Association of Decreased Physical Activity with Rheumatoid Mid-Hindfoot Deformity/Destruction

Takaaki Noguchi, Makoto Hirao, Shigeyoshi Tsuji, Kosuke Ebina, Hideki Tsuboi, Yuki Etani, Shosuke Akita and Jun Hashimoto
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Takaaki Noguchi: Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kawachinagano 586-8521, Osaka, Japan
Makoto Hirao: Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan
Shigeyoshi Tsuji: Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kawachinagano 586-8521, Osaka, Japan
Kosuke Ebina: Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita City 565-0871, Osaka, Japan
Hideki Tsuboi: Department of Orthopaedic Surgery, Osaka Rosai Hospital, 1179-3 Kita Ward Nagasonecho, Sakai 591-8025, Osaka, Japan
Yuki Etani: Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan
Shosuke Akita: Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kawachinagano 586-8521, Osaka, Japan
Jun Hashimoto: Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kawachinagano 586-8521, Osaka, Japan

IJERPH, 2021, vol. 18, issue 19, 1-11

Abstract: Foot/ankle problems remain important issues in rheumatoid arthritis (RA) patients. Although forefoot deformity generally takes a major place in surgical treatment, concomitant mid-hindfoot deformity is also commonly seen. In this situation, it can be easy to overlook that mid-hindfoot deformity can also induce or exacerbate clinical problems behind the forefoot events. Thus, the relationship between mid-hindfoot deformity/destruction and physical activity/ADL was investigated. Radiographic findings of 101 lower limbs (59 patients) were retrospectively evaluated. Alignment parameters in the lower extremity and joint destruction grade (Larsen grade) were measured. The timed-up-and-go (TUG) test, modified health assessment questionnaire (mHAQ), pain, self-reported scores for the foot and ankle (SAFE-Q), and RA disease activity were investigated to assess clinical status. The relationships among these parameters were evaluated. Subtalar joint destruction was correlated with TUG time (r = 0.329), mHAQ score (r = 0.338), and SAFE-Q: social functioning (r = 0.332). TUG time was correlated with the HKA (r = ?0.527), talo-1st metatarsal angle (r = 0.64), calcaneal pitch angle (r = ?0.433), M1-M5A (r = ?0.345), and M2-M5A (r = ?0.475). On multivariable linear regression analysis, TUG time had a relatively strong correlation with the talo-1st metatarsal angle (? = 0.452), and was negatively correlated with calcaneal pitch angle (? = ?0.326). Ankle joint destruction was also correlated with TUG time (? = 0.214). Development of structural problems or conditions in mid-hindfoot, especially flatfoot deformity, were related with decreased physical activity in RA patients. Wearing an insole (arch support) as a preventative measure and short foot exercise should be considered from the early phase of deformity/destruction in the mid-hindfoot in the management of RA.

Keywords: physical activity/activity; daily living; midfoot; hindfoot; flatfoot; rheumatoid arthritis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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