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- DOI: 10.1002/acr.22826
- PMID: 26713755
- UKPMCID: 26713755
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Are Pressure Time Integral and Cumulative Plantar Stress Related to 1(st) Metatarsophalangeal Joint Pain: The Multicenter Osteoarthritis Study.
Rao, Smita; Gross, K Douglas; Niu, Jingbo; Nevitt, Michael; Lewis, Beth; Torner, James; Hietpas, Jean; Felson, David; Hillstrom, Howard
Arthritis care & research. 2015;[Epub ahead of print].
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Full-text held externally
- DOI: 10.1002/acr.22826
- PMID: 26713755
- UKPMCID: 26713755
Abstract
OBJECTIVE: To examine the relationship between plantar stress over a step, cumulative plantar stress over a day and 1(st) metatarsophalangeal (MTP) joint pain among older adults. METHODS: Plantar stress and 1(st) MTP pain were assessed within the Multicenter Osteoarthritis Study (MOST). All included participants were asked if they had pain, aching or stiffness at the 1(st) MTP joint on most days for the past 30 days. Pressure time integral (PTI) was quantified as participants walked on a pedobarograph, and mean steps per day were obtained using an accelerometer. Cumulative plantar stress was calculated as the product of regional PTI and mean steps per day. Quintiles of hallucal and 2(nd) metatarsal PTI and cumulative plantar stress were generated. The relationship between predictors and the odds ratio of 1(st) MTP pain was assessed using a logistic regression model. RESULTS: Feet in the quintile with the lowest hallux PTI had 2.14 times increased odds of 1(st) MTP pain (95% confidence interval [95% CI]:1.42-3.25, p<0.01). Feet in the quintile with the lowest 2(nd) metatarsal PTI had 1.50 times increased odds of 1(st) MTP pain (95% CI:1.01-2.23, p=0.042). Cumulative plantar stress was unassociated with 1(st) MTP pain. CONCLUSION: Lower PTI was modestly associated with increased prevalence of frequent 1st MTP pain at both the hallux and 2(nd) metatarsal. Lower plantar loading may indicate the presence of an antalgic gait strategy and may reflect an attempt at pain avoidance. The lack of association with cumulative plantar stress may suggest that they do not limit their walking as a pain-avoidance mechanism. This article is protected by copyright. All rights reserved.
Keyword(s)
Foot pain; cumulative stress; gait; metatarsophalangeal; plantar pressure; walking