Biomechanical Podiatric Evaluation in an Italian Cohort of Patients with Systemic Sclerosis: A Pilot Study



The aim of the present pilot study was to evaluate podiatric problems in an Italian cohort of patients with Systemic sclerosis (SSc) by assessing their received podiatric services, foot pain and disabilities, and biomechanical foot deformities.

For this purpose, 25 consecutive SSc patients were enrolled from the Division of Rheumatology at the University of Florence.

All SSc patients were assessed by: Standards of Care for People with Foot Musculoskeletal Health problems: Audit Tool, Foot Function Index (FFI), Weight and non-weight bearing foot joint assessment, Foot Posture Index (FPI) and Gait Cycle, Health Assessment Questionnaire (HAQ) and Medical Outcomes Survey Short Form 36 (SF-36).

The findings of the study revealed that most of the patients with SSc had not received adequate information about foot health in SSc, and preventative information was scarce.

It was also observed that patients with SSc had less pain, disability and activity limitations compared to patients with rheumatoid arthritis (RA), which when assessed by the FFI, has an average value of 6.7.

Biomechanical evaluation of the subtalar joint showed that majority of the patients had a rearfoot varus deformity and that no patient presented a rearfoot valgus deformity.

The biomechanical evaluation of the midtarsal joint revealed the absence of a deformity, with 42 percent of the SSc patients presenting a forefoot varus deformity and 6 percent showing a forefoot valgus deformity.

Only 2 percent presented an equinus ankle deformity with limitation of ankle movement, both with the knee extended and flexed.

In addition, patients showed deformities of the first ray both in the dorsiflexed and plantar flexed positions.

The weight-bearing foot joint observation, made with the FPI demonstrated that patients with SSc have a pronated foot and a highly pronated overall foot posture much more commonly than healthy people.

References:

  1. Bongi, S. M., Ravenni, G., Ciampi, B., Rosso, A. D., Aoufy, K. E. (2016) Biomechanical Podiatric Evaluation in an Italian Cohort of Patients with Systemic Sclerosis: A Pilot Study. European Journal of Rheumatology: 2016, Vol. 3, pp. 169-174. DOI: 10.5152/eurjrheum.2016.053

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