Abstract
ObjectivesOsteoarthritis (OA) of the foot-ankle complex is understudied. Understanding determinants of pain and activity limitations is necessary to improve management of foot OA. The aim of the present study was to investigate demographic, foot-specific and comorbidity-related factors associated with pain and activity limitations in patients with foot OA. MethodsThis exploratory cross-sectional study included 75 patients with OA of the foot and/or ankle joints. Demographic and clinical data were collected with questionnaires and by clinical examination. The outcome variables of pain and activity limitations were measured using the Foot Function Index (FFI). Potential determinants were categorized into demographic factors (e.g., age, sex), foot-specific factors (e.g., plantar pressure and gait parameters), and comorbidity-related factors (e.g., type and amount of comorbid diseases). Multivariable regression analyses with backward selection (p-out≥0.05) were performed in two steps, leading to a final model. ResultsOf all potential determinants, nine factors were selected in the first step. Five of these factors were retained in the second step (final model): female sex, pain located in the hindfoot, higher body mass index (BMI), neurological comorbidity, and Hospital Anxiety and Depression Scale (HADS) score were positively associated with the FFI score. The explained variance (R2) for the final model was 0.580 (adjusted R2 = 0.549). ConclusionFemale sex, pain located in the hindfoot, higher BMI, neurological comorbidity and greater psychological distress were independently associated with a higher level of foot-related pain and activity limitations. By addressing these factors in the management of foot OA, pain and activity limitations may be reduced.
Highlights
Osteoarthritis (OA) is a common, degenerative, and debilitating disease
Some studies have shown that demographic factors such as older age [6], female sex, and lower educational level in patients with foot OA [7] are associated with pain and activity limitations
Being female, having pain located in the hindfoot, a higher body mass index (BMI), neurological comorbidity and a higher Hospital Anxiety and Depression Scale (HADS) score were independently associated with a higher Foot Function Index (FFI) score, indicating a relationship with a higher level of foot-related pain and activity limitations
Summary
Osteoarthritis (OA) is a common, degenerative, and debilitating disease. Despite its high prevalence and the individual and societal burden of the disease, OA of the foot has not been studied extensively, in contrast to OA of the knee and hip [1,2,3,4]. Some studies have shown that demographic factors such as older age [6], female sex, and lower educational level in patients with foot OA [7] are associated with pain and activity limitations. These factors have been shown to be associated with worsening of pain and activity limitations in knee and hip OA [8,9]. In addition to these factors, foot-specific factors, such as the location and pattern of foot symptoms, radiographic joint damage, and plantar pressure distribution may
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