participants with a 0º 1stMTPJ angle. The clear predominance of a central-shift pattern, at the expense of a medial-shift, occurred with the largest (20º) 1stMTPJ angle among girls. Additionally, the BMI distributions associated with 1stMTPJ angle characteristics showed opposite trends between the sexes. Conclusions: Valgus alignment of 1stMTPJ among adolescents were associated with limitations in weight-shifting freedom of the foot during walking, that could be involved in maintaining balance. An 1stMTPJ angle of 20º, where distinct limitations were observed, might serve as a criterion of HV pathology.