The associations of leg lean mass with foot pain, posture and function in the Framingham foot study

Abstract

Background: Foot disorders are common in older adults and associated with impaired lower extremity function. Reduced muscle mass may play a role in the etiology of foot disorders and consequent poor function. Methods: We examined the association of leg lean mass with foot pain, posture and function among 1,795 individuals (mean age 67 years) from the population-based Framingham Foot Study (2002)(2003)(2004)(2005)(2006)(2007)(2008). Pain was assessed via questionnaire, and a pressure mat classified foot posture (arch: high, low, referent) during standing and function (pronation, supination, referent) during gait. Leg lean mass was measured by whole body dual energy x-ray absorptiometry.Results: In age-and body mass index-adjusted logistic (pain) and multinomial logistic (posture, function) regression models, a 1-standard deviation increase in leg lean mass was associated with lower odds of foot pain (OR = 0.76, 95% CI: 0.68, 0.86) and pronation (OR = 0.76, 95% CI: 0.67, 0.85), and higher odds of supination (OR = 1.17, 95% CI: 1.04, 1.31). Adjustment for sex attenuated these associations. Higher leg lean mass was associated with lower odds of high arch, even after adjustment for sex (OR = 0.73, 95% CI: 0.60, 0.89). Conclusions: Though not related to foot pain or function, reduced leg lean mass was associated with extreme foot posture in older adults. Loss of muscle mass with aging may thus play a role in the etiology of functional impairment due to foot disorders.

ISB recommendations for skin-marker-based multi-segment foot kinematics

“…There is substantial clinical (Yan et al, 2020), biomechanical (Hillstrom et al, 2013;Mootanah et al, 2013;Rao et al, 2011;Shultz et al, 2017;Song et al, 1996) and epidemiological (Galica et al, 2013;Golightly et al, 2019Golightly et al, , 2014Hagedorn et al, 2013;McLean et al, 2014;Menz et al, 2013;Nguyen et al, 2013;Riskowski et al, 2013;Song et al, 2018) evidence that there is more than one 'normal' or 'control' foot. There are asymptomatic feet but they may have a planus, rectus or cavus morphology with tendencies towards three-dimensional (3D) pronation, neutral or supination posture.…”