Plantar sensitivity, foot loading and walking pain in rheumatoid arthritis

Funktionsbereich Bewegungsanalytik Klinik und Poliklinik für Allgemeine Orthopädie, Universitätsklinikum Münster, Domagkstr. 3D-48129 Münster, Germany.
Rheumatology (Impact Factor: 4.48). 02/2006; 45(2):212-4. DOI: 10.1093/rheumatology/kei137
Source: PubMed


The aim of the present study was to investigate the tactile sensitivity of the plantar surface in rheumatoid feet and its relationship to walking pain and plantar foot loading characteristics.
In 25 patients with rheumatoid arthritis (RA) and 21 healthy controls, Semmes-Weinstein monofilaments were used to assess tactile sensitivity in six foot regions. Walking pain was examined clinically. Pedography was used to analyse foot loading parameters during barefoot walking.
In RA patients, plantar sensitivity was significantly decreased under all foot regions examined compared with the control group (P<0.05). A loss of protective sensation was found in a total of 10 regions in seven patients but not in the control group. In the RA patients, foot loading was reduced in the hindfoot (P<0.05) but was slightly increased in the forefoot (not significant). Average walking pain was 3.8 +/- 2.1 on a scale from 0 to 10 but did not correlate with the sensitivity levels.
In patients with RA, no direct relationship between pain intensity and plantar foot loading was found. The decreased tactile sensitivity may be indicative of a disturbed sensation for high plantar pressures. Therefore, pedography can be useful as an additional tool in the detection of excessive forefoot loading before complications are manifested.

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    • "The tactile sensitivity of the foot and the lower leg in rheumatic patients has been studied by a number of authors. The aim of their studies was to determine the causes of patients’ walking problems [6, 7]. "
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    ABSTRACT: IntroductionClinical symptoms of rheumatic diseases can cause changes in the level of skin tactile sensitivity.AimTo determine the tactile threshold of the hands in female patients with rheumatic diseases. It also attempted to determine correlations between rheumatic patients’ tactile sensitivity and the degree of articular movement limitations, the Barthel Index (BI) and Edinburgh Handedness Inventory (EHI) results, the level of disability of the right hand and the left hand as well as age, education and eyesight.Material and methodsNinety-nine female rheumatic patients aged 19–87 years took part in the study. The control group comprised 45 healthy women aged 23–80 years. The measurement of the tactile threshold was performed using the Touch-Test™ Sensory Evaluators (Semmes-Weinstein Monofilaments Test). The tactile threshold was measured at three sites on the hand: the little finger, the index finger and the metacarpus.ResultsThe patients’ tactile sensitivity ranges were classified as normal, diminished light touch and diminished protective touch. The degree of their disability was correlated with tactile sensitivity. The patients’ tactile sensitivity worsens with age, but it is not correlated with the level of education. The lateralization was similar to that of the control group and was not correlated with tactile sensitivity. The worsening eyesight, independent of rheumatic disease, corresponds, however, with decreasing tactile sensitivity.ConclusionsThe patients represented a group with a medium level of functional disability and lower tactile sensitivity.
    Postepy Dermatologii I Alergologii 06/2014; 31(3):139-45. DOI:10.5114/pdia.2014.40933 · 0.85 Impact Factor
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    • "Loading patterns of the injured foot are usually compared either with the contralateral foot (assuming that the healthy foot shows normal function) or with a group of healthy subjects. However, due to pain or discomfort, patients show substantial variations in gait dynamics compared to control, including the unaffected contralateral side not exhibiting a healthy walking pattern (Rosenbaum et al., 2006; Valderrabano et al., 2006). (4) Additionally, peak pressure values should be interpreted with caution, as local callosities or deformities may cause high peak pressures and alter the results. "
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    Gait & posture 02/2012; 36(1):157-9. DOI:10.1016/j.gaitpost.2012.01.013 · 2.75 Impact Factor
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