Foot pain and functional limitation in healthy adults with hallux valgus: a cross-sectional study

Nix, Sheree E., Vicenzino, Bill T. and Smith, Michelle D. (2012) Foot pain and functional limitation in healthy adults with hallux valgus: a cross-sectional study. BMC Musculoskeletal Disorders, 13 197.1-197.10. doi:10.1186/1471-2474-13-197

Author Nix, Sheree E.
Vicenzino, Bill T.
Smith, Michelle D.
Title Foot pain and functional limitation in healthy adults with hallux valgus: a cross-sectional study
Journal name BMC Musculoskeletal Disorders   Check publisher's open access policy
ISSN 1471-2474
Publication date 2012-10
Year available 2012
Sub-type Article (original research)
DOI 10.1186/1471-2474-13-197
Open Access Status DOI
Volume 13
Start page 197.1
End page 197.10
Total pages 10
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2013
Language eng
Formatted abstract
Background: Hallux valgus (HV) is a very common deformity of the first metatarsophalangeal joint that often requires surgical correction. However, the association between structural HV deformity and related foot pain and disability is unclear. Furthermore, no previous studies have investigated concerns about appearance and difficulty with footwear in a population with HV not seeking surgical correction. The aim of this cross-sectional study was to investigate foot pain, functional limitation, concern about appearance and difficulty with footwear in otherwise healthy adults with HV compared to controls.

Methods: Thirty volunteers with HV (radiographic HV angle >15 degrees) and 30 matched controls were recruited for this study (50 women, 10 men; mean age 44.4 years, range 20 to 76 years). Differences between groups were examined for self-reported foot pain and disability, satisfaction with appearance, footwear difficulty, and pressure-pain threshold at the first metatarsophalangeal joint. Functional measures included balance tests, walking performance, and hallux muscle strength (abduction and plantarflexion). Mean differences (MD) and 95% confidence intervals (CI) were calculated.

Results: All self-report measures showed that HV was associated with higher levels of foot pain and disability and significant concerns about appearance and footwear (p < 0.001). Lower pressure-pain threshold was measured at the medial first metatarsophalangeal joint in participants with HV (MD = -133.3 kPa, CI: -251.5 to -15.1). Participants with HV also showed reduced hallux plantarflexion strength (MD = -37.1 N, CI: -55.4 to -18.8) and abduction strength (MD = -9.8 N, CI: -15.6 to -4.0), and increased mediolateral sway when standing with both feet with eyes closed (MD = 0.34 cm, CI: 0.04 to 0.63).

Conclusions: These findings show that HV negatively impacts on self-reported foot pain and function, and concerns about foot appearance and footwear in otherwise healthy adults. There was also evidence of impaired hallux muscle strength and increased postural sway in HV subjects compared to controls, although general physical functioning and participation in physical activity were not adversely affected.
Keyword Hallux valgus
Foot pain
Physical function
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article 197

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Health and Rehabilitation Sciences Publications
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