J. Woodburn et Ps. Helliwell, RELATION BETWEEN HEEL POSITION AND THE DISTRIBUTION OF FOREFOOT PLANTAR PRESSURES AND SKIN CALLOSITIES IN RHEUMATOID-ARTHRITIS, Annals of the Rheumatic Diseases, 55(11), 1996, pp. 806-810
Objective-To investigate the relation between the position of the rear
foot and the distribution of forefoot plantar pressures and skin callo
sities in rheumatoid arthritis. Methods-Plantar pressures and callosit
y patterns were measured in 102 rheumatoid arthritis patients (120 fee
t with normal. heel alignment and 84 feet with valgus heel alignment m
easured by goniometry) and in 42 (84 feet) age matched healthy adults.
Peak pressures (kPa) were measured across the metatarsal heads in-sho
e using an FScan system and the distribution of plantar callosities wa
s visually mapped for each foot. Results-Peak pressures were significa
ntly greater at all but the first metatarsal head in the rheumatoid no
rmal heel alignment and healthy adult groups than in the rheumatoid va
lgus heel group. The feet of both the rheumatoid normal heel group and
the healthy adult group behaved the same, the highest peak pressures
registering on the central metatarsal heads. However, only in the rheu
matoid group were plantar callosities found at these sites. In the rhe
umatoid valgus heel group, lateral metatarsal heads were frequently no
n-weightbearing, producing gross loading patterns with a dominant medi
al distribution. Peak pressures were shifted to the medial forefoot ac
companied by a higher prevalence of callosities. The results, however,
failed to establish clearly an association between peak pressures and
callus formation. Conclusions-In rheumatoid arthritis there is an imp
ortant interrelation between the rearfoot position and forefoot pressu
re sites.