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Associations of foot and ankle characteristics with knee symptoms and function in individuals with patellofemoral osteoarthritis

journal contribution
posted on 10.11.2020, 23:39 by Jade Tan, Kay Crossley, Shannon Munteanu, Natalie J Collins, Harvi Hart, Joel W Donnar, G Cleary, IC O'Sullivan, LR Maclachlan, Catherine Derham, Hylton Menz
© 2020 The Author(s). Background: Foot and ankle characteristics are associated with patellofemoral pain (PFP) and may also relate to patellofemoral osteoarthritis (PFOA). A greater understanding of these characteristics and PFOA, could help to identify effective targeted treatments. Objectives: To determine whether foot and ankle characteristics are associated with knee symptoms and function in individuals with PFOA. Methods: For this cross-sectional study we measured weightbearing ankle dorsiflexion range of motion, foot posture (via the Foot Posture Index [FPI]), and midfoot mobility (via the Foot Measurement Platform), and obtained patient-reported outcomes for knee symptoms and function (100 mm visual analogue scales, Anterior Knee Pain Scale [AKPS], Knee injury and Osteoarthritis Outcome Score, repeated single step-ups and double-leg sit-to-stand to knee pain onset). Pearson's r with significance set at p < 0.05 was used to determine the association between foot and ankle charateristics, with knee symptoms and function, adjusting for age. Results: 188 participants (126 [67%] women, mean [SD] age of 59.9 [7.1] years, BMI 29.3 [5.6] kg/m2) with symptomatic PFOA were included in this study. Lower weightbearing ankle dorsiflexion range of motion had a small significant association with higher average knee pain (partial r = - 0.272, p < 0.001) and maximum knee pain during stair ambulation (partial r = - 0.164, p = 0.028), and lower scores on the AKPS (indicative of greater disability; partial r = 0.151, p = 0.042). Higher FPI scores (indicating a more pronated foot posture) and greater midfoot mobility (foot mobility magnitude) were significantly associated with fewer repeated single step-ups (partial r = - 0.181, p = 0.023 and partial r = - 0.197, p = 0.009, respectively) and double-leg sit-to-stands (partial r = - 0.202, p = 0.022 and partial r = - 0.169, p = 0.045, respectively) to knee pain onset, although the magnitude of these relationships was small. The amount of variance in knee pain and disability explained by the foot and ankle characteristics was small (R2-squared 2 to 8%). Conclusions: Lower weightbearing ankle dorsiflexion range of motion, a more pronated foot posture, and greater midfoot mobility demonstrated small associations with worse knee pain and greater disability in individuals with PFOA. Given the small magnitude of these relationships, it is unlikely that interventions aimed solely at addressing foot and ankle mobility will have substantial effects on knee symptoms and function in this population. Trial registration: The RCT was prospectively registered on 15 March 2017 with the Australia and New Zealand Clinical Trials Registry (ANZCTRN12617000385347).

Funding

This work is supported by the National Health and Medical Research Council (Australia) (ID: 1106852; 2016-2019). JMT is currently receiving a La Trobe PhD stipend scholarship. HBM is currently a National Health and Medical Research Council Senior Research Fellow (ID: 1135995). NJC previously held a University of Queensland Postdoctoral Research Fellowship (2015-2017). HFH is currently funded by a Transdisciplinary Bone & Joint Training Award from the Collaborative Training Program in Musculoskeletal Health Research at Western University. The funding source and supporting bodies had no role in the design, execution, analyses, and interpretation of data in this study.

National Health and Medical Research Council (Australia) | 1106852

La Trobe PhD stipend scholarship

Collaborative Training Program in Musculoskeletal Health Research at Western University

History

Publication Date

23/09/2020

Journal

Journal of Foot and Ankle Research

Volume

13

Issue

1

Article Number

57

Pagination

10p.

Publisher

BioMed Central

ISSN

1757-1146

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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