Functional impairments characterizing mild, moderate, and severe hallux valgus

Hurn, Sheree E., Vicenzino, Bill and Smith, Michelle D. (2015) Functional impairments characterizing mild, moderate, and severe hallux valgus. Arthritis Care and Research, 67 1: 80-88. doi:10.1002/acr.22380

Author Hurn, Sheree E.
Vicenzino, Bill
Smith, Michelle D.
Title Functional impairments characterizing mild, moderate, and severe hallux valgus
Journal name Arthritis Care and Research   Check publisher's open access policy
ISSN 2151-4658
Publication date 2015-01
Year available 2014
Sub-type Article (original research)
DOI 10.1002/acr.22380
Open Access Status
Volume 67
Issue 1
Start page 80
End page 88
Total pages 9
Place of publication Hoboken NJ, United States
Publisher John Wiley & Sons
Collection year 2015
Language eng
Formatted abstract

Hallux valgus (HV) has been linked to functional disability and increased risk of falls, but mechanisms underpinning functional disability are unclear. This study investigated functional performance, muscle strength, and plantar pressures in adults with mild, moderate, and severe HV compared to controls, while considering the influence of foot pain.


Sixty adults with HV (classified as mild, moderate, and severe on dorsalplantar radiographs) and 30 controls participated. Measures included hallux plantar flexion and abduction strength, walking performance, postural sway, and forefoot plantar pressures. Multivariate analysis of covariance and pairwise comparisons (P < 0.05 after Bonferroni adjustment) were used to investigate differences between groups, adjusting for age, sex, body mass index, and foot pain.


Hallux plantar flexion and abduction strength were significantly reduced in those with moderate (mean differences: plantar flexion −45.8 N, abduction −12.3 N; P < 0.001) and severe HV (plantar flexion −50.1 N; P < 0.001, abduction −11.2 N; P = 0.01) compared to controls. A significant reduction in hallux peak pressure and pressure-time integral was evident in moderate (peak pressure −90.8 kPa; P < 0.001) and severe HV (peak pressure −106.2 kPa; P < 0.001) compared to controls. Those with severe HV also demonstrated increased mediolateral postural sway in single leg stance compared to controls (3.5 cm; P = 0.01).


Moderate to severe HV is associated with reduced hallux plantar pressures and strength measures, while relatively normal function compared to controls was found in those with mild deformity. Greater understanding of specific functional deficits associated with different stages of HV will help inform clinical management and future research.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 27 Dec 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Health and Rehabilitation Sciences Publications
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