title: Spatiotemporal gait parameters and plantar pressure distribution during barefoot walking in people with gout and asymptomatic hyperuricemia: comparison with healthy individuals with normal serum urate concentrations.
abstract: BACKGROUND
  To identify spatiotemporal gait parameters and plantar pressure distribution during barefoot walking in people with gout and people with asymptomatic hyperuricemia by comparing them to healthy individuals with normal serum urate concentrations.
  
  
  METHODS
  Eighty-seven participants were included: 24 with gout, 29 with asymptomatic hyperuricemia and 34 age- and sex-matched normouricemic control participants. Spatiotemporal parameters of gait were assessed during level barefoot walking using a GAITRite® walkway. Peak plantar pressure and pressure time integrals were recorded using a TekScan MatScan®. Results were adjusted for age and body mass index.
  
  
  RESULTS
  Compared to normouricemic control participants, participants with gout demonstrated increased step time (P = 0.022) and stance time (P = 0.022), and reduced velocity (P = 0.050). Participants with gout also walked with decreased peak pressure at the heel (P = 0.012) and hallux (P = 0.036) and increased peak pressure (P < 0.001) and pressure time integrals (P = 0.005) at the midfoot. Compared to normouricemic control participants, participants with asymptomatic hyperuricemia demonstrated increased support base (P = 0.002), double support time (P < 0.001) and cadence (P = 0.028) and reduced swing time (P = 0.019) and single support time (P = 0.020) as well as increased pressure at the midfoot (P = 0.013), first metatarsal (P = 0.015) and second metatarsal (P = 0.007).
  
  
  CONCLUSIONS
  During barefoot walking, people with gout walk slower with plantar pressure patterns suggestive of apropulsive and antalgic gait strategies. Individuals with asymptomatic hyperuricemia also demonstrate altered barefoot gait patterns when compared to normouricemic control participants. Clinicians may consider dynamic gait outcomes when assessing and managing foot and lower limb related pain and disability in individuals with gout and asymptomatic hyperuricemia.
authors.affiliation: Department of Podiatry, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Sarah
authors.initials: S
authors.lastname: Stewart
authors.affiliation: Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand ; Department of Rheumatology, Auckland District Health Board, P.O. Box 92189, Auckland, New Zealand.
authors.forename: Nicola
authors.initials: N
authors.lastname: Dalbeth
authors.affiliation: Department of Biostatistics & Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland, 1142 New Zealand ; Health Intelligence & Informatics, Ko Awatea, Counties Manukau Health, Private Bag 93311, Auckland, 1640 New Zealand.
authors.forename: Alain C
authors.initials: AC
authors.lastname: Vandal
authors.affiliation: Department of Podiatry, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Keith
authors.initials: K
authors.lastname: Rome
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005528:Foot / Q000503:physiopathology*; D005684:Gait / Q000502:physiology*; D006073:Gout / Q000503:physiopathology*; D006801:Humans; D033461:Hyperuricemia / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D014527:Uric Acid / Q000097:blood; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology
chemical_list: D014527:Uric Acid
keywords: Asymptomatic hyperuricemia; Gait; Gout; Plantar pressure