Gardner-Medwin, Janet

Hendry, Gordon J

Turner, Debbie E

Woodburn, Jim

English

PubMed

Gordon J Hendry

Janet Gardner-Medwin

Debbie E Turner

Jim Woodburn

Crossref

ORAL PRESENTATION Open AccessApplication of a novel multi-segment foot modelto assess foot function in children andadolescents with juvenile idiopathic arthritisGordon J Hendry1*, Janet Gardner-Medwin3, Debbie E Turner2, Jim Woodburn2From Australasian Podiatry Council Conference 2011Melbourne, Australia. 26-29 April 2011BackgroundFoot and ankle disease has been associated with impair-ments and disability in JIA, and altered gait patternshave been described. However, the extent to which dis-ease-related foot impairments impact on localised bio-mechanical foot function remains unknown. The aim ofthis study was to compare biomechanical foot functionbetween patients with JIA and healthy participants.Methods14 JIA patients with a history of foot disease and 10healthy controls were recruited. Participants underwent3D gait analysis, plantar foot pressure and spatio-tem-poral gait evaluation. Each participant completed theJuvenile Arthritis Foot Disability Index (JAFI) andCHAQ. US scores for effusions and synovial hypertro-phy, tender/swollen foot joint counts, and deformityscores were recorded to assess localised disease activityand impairments. Mean differences and 95% confidenceintervals (CI) were calculated using the t distribution.ResultsIn the JIA group there were low but variable levels oflocalised disease activity indicated by low median (range)scores for tender [0 (0-4); 0 (0-5)], and swollen foot joints[0 (0-3); 0 (0-3)], US effusions [2 (0-6); 3 (0-7)] and syno-vitis [0 (0-3); 0 (0-2)]. Mild to moderate foot relatedimpairments [JAFI; 1 (0-3)] and foot deformity scores[forefoot; 2 (0-7), 0.5 (0-5); rearfoot; 2.5 (1-5); 3.5 (2-5)]were observed. No significant differences were observedbetween group means for all core variables except rightpeak mid-foot dorsi-flexion [mean (95% CI) difference-3.04° (-5.79, -0.30)]. There were trends towards reducedwalking velocity [mean difference 7.81cm/s (-8.26,23.88)], greater variability in mid-foot contact area (cm2)[mean (SD) 19.77 (11.63); 19.04 (12.27) JIA group versus19.31 (5.29), 19.01 (4.46) controls], and lower peak fore-foot pressures (kPa) in the JIA group [mean difference59.33 (-58.38, 177.03); 13.36 (-121.02, 147.73)].ConclusionsAt the group level, foot function appeared normaldespite moderate levels of self reported impairment anddisability in participants with JIA. At the individual leveldetailed changes in foot function relevant to flat-footed-ness or highly arched foot types were detected. Preli-minary findings suggest that such foot types may beassociated with abnormal foot segment rotations.Further study is required to evaluate foot biomechanicsin clinically meaningful homogeneous subgroups of JIApatients.Author details1School of Biomedical and Health Sciences, University of Western Sydney,Sydney, Locked Bag 1797, Australia. 2Glasgow Caledonian University,Glasgow, G4 0BA, UK. 3University of Glasgow, Glasgow, G12 8QQ, UK.Published: 20 May 2011doi:10.1186/1757-1146-4-S1-O20Cite this article as: Hendry et al.: Application of a novel multi-segmentfoot model to assess foot function in children and adolescents withjuvenile idiopathic arthritis. Journal of Foot and Ankle Research 20114(Suppl 1):O20.* Correspondence: gordon.hendry@gcu.ac.uk1School of Biomedical and Health Sciences, University of Western Sydney,Sydney, Locked Bag 1797, AustraliaFull list of author information is available at the end of the articleHendry et al. Journal of Foot and Ankle Research 2011, 4(Suppl 1):O20http://www.jfootankleres.com/content/4/S1/O20JOURNAL OF FOOTAND ANKLE RESEARCH© 2011 Hendry et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.

