title: Hallux valgus and plantar pressure loading: the Framingham foot study.
abstract: BACKGROUND
  Hallux valgus (HV), a common structural foot deformity, can cause foot pain and lead to limited mobility. The purpose of this study was to evaluate differences in plantar pressure and force during gait by HV status in a large population-based cohort of men and women.
  
  
  METHODS
  A trained examiner performed a validated physical examination on participants' feet and recorded the presence of hallux valgus and other specific foot disorders. Each foot was classified into one of four mutually exclusive groups based on the foot examination. Foot groups were: (i) HV only, (ii) HV and at least one additional foot disorder (FD), (iii) no HV but at least one other FD, and (iv) neither HV nor FD (referent). Biomechanical data for both feet were collected using Tekscan Matscan. Foot posture during quiet standing, using modified arch index (MAI), and foot function during gait, using center of pressure excursion index (CPEI), were calculated per foot. Further, walking scans were masked into eight sub-regions using Novel Automask, and peak pressure and maximum force exerted in each region were calculated.
  
  
  RESULTS
  There were 3205 participants, contributing 6393 feet with complete foot exam data and valid biomechanical measurements. Participants with HV had lower hallucal loading and higher forces at lesser toes as well as higher MAI and lower CPEI values compared to the referent. Participants with HV and other FDs were also noted to have aberrant rearfoot forces and pressures.
  
  
  CONCLUSIONS
  These results suggest that HV alters foot loading patterns and pressure profiles. Future work should investigate how these changes affect the risk of other foot and lower extremity ailments.
authors.affiliation: Institute for Aging Research at Hebrew Senior Life, 1200 Centre Street, Boston, MA, USA.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Galica
authors.affiliation: Institute for Aging Research at Hebrew Senior Life, 1200 Centre Street, Boston, MA, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Hagedorn
authors.affiliation: Institute for Aging Research at Hebrew Senior Life, 1200 Centre Street, Boston, MA, USA.|Beth Israel Deaconess Medical Center, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Alyssa B
authors.initials: AB
authors.lastname: Dufour
authors.affiliation: Glasgow Caledonian University, Glasgow, UK.
authors.forename: Jody L
authors.initials: JL
authors.lastname: Riskowski
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Hillstrom
authors.affiliation: Institute for Aging Research at Hebrew Senior Life, 1200 Centre Street, Boston, MA, USA.
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Casey
authors.affiliation: Institute for Aging Research at Hebrew Senior Life, 1200 Centre Street, Boston, MA, USA.|Beth Israel Deaconess Medical Center, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Marian T
authors.initials: MT
authors.lastname: Hannan