title: Adaptive changes of foot pressure in hallux valgus patients.
abstract: BACKGROUND
  Hallux valgus (HV) is one of the most common deformities in podiatric and orthopedic practice. Plantar pressure technology has been widely used in studying the pressure distribution in HV patients for better assessment to plan interventions. However, previous studies produced an array of controversial findings and most of them only focused on the forefoot.
  
  
  METHODS
  We examined the dynamic changes of foot pressure of the whole foot with a large-sample investigation (229 patients and 35 controls). Foot pain, which has been largely neglected previously, was used to group the participants.
  
  
  RESULTS
  Compared to healthy controls, patients had significantly higher loading of the first and second metatarsals, where the transverse arch usually collapses, and significantly less loading of the hallux. Moreover, forces in most regions reached their maximum late, indicating a slow build-up of loading. Patients shortened the loading duration on their forefoot, loaded more on the medial foot starting from early foot contact, and delayed the medial-to-lateral load transition. Notably, nearly all these changes were more pronounced in patients with pain.
  
  
  CONCLUSIONS
  Biomechanical changes in HV patients are not only caused by physical deformity but also by modified neural control strategies, possibly to alleviate discomfort and to accommodate the foot deformity. Our results suggest that dynamic evaluation of the whole foot and consideration of foot pain are necessary for the functional assessment of foot pressure in HV patients. The foot balance changes have important clinical implications.
authors.affiliation: Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Wen
authors.forename: Qicheng
authors.initials: Q
authors.lastname: Ding
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Yu
authors.forename: Weidong
authors.initials: W
authors.lastname: Sun
authors.forename: Qining
authors.initials: Q
authors.lastname: Wang
authors.forename: Kunlin
authors.initials: K
authors.lastname: Wei
mesh_terms: D000054:Acceleration; D000222:Adaptation, Physiological; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D001835:Body Weight; D003430:Cross-Sectional Studies; D005260:Female; D005545:Forefoot, Human / Q000503:physiopathology; D005684:Gait / Q000502:physiology; D006215:Hallux Valgus / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology; D011312:Pressure; D011859:Radiography; D012016:Reference Values; D013314:Stress, Mechanical; D016474:Weight-Bearing