Tibialis posterior muscle pain effects on hip,knee and ankle gait mechanics |
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| Affiliation: | 1. Center for Sensory-Motoric Interaction (SMI®), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, DK-9220 Aalborg East, Denmark;2. Centre for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, DK-9800 Hjoerring, Denmark;3. Department of Rheumatology, Hjørring Hospital, Bispensgade 37, DK-9800 Hjørrring, Denmark;4. Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, DK-9000, Denmark;5. King Christian 10th Hospital for Rheumatic Diseases, University of Southern Denmark, Toldbodgade 3, DK-6300 Gråsten, Denmark;6. Department of Materials and Production, Aalborg University, Fibigerstraede 16, DK-9220 Aalborg East, Denmark;1. Fellow, The Orthopaedic Foot and Ankle Unit, Netcare Linksfield Hospital, Johannesburg, South Africa;2. Consultant Orthopaedic Surgeon, Department of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa;3. Director, The Orthopaedic Foot and Ankle Unit, Netcare Linksfield Hospital, Johannesburg, South Africa;4. Honorary Adjunct Professor, Department of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa;5. Consultant Orthopaedic Surgeon, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Science University, Ga-Rankuwa, South Africa;6. Assistant Director, The Orthopaedic Foot and Ankle Unit, Netcare Linksfield Hospital, Johannesburg, South Africa;1. Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada;2. Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA;1. Sports Medicine and Neuromechanics Laboratory, Department of Movement Sciences and Health, University of West Florida, Pensacola, FL, USA;2. Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA;3. Andrews Research and Education Foundation, Gulf Breeze, FL, USA;4. Biomechanics Laboratory, Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA, USA;5. Department of Orthopaedic Surgery, Columbus Orthopaedic, Columbus, MS, USA |
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| Abstract: | BackgroundTibialis posterior (TP) dysfunction is a common painful complication in patients with rheumatoid arthritis (RA), which can lead to the collapse of the medial longitudinal arch. Different theories have been developed to explain the causality of tibialis posterior dysfunction. In all these theories, pain is a central factor, and yet, it is uncertain to what extent pain causes the observed biomechanical alterations in the patients. The aim of this study was to investigate the effect of experimental tibialis posterior muscle pain on gait mechanics in healthy subjects.MethodsTwelve healthy subjects were recruited for this randomized crossover study. Experimental pain was induced by ultrasound-guided injection of 1 mL hypertonic saline into the upper part of the right tibialis posterior muscle with the use of isotonic saline as non-pain-inducing control. Subsequently, kinematic data during three self-paced over ground walking for each condition were collected. Ground reaction forces and external moments were measured from force plates installed in the floor. Painful areas were evaluated using body charts and pain intensity scoring via a verbal numerical rating scale.FindingsDecreased hip internal rotation was observed during the pain condition at the end of the stance phase. There were no changes in gait velocity and duration of stand phase between the pain and no pain conditions. Reduced external joint moment was found for external knee rotation and for external hip rotation.InterpretationThe study has demonstrated that induced pain in the TP muscle evokes kinematic alteration in the hip and the knee joints, but not in the ankle, which suggest an underlying early stage joint compensatory mechanism. These findings suggest the need to include those joints in current physical evaluations of tibialis posterior dysfunction. |
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| Keywords: | Tibialis posterior Dysfunction Gait Experimental pain Rheumatoid arthritis |
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