title: Foot and ankle kinematics in rheumatoid arthritis: influence of foot and ankle joint and leg tendon pathologies.
abstract: OBJECTIVE
  From early onset of the disease, patients with rheumatoid arthritis (RA) experience walking impairments. Pathologic effects of RA on foot and ankle structures have been studied clinically, but little is known as to how they relate to kinematic changes during gait. The aim of this study was to explore the relationship between clinically observed pathologies of foot and ankle joints and leg tendons and the corresponding gait kinematics.
  
  
  METHODS
  The gait of 25 subjects with varying stages of RA was recorded and foot and ankle kinematics were assessed. Magnetic resonance imaging was performed for each subject: first metatarsophalangeal (MTP) joint, midfoot, and hindfoot synovitis, erosion scores, and leg tendon involvement were determined. The joint alignment and motion score represented daily clinical assessment. The 95% confidence intervals of the Spearman's correlation coefficient tests were used to explore the relationships between the clinical and kinematic parameters.
  
  
  RESULTS
  Maximum first MTP joint dorsiflexion at preswing was related to reduced first MTP joint passive motion, first MTP joint synovitis and erosion, midfoot synovitis and erosion, and hindfoot erosion. Midfoot pronation range of motion during single stance was related to subtalar alignment and Achilles tendon involvement. Hindfoot eversion range of motion during single stance was related to subtalar alignment and peroneus longus tendon involvement. Involvement of the tibialis posterior tendon could not be identified as an independent factor influencing foot or ankle kinematics.
  
  
  CONCLUSIONS
  Our findings suggest moderate to strong relationships between foot and ankle gait kinematics and structural pathologies.
authors.affiliation: Roessingh Research and Development, Enschede, The Netherlands. r.dubbeldam@rrd.nl
authors.forename: R
authors.initials: R
authors.lastname: Dubbeldam
authors.forename: H
authors.initials: H
authors.lastname: Baan
authors.forename: A V
authors.initials: AV
authors.lastname: Nene
authors.forename: K W
authors.initials: KW
authors.lastname: Drossaers-Bakker
authors.forename: M A F J
authors.initials: MA
authors.lastname: van de Laar
authors.forename: H J
authors.initials: HJ
authors.lastname: Hermens
authors.forename: J H
authors.initials: JH
authors.lastname: Buurke
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D005260:Female; D005528:Foot / Q000503:physiopathology*; D005684:Gait / Q000502:physiology*; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D052256:Tendinopathy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D013710:Tendons / Q000473:pathology*; D016138:Walking / Q000502:physiology; D055815:Young Adult