title: Facilitating the interpretation of pedobarography: the relative midfoot index as marker for pathologic gait in ankle osteoarthritic and contralateral feet.
abstract: BACKGROUND
  Pedobarography offers dynamic information about the foot, but the interpretation of its large data is challenging. In a prior study it was shown that attention can be restricted to pedobarographic midfoot load data. We aim to verify this observation in ankle osteoarthritic and contralateral feet.
  
  
  METHODS
  We assessed both feet of 120 patients with end-stage ankle osteoarthritis (OA) and 35 healthy volunteers with AOFAS-score and dynamic pedobarography in barefoot condition. We introduce a new parameter, the Relative Midfoot Index (RMI), representing the depth of the midfoot weighted by the maximal force (MF) in the hindfoot and forefoot. Main outcome measures were the RMI, MF and contact times in the hindfoot, midfoot and forefoot. Ankle OA, contralateral and healthy feet were compared with ANOVA.
  
  
  RESULTS
  The RMI was significantly smaller in OA feet (0.65 ± 0.19) and contralateral feet (0.69 ± 0.15) than in healthy feet (0.84 ± 0.08,p <0.0001). There was no significant difference between OA and contralateral feet. The RMI showed a correlation of 0.48 with the AOFAS score. Contralateral and OA feet were significantly different from healthy feet (p <0.001) in all parameters except the hindfoot MF. An RMI <0.8 showed a positive predictive value of 80% and sensitivity of 78% for being unhealthy.
  
  
  CONCLUSIONS
  The RMI assists the interpretation of pedobarographic parameters and provides a user-friendly indicator for unhealthy foot conditions with a cut-off value of 0.8. The contralateral feet of ankle OA patients differed significantly from healthy feet and are therefore not suitable as control group. Level of Evidence: 3 case control study.
authors.affiliation: Orthopedic Department, University of Basel, Basel, Switzerland.
authors.forename: Frigg
authors.initials: F
authors.lastname: Arno
authors.affiliation: Department of Philosophy, Logic and Scientific Method, London School of Economics, London, UK.
authors.forename: Frigg
authors.initials: F
authors.lastname: Roman
authors.affiliation: Orthopedic Department, University of Basel, Basel, Switzerland.
authors.forename: Wiewiorski
authors.initials: W
authors.lastname: Martin
authors.affiliation: Orthopedic Department, University of Basel, Basel, Switzerland.
authors.forename: Goldoni
authors.initials: G
authors.lastname: Jennifer
authors.affiliation: Orthopedic Department, University of Basel, Basel, Switzerland.
authors.forename: Horisberger
authors.initials: H
authors.lastname: Monika
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D005528:Foot / Q000503:physiopathology*; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology*; D011312:Pressure; D016474:Weight-Bearing / Q000502:physiology
keywords: Ankle osteoarthritis; Contralateral feet; Control group; Gait; Pedobarography