title: Hallux valgus surgery may produce early improvements in balance control: results of a cross-sectional pilot study.
abstract: BACKGROUND
  Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance.
  
  
  METHODS
  Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants. Assessments were made in the clinic using body-worn sensors.
  
  
  RESULTS
  Patients in the preoperative group generally demonstrated poorer static balance control compared with the other two groups. Despite similar age and body mass index, postoperative patients exhibited 29% and 63% less center of mass sway than preoperative patients during double-and single-support balance assessments, respectively (analysis of variance P =.17 and P =.14, respectively [both eyes open condition]). Overall, gait performance was similar among the groups, except for speed during gait initiation, where lower speeds were encountered in the postoperative group compared with the preoperative group (Scheffe P = .049).
  
  
  CONCLUSIONS
  This study provides supportive evidence regarding the benefits of corrective lower-extremity surgery on certain aspects of balance control. Patients seem to demonstrate early improvements in static balance after corrective HV surgery, whereas gait improvements may require a longer recovery time. Further research using a longitudinal study design and a larger sample size capable of assessing the long-term effects of HV surgical correction on balance and gait is probably warranted.
authors.affiliation: Center for Lower Extremity Ambulatory Research, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL.
authors.forename: Saba
authors.initials: S
authors.lastname: Sadra
authors.forename: Adam
authors.initials: A
authors.lastname: Fleischer
authors.forename: Erin
authors.initials: E
authors.lastname: Klein
authors.forename: Gurtej S
authors.initials: GS
authors.lastname: Grewal
authors.forename: Jessica
authors.initials: J
authors.lastname: Knight
authors.forename: Lowell Scott
authors.initials: LS
authors.lastname: Weil
authors.forename: Lowell
authors.initials: L
authors.lastname: Weil
authors.forename: Bijan
authors.initials: B
authors.lastname: Najafi
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006215:Hallux Valgus / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010865:Pilot Projects; D011184:Postoperative Period; D004856:Postural Balance / Q000502:physiology*; D057234:Preoperative Period; D020127:Recovery of Function; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome