Foot and Leg Muscle Weakness in People With Midfoot Osteoarthritis

Abstract

Objective To compare foot and leg muscle strength in people with symptomatic midfoot osteoarthritis (OA) with asymptomatic controls, and to determine the association between muscle strength, foot pain, and disability. Methods Participants with symptomatic midfoot OA and asymptomatic controls were recruited for this cross‐sectional study from general practices and community health clinics. The maximum isometric muscle strength of the ankle plantarflexors, dorsiflexors, invertors and evertors, and the hallux and lesser toe plantarflexors was measured using hand‐held dynamometry. Self‐reported foot pain and foot‐related disability were assessed with the Manchester Foot Pain and Disability Index. Differences in muscle strength were compared between groups. Multivariable regression was used to determine the association between muscle strength, foot pain, and disability after adjusting for covariates. Results People with midfoot OA (n = 52) exhibited strength deficits in all muscle groups, ranging from 19% (dorsiflexors) to 30% (invertors) relative to the control group (n = 36), with effect sizes of 0.6–1.1 (P < 0.001). In those with midfoot OA, ankle invertor muscle strength was negatively and independently associated with foot pain (β = –0.026 [95% confidence interval (95% CI) –0.051, –0.001]; P = 0.045). Invertor muscle strength was negatively associated with foot‐related disability, although not after adjustment for depressive symptoms (β = –0.023 [95% CI –0.063, 0.017]; P = 0.250). Conclusion People with symptomatic midfoot OA demonstrate weakness in the foot and leg muscles compared to asymptomatic controls. Preliminary indications from this study suggest that strengthening of the foot and leg muscles may offer potential to reduce pain and improve function in people with midfoot OA.

Foot Osteoarthritis: Addressing an Overlooked Global Public Health Problem

“…In this issue of Arthritis Care & Research (4), Arnold et al advance the field of foot OA with their novel study on associations of foot and leg muscle strength with symptomatic midfoot OA, a frequent type of foot OA. This study builds on prior research demonstrating the associations of muscle weakness with OA at the hip, knee, and hand with pain and impaired physical function.…”

“…An important advancement in the field of foot OA was the development of the La Trobe Foot Atlas (5), which individually scores radiographic presentation of osteophytes and joint space narrowing at the first MTP joint and 4 midfoot joints: first and second cuneometatarsal joints, navicular‐first cuneiform joint, and talonavicular joint. This atlas, which was used by Arnold et al (4), has improved our ability to estimate the prevalence of foot OA in populations. With the recent emergence of longitudinal radiographic foot data, questions have arisen over how to define incident and progressive disease, and unfortunately, the La Trobe Foot Atlas was not designed to address these issues.…”

Foot and Ankle Characteristics in Gout: A Systematic Review

“…While gouty tophi presence assessed by clinical examination may not reflect the true burden in people with gout, the varying prevalence of subclinical deposition of tophi highlights the value of imaging recommendations and reporting guidelines [41,42] . Equally, concomitant foot osteoarthritis may affect joint range of motion and muscle strength [43,44] : with Roddy et al, [45] suggesting that one in six older adults are affected by foot osteoarthritis. This indicates the need for more research to confirm the role of osteoarthritis and reduced range of motion at the first MPTJ in those with gout.…”

Morphological variation of the hemophilic talus

“…Hemophilia is a sex-linked genetic disorder, hence the patient group was entirely male. The control group was selected from a pre-existing research imaging dataset (Arnold et al, 2020), choosing scans from male volunteers free of ankle joint disease, with images with the correct field of view to include the entire talus.…”

“…Clinical assessment has shown as this joint disease progresses, the talus appears to collapse with changes in geometry, joint space and function. In other diseases affecting the ankle joint, such as clubfoot, talar flattening has been linked with joint incongruity, loss of range of motion and altered gait patterns (Bach et al, 2002;Kolb et al, 2017;Shivers et al, 2020) which pose a significant burden to the patient in terms of pain and disability.…”