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Article

Association of Decreased Physical Activity with Rheumatoid Mid-Hindfoot Deformity/Destruction

1
Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kawachinagano 586-8521, Osaka, Japan
2
Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan
3
Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita City 565-0871, Osaka, Japan
4
Department of Orthopaedic Surgery, Osaka Rosai Hospital, 1179-3 Kita Ward Nagasonecho, Sakai 591-8025, Osaka, Japan
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(19), 10037; https://doi.org/10.3390/ijerph181910037
Received: 31 August 2021 / Revised: 21 September 2021 / Accepted: 23 September 2021 / Published: 24 September 2021
(This article belongs to the Section Global Health)
Foot/ankle problems remain important issues in rheumatoid arthritis (RA) patients. Although forefoot deformity generally takes a major place in surgical treatment, concomitant mid-hindfoot deformity is also commonly seen. In this situation, it can be easy to overlook that mid-hindfoot deformity can also induce or exacerbate clinical problems behind the forefoot events. Thus, the relationship between mid-hindfoot deformity/destruction and physical activity/ADL was investigated. Radiographic findings of 101 lower limbs (59 patients) were retrospectively evaluated. Alignment parameters in the lower extremity and joint destruction grade (Larsen grade) were measured. The timed-up-and-go (TUG) test, modified health assessment questionnaire (mHAQ), pain, self-reported scores for the foot and ankle (SAFE-Q), and RA disease activity were investigated to assess clinical status. The relationships among these parameters were evaluated. Subtalar joint destruction was correlated with TUG time (r = 0.329), mHAQ score (r = 0.338), and SAFE-Q: social functioning (r = 0.332). TUG time was correlated with the HKA (r = −0.527), talo-1st metatarsal angle (r = 0.64), calcaneal pitch angle (r = −0.433), M1-M5A (r = −0.345), and M2-M5A (r = −0.475). On multivariable linear regression analysis, TUG time had a relatively strong correlation with the talo-1st metatarsal angle (β = 0.452), and was negatively correlated with calcaneal pitch angle (β = −0.326). Ankle joint destruction was also correlated with TUG time (β = 0.214). Development of structural problems or conditions in mid-hindfoot, especially flatfoot deformity, were related with decreased physical activity in RA patients. Wearing an insole (arch support) as a preventative measure and short foot exercise should be considered from the early phase of deformity/destruction in the mid-hindfoot in the management of RA. View Full-Text
Keywords: physical activity/activity; daily living; midfoot; hindfoot; flatfoot; rheumatoid arthritis physical activity/activity; daily living; midfoot; hindfoot; flatfoot; rheumatoid arthritis
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MDPI and ACS Style

Noguchi, T.; Hirao, M.; Tsuji, S.; Ebina, K.; Tsuboi, H.; Etani, Y.; Akita, S.; Hashimoto, J. Association of Decreased Physical Activity with Rheumatoid Mid-Hindfoot Deformity/Destruction. Int. J. Environ. Res. Public Health 2021, 18, 10037. https://doi.org/10.3390/ijerph181910037

AMA Style

Noguchi T, Hirao M, Tsuji S, Ebina K, Tsuboi H, Etani Y, Akita S, Hashimoto J. Association of Decreased Physical Activity with Rheumatoid Mid-Hindfoot Deformity/Destruction. International Journal of Environmental Research and Public Health. 2021; 18(19):10037. https://doi.org/10.3390/ijerph181910037

Chicago/Turabian Style

Noguchi, Takaaki, Makoto Hirao, Shigeyoshi Tsuji, Kosuke Ebina, Hideki Tsuboi, Yuki Etani, Shosuke Akita, and Jun Hashimoto. 2021. "Association of Decreased Physical Activity with Rheumatoid Mid-Hindfoot Deformity/Destruction" International Journal of Environmental Research and Public Health 18, no. 19: 10037. https://doi.org/10.3390/ijerph181910037

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