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Motion of the multisegmental foot in hallux valgus.
Canseco K, Rankine L, Long J, Smedberg T, Marks RM, Harris GF. Foot Ankle Int. 2010 Feb;31(2):146-52.
Quote:
BACKGROUND: Hallux valgus is a common condition characterized by lateral deviation of the large toe and medial deviation of the first metatarsal. While some gait analyses of patients with hallux valgus have been performed using plantar pressures, very little is known about the kinematics of gait in this population. The purpose of this study was to evaluate triplanar kinematics in patients with hallux valgus using a multisegmental foot model.
MATERIALS AND METHODS: A 15-camera Vicon Motion Analysis System was used to evaluate the gait of 38 feet in 33 patients with mild to severe hallux valgus. The Milwaukee foot model was used to characterize dynamic foot and ankle kinematics and temporal-spatial parameters. Values were compared with normal subjects. Outcomes were evaluated using the SF-36 assessment tool.
RESULTS: Patients with hallux valgus showed significantly decreased velocity and stride length and prolonged stance. Significant alterations in gait kinematics were observed in various planes in all segments (hallux, forefoot, hindfoot, and tibia) of the foot and ankle, particularly in the ranges of motion of the hallux and the forefoot.
CONCLUSION: The results demonstrate significantly altered kinematic and temporal-spatial parameters reflective of reduced ambulatory function in patients with hallux valgus. As reports describing multisegmental foot and ankle kinematics in this population are limited, this study is valuable in characterizing gait in patients with hallux valgus.
CLINICAL RELEVANCE: A better understanding of altered gait dynamics of the multisegmental foot in patients with hallux valgus provides valuable insight on how distal pathology affects proximal segments.
BACKGROUND: Hallux valgus is a very common foot deformity in modern societies. The impact of this condition on foot function has been described qualitatively and quantitatively. Published patho-mechanical models are mainly underpinned by findings originating from plantar pressure measurements. However, the kinematical patterns of the many foot segments during gait have not been quantified. This study aims to evaluate the kinematics of the various foot segments in the presence of this deformity.
METHODS: Using the Oxford Foot Model and a 12-camera Motion Analysis System, gait analysis was conducted on a convenience sample of 20 participants with hallux valgus and compared to that of 22 randomly selected symptom-free volunteers. Differences between temporal and kinematical data between groups were analyzed using the unpaired parametric Student t-test (significance level p<0.01).
RESULTS: During specific gait events, a different range of motion was found at several inter-segment angles. Particularly, the range of motion of the hallux (sagittal plane) and hindfoot (frontal-transverse planes) during stance were significantly different (p<0.01).
CONCLUSION: Sagittal plane kinematics of the hallux is affected by the first ray deformity in this condition. However, the impact on other segments was found to be limited. This suggests that the patho-mechanical consequences remain limited to the weight bearing function of the first ray.
Gait changes in hallux valgus
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