title: Plantar forefoot pressures in psoriatic arthritis-related dactylitis: an exploratory study.
abstract: Dactylitis is a common feature of psoriatic arthritis (PsA); local physical trauma has been identified as a possible contributing factor. The aim of this study was to explore differences in forefoot plantar pressures in patients with PsA with and without dactylitis and compare to healthy controls. Thirty-six participants were recruited into three groups: group A PsA plus a history of dactylitis; group B PsA, no dactylitis; group C control participants. Forefoot plantar pressures were measured barefoot and in-shoe at the left second and fourth toes and corresponding metatarsophalangeal joints. Temporal and spatial parameters were measured and data from the foot impact scale for rheumatoid arthritis (FIS-RA), EQ5D and health assessment questionnaire (HAQ) were collected. Pressure time integral peak plantar pressure, and contact time barefoot and in-shoe were not significantly different between groups. Temporal and spatial parameters reported no significant differences between groups. ANOVA analysis and subsequent post hoc testing using Games-Howell test yielded significance in FIS-RA scores between both PsA groups versus controls, A p ≤ 0.0001 and PsA group B p < 0.0001 in the FIS-RA impairment and footwear domain, PsA group A p < 0.03 and PsA group B p ≤ 0.05 in the FIS-RA activity and participation domain compared to controls. This is the first exploratory study to investigate forefoot plantar pressures in patients with and without historical dactylitis in PsA. FIS-RA scores indicate PsA patients have significant limitations compared to controls, although a history of dactylitis does not appear to worsen patient reported outcomes.
authors.affiliation: Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK. r.a.wilkins@leeds.ac.uk.|Foot Health Department, Leeds Teaching Hospitals NHS Trust, Lower Ground Floor, Chancellor Wing, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK. r.a.wilkins@leeds.ac.uk.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Wilkins
authors.affiliation: Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.|Foot Health Department, Leeds Teaching Hospitals NHS Trust, Lower Ground Floor, Chancellor Wing, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Siddle
authors.affiliation: Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Redmond
authors.affiliation: Section of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.|Rheumatology Department, Bradford Teaching Hospitals NHS foundation Trust, St Luke's Hospital, Little Horton Lane, Bradford, BD5 0NA, UK.
authors.forename: Philip S
authors.initials: PS
authors.lastname: Helliwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015535:Arthritis, Psoriatic / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005534:Foot Diseases / Q000209:etiology / Q000503:physiopathology*; D005545:Forefoot, Human / Q000503:physiopathology*; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012775:Shoes; D014034:Toes / Q000503:physiopathology*; D055815:Young Adult
keywords: Dactylitis; Plantar pressure measurement; Psoriatic arthritis; Toe