Abstract
BackgroundPedobarography offers dynamic information about the foot, but the interpretation of its large data is challenging. In a prior study it was shown that attention can be restricted to pedobarographic midfoot load data. We aim to verify this observation in ankle osteoarthritic and contralateral feet.MethodsWe assessed both feet of 120 patients with end-stage ankle osteoarthritis (OA) and 35 healthy volunteers with AOFAS-score and dynamic pedobarography in barefoot condition. We introduce a new parameter, the Relative Midfoot Index (RMI), representing the depth of the midfoot weighted by the maximal force (MF) in the hindfoot and forefoot. Main outcome measures were the RMI, MF and contact times in the hindfoot, midfoot and forefoot. Ankle OA, contralateral and healthy feet were compared with ANOVA.ResultsThe RMI was significantly smaller in OA feet (0.65 ± 0.19) and contralateral feet (0.69 ± 0.15) than in healthy feet (0.84 ± 0.08, p < 0.0001). There was no significant difference between OA and contralateral feet. The RMI showed a correlation of 0.48 with the AOFAS score. Contralateral and OA feet were significantly different from healthy feet (p < 0.001) in all parameters except the hindfoot MF. An RMI <0.8 showed a positive predictive value of 80% and sensitivity of 78% for being unhealthy.ConclusionThe RMI assists the interpretation of pedobarographic parameters and provides a user-friendly indicator for unhealthy foot conditions with a cut-off value of 0.8. The contralateral feet of ankle OA patients differed significantly from healthy feet and are therefore not suitable as control group.Level of Evidence: 3 case control study
Highlights
Pedobarography offers dynamic information about the foot, but the interpretation of its large data is challenging
The value for the Relative Midfoot Index (RMI) was significantly smaller in osteoarthritic feet compared to healthy feet (p < 0.0001)
As regards the cut-off, results showed that a relative midfoot index of 0.8 was the best compromise with a positive predictive value of 80% and sensitivity of 78% to determine whether a foot is healthy or not (Table 3)
Summary
Pedobarography offers dynamic information about the foot, but the interpretation of its large data is challenging. Pedobarography offers dynamic information about the foot during the rollover process and adds in important ways to static radiographic imaging It is performed in the research setting, requires little time, and has low costs compared to a more complex three dimensional gait analysis. Such a measurement provides values of 72–198 (4 to 11 times 18) parameters for each foot [9] These raw data are hard to interpret, and left unprocessed they provide no useful information. For this reason different authors have chosen to focus on selected parameters: average pressure [10], peak pressure [11], pressure time integral and contact time [1, 12]. It remains unclear whether selectively focussing on one of these is appropriate because
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