Journal of Foot and Ankle Research

Application of a novel multi-segment foot model to assess foot function in children and adolescents with juvenile idiopathic arthritis

Springer - Publisher Connector

ORAL PRESENTATION Open Access
Application of a novel multi-segment foot model
to assess foot function in children and
adolescents with juvenile idiopathic arthritis
Gordon J Hendry1*, Janet Gardner-Medwin3, Debbie E Turner2, Jim Woodburn2
From Australasian Podiatry Council Conference 2011
Melbourne, Australia. 26-29 April 2011
Background
Foot and ankle disease has been associated with impair-
ments and disability in JIA, and altered gait patterns
have been described. However, the extent to which dis-
ease-related foot impairments impact on localised bio-
mechanical foot function remains unknown. The aim of
this study was to compare biomechanical foot function
between patients with JIA and healthy participants.
Methods
14 JIA patients with a history of foot disease and 10
healthy controls were recruited. Participants underwent
3D gait analysis, plantar foot pressure and spatio-tem-
poral gait evaluation. Each participant completed the
Juvenile Arthritis Foot Disability Index (JAFI) and
CHAQ. US scores for effusions and synovial hypertro-
phy, tender/swollen foot joint counts, and deformity
scores were recorded to assess localised disease activity
and impairments. Mean differences and 95% confidence
intervals (CI) were calculated using the t distribution.
Results
In the JIA group there were low but variable levels of
localised disease activity indicated by low median (range)
scores for tender [0 (0-4); 0 (0-5)], and swollen foot joints
[0 (0-3); 0 (0-3)], US effusions [2 (0-6); 3 (0-7)] and syno-
vitis [0 (0-3); 0 (0-2)]. Mild to moderate foot related
impairments [JAFI; 1 (0-3)] and foot deformity scores
[forefoot; 2 (0-7), 0.5 (0-5); rearfoot; 2.5 (1-5); 3.5 (2-5)]
were observed. No significant differences were observed
between group means for all core variables except right
peak mid-foot dorsi-flexion [mean (95% CI) difference
-3.04° (-5.79, -0.30)]. There were trends towards reduced
walking velocity [mean difference 7.81cm/s (-8.26,
23.88)], greater variability in mid-foot contact area (cm2)
[mean (SD) 19.77 (11.63); 19.04 (12.27) JIA group versus
19.31 (5.29), 19.01 (4.46) controls], and lower peak fore-
foot pressures (kPa) in the JIA group [mean difference
59.33 (-58.38, 177.03); 13.36 (-121.02, 147.73)].
Conclusions
At the group level, foot function appeared normal
despite moderate levels of self reported impairment and
disability in participants with JIA. At the individual level
detailed changes in foot function relevant to flat-footed-
ness or highly arched foot types were detected. Preli-
minary findings suggest that such foot types may be
associated with abnormal foot segment rotations.
Further study is required to evaluate foot biomechanics
in clinically meaningful homogeneous subgroups of JIA
patients.
Author details
1School of Biomedical and Health Sciences, University of Western Sydney,
Sydney, Locked Bag 1797, Australia. 2Glasgow Caledonian University,
Glasgow, G4 0BA, UK. 3University of Glasgow, Glasgow, G12 8QQ, UK.
Published: 20 May 2011
doi:10.1186/1757-1146-4-S1-O20
Cite this article as: Hendry et al.: Application of a novel multi-segment
foot model to assess foot function in children and adolescents with
juvenile idiopathic arthritis. Journal of Foot and Ankle Research 2011
4(Suppl 1):O20.
* Correspondence: gordon.hendry@gcu.ac.uk
1School of Biomedical and Health Sciences, University of Western Sydney,
Sydney, Locked Bag 1797, Australia
Full list of author information is available at the end of the article
Hendry et al. Journal of Foot and Ankle Research 2011, 4(Suppl 1):O20
http://www.jfootankleres.com/content/4/S1/O20
JOURNAL OF FOOT
AND ANKLE RESEARCH
© 2011 Hendry et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


Turner Debbie E

Gardner-Medwin Janet

Hendry Gordon J

Woodburn Jim

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Application of a novel multi-segment foot model to assess foot function in children and adolescents with juvenile idiopathic arthritis

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