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AIM: Recent pedobarographic analyses have shown that in spite of acceptable clinical and radiological results after hallux valgus surgery, there is decreased function of the big toe and the first ray, respectively. The aim of this prospective study was to evaluate if physiotherapy can help to increase big toe function and to restore physiological gait patterns after hallux valgus surgery.
METHODS: 33 patients (31 females, 2 males, 34 feet) with a mild to moderate hallux valgus deformity have been included in this study. 22 patients underwent Austin osteotomy and 11 patients underwent Scarf osteotomy, respectively. Postsurgically, the patients wore the Rathgeber postop shoe for 4 weeks. After this period they received physiotherapy. Pedobarographic examinations were performed with the EMED-at platform 4 weeks, 8 weeks and 6 months after surgery. The AOFAS score and ROM of the first MTP joint were evaluated prior to surgery and 6 months after surgery. Also, patient's satisfaction has been evaluated 6 months after surgery.
RESULTS: In the big toe region peak pressure increased from 80.7 kPa 4 weeks after surgery to 171.9 kPa 8 weeks after surgery (p < 0.0001) and 336.1 kPa 6 months after surgery. In the same period maximum force increased from 18.6 N to 47.6 N and 90.9 N, respectively. In the first metatarsal head region peak pressure increased from 141.4 kPa 4 weeks postoperatively to 215.8 kPa 8 weeks postoperatively and 292.7 kPa 6 months after surgery (p < 0.0001). The AOFAS score increased from 60.8 presurgically to 94.0 at 6 months after surgery and ROM of the first MTP joint increased during the same period from 66 degrees to 70 degrees .
CONCLUSIONS: The authors conclude that postoperative physiotherapy improves big toe function and pressure distribution in the region of the first metatarsal head. This helps to restore physiological gait patterns after hallux valgus surgery.
Re: Effect of physiotherapy following hallux valgus surgery
Quote:
Originally Posted by NewsBot
The authors conclude that postoperative physiotherapy improves big toe function and pressure distribution in the region of the first metatarsal head. This helps to restore physiological gait patterns after hallux valgus surgery.
How can they conclude that in the absence of a control group? How do they know that they would not have got the same result if physiotherapy was not used?
Re: Effect of physiotherapy following hallux valgus surgery
Good point DaVinci,
Comparing weight-bearing dynamics at 4 weeks post-op, with weight-bearing dynamics at 8 weeks, then 6 months ...... and they didn't control for pain reduction over this period of time .....
Also, use of the word ‘physiotherapy’ (profession) instead of ‘physical therapy’ (range of treatments) suggests bias just from reading the title …
Effect of physiotherapy following hallux valgus surgery
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