Background

Previous research showed that hallux rigidus (HR) affects foot and ankle kinematics during gait. It is unclear if HR affects lower limb kinematics as well.

Research question

Does HR affect lower limb kinematics, and if so, is gait deviation correlated with patient-reported outcome?

Methods

This was a retrospective case-control study, including 15 HR patients and 15 healthy controls who underwent three-dimensional gait analysis by using the Plug-in Gait lower body model. The Gait Profile Score (GPS), a gait index score describing gait deviation and composed out of nine Gait Variable Scores (GVS), and intersegmental range of motion of lower limb joints were assessed. Patient-reported outcome was assessed with the Foot Function Index (FFI) and Manchester-Oxford Foot Questionnaire (MOXFQ). Data were analysed with Student t-tests and Spearman rank correlations.

Results

HR significantly affects gait, reflected by a higher GPS in HR subjects as compared to healthy controls. Gait deviation was seen in ankle flexion (GVS_{ankle flexion}) and to a lesser extent in pelvic rotation (GVS_{pelvic rotation}). Interestingly, these differences were not detected when lower limb kinematics were evaluated by comparing the intersegmental ranges of motion of these joints. Positive correlations were present between patient-reported outcomes and GPS, especially functional subdomains, were positively correlated with GPS and GVS_{ankle flexion}.

Significance

This study demonstrated that HR, next to foot kinematics, additionally affects lower limb kinematics evaluated with an objective gait index score, i.e. GPS. The positive correlation between the GPS and patient-reported outcome can be seen as the first step in defining whether objectively measured gait indices can be used in considering surgery since most of the benefit of surgery will be expected in the patients with most gait deviation.

中文翻译：

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僵直拇趾影响步态谱评分评估的下肢运动学

背景

先前的研究表明，拇趾僵硬（HR）在步态过程中影响脚和踝的运动学。目前尚不清楚HR是否也会影响下肢运动学。

研究问题

HR是否会影响下肢运动学，如果这样，步态偏差是否与患者报告的结果相关？

方法

这是一项回顾性病例对照研究，包括15名HR患者和15名健康对照，他们使用Plug-in Gait下半身模型进行了三维步态分析。评估步态剖面评分（GPS），描述步态偏离并由9个步态变量评分（GVS）组成的步态指数评分，以及下肢关节的节间运动范围。通过脚功能指数（FFI）和曼彻斯特-牛津脚问卷（MOXFQ）评估患者报告的结局。用Student t检验和Spearman等级相关性分析数据。

结果

与健康对照组相比，HR受试者的GPS较高，因此HR显着影响步态。在踝关节屈曲（GVS_{踝关节屈曲}）中观察到步态偏离，在骨盆旋转（GVS_骨盆旋转）中观察到步态偏离。有趣的是，通过比较这些关节的节段间运动范围来评估下肢运动学时，未检测到这些差异。患者报告的结局与GPS呈正相关，尤其是功能子域与GPS和GVS_{踝关节屈曲}呈正相关。

意义

这项研究表明，HR（仅次于脚运动学）还会影响以客观步态指数评分（即GPS）评估的下肢运动学。GPS与患者报告的结果之间的正相关性可以看作是定义是否可以在考虑手术时使用客观测量的步态指数的第一步，因为大多数步态偏差的患者都有望获得手术的大部分收益。