Skip to main content
Top
Published in: Journal of Foot and Ankle Research 1/2013

Open Access 01-12-2013 | Research

Assessment of foot and ankle muscle strength using hand held dynamometry in patients with established rheumatoid arthritis

Authors: Matthew Carroll, William Joyce, Angela Brenton-Rule, Nicola Dalbeth, Keith Rome

Published in: Journal of Foot and Ankle Research | Issue 1/2013

Login to get access

Abstract

Background

The foot and ankle are frequently affected in patients with rheumatoid arthritis (RA). One of the negative consequences of RA on the physical function of patients is a decrease in muscle strength. However, little is known about foot and muscle strength in this population. The aim of the study was to evaluate significant differences in foot and ankle muscle strength between patients with established RA against age and sex-matched controls using hand-held dynamometry.

Methods

The maximal muscle strength of ankle plantarflexion, dorsiflexion, eversion and inversion was assessed in 14 patients with RA, mean (SD) disease duration of 22 (14.1) years, and 20 age and sex-matched control participants using hand-held dynamometry.

Results

Significant differences were observed in muscle strength between the two groups in plantarflexion (p = 0.00), eversion (p = 0.04) and inversion (p = 0.01). No significant difference was found in dorsiflexion (p > 0.05). The patients with RA displayed a significantly lower plantarflexion-dorsiflexion ratio than the control participants (p = 0.03).

Conclusions

The results from this study showed that the RA patients displayed a significant decrease in ankle dorsiflexion, eversion and inversion when compared to the non-RA control group suggesting that foot and ankle muscle strength may be affected by the pathological processes in RA. This study is a preliminary step for the measurement of muscle impairments within the RA population.
Literature
1.
go back to reference Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO: Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against rheumatism collaborative initiative. Ann Rheum Dis. 2010, 69: 1580-1588. 10.1136/ard.2010.138461.CrossRefPubMed Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO: Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against rheumatism collaborative initiative. Ann Rheum Dis. 2010, 69: 1580-1588. 10.1136/ard.2010.138461.CrossRefPubMed
2.
go back to reference MacSween A, Brydson G, Hamilton J: The effect of custom moulded ethyl vinyl acetate foot orthoses on the gait of patients with rheumatoid arthritis. Foot. 1999, 69: 128-133.CrossRef MacSween A, Brydson G, Hamilton J: The effect of custom moulded ethyl vinyl acetate foot orthoses on the gait of patients with rheumatoid arthritis. Foot. 1999, 69: 128-133.CrossRef
3.
go back to reference Baillet A, Vaillant M, Guinot M, Juvin R, Gaudin P: Efficacy of resistance exercises in rheumatoid arthritis: meta-analysis of randomized controlled trials. Rheumatology. 2012, 51: 519-527. 10.1093/rheumatology/ker330.CrossRefPubMed Baillet A, Vaillant M, Guinot M, Juvin R, Gaudin P: Efficacy of resistance exercises in rheumatoid arthritis: meta-analysis of randomized controlled trials. Rheumatology. 2012, 51: 519-527. 10.1093/rheumatology/ker330.CrossRefPubMed
4.
go back to reference Breedland I, van Scheppingen C, Leijsma M, Verheij-Jansen NP, van Weert E: Effects of a group-based exercise and educational program on physical performance and disease self-management in rheumatoid arthritis: a randomized controlled study. Phys Ther. 2011, 91: 879-893. 10.2522/ptj.20090010.CrossRefPubMed Breedland I, van Scheppingen C, Leijsma M, Verheij-Jansen NP, van Weert E: Effects of a group-based exercise and educational program on physical performance and disease self-management in rheumatoid arthritis: a randomized controlled study. Phys Ther. 2011, 91: 879-893. 10.2522/ptj.20090010.CrossRefPubMed
5.
go back to reference Garling EH, Wolterbeek N, Velzeboer S, Nelissen RG, Valstar ER, Doorenbosch CA, Harlaar J: Co-contraction in RA patients with a mobile bearing total knee prosthesis during a step-up task. Knee Surg Sports Traumatol Arthrosc. 2008, 16: 734-740. 10.1007/s00167-008-0537-7.CrossRefPubMedPubMedCentral Garling EH, Wolterbeek N, Velzeboer S, Nelissen RG, Valstar ER, Doorenbosch CA, Harlaar J: Co-contraction in RA patients with a mobile bearing total knee prosthesis during a step-up task. Knee Surg Sports Traumatol Arthrosc. 2008, 16: 734-740. 10.1007/s00167-008-0537-7.CrossRefPubMedPubMedCentral
6.
go back to reference Fries JF, Spitz P, Kraines RG, Holman HR: Measurement of patient outcome in arthritis. Arthritis Rheum. 1980, 23: 137-145. 10.1002/art.1780230202.CrossRefPubMed Fries JF, Spitz P, Kraines RG, Holman HR: Measurement of patient outcome in arthritis. Arthritis Rheum. 1980, 23: 137-145. 10.1002/art.1780230202.CrossRefPubMed
7.
go back to reference Stark T, Walker B, Phillips JK, Fejer R, Beck R: Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review. PMR. 2011, 3: 472-479.CrossRef Stark T, Walker B, Phillips JK, Fejer R, Beck R: Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review. PMR. 2011, 3: 472-479.CrossRef
8.
go back to reference Wang CY, Olson SL, Protas EJ: Test-retest strength reliability: hand-held dynamometry in community-dwelling elderly fallers. Arch Phys Med Rehabil. 2002, 83: 811-835. 10.1053/apmr.2002.32743.CrossRefPubMed Wang CY, Olson SL, Protas EJ: Test-retest strength reliability: hand-held dynamometry in community-dwelling elderly fallers. Arch Phys Med Rehabil. 2002, 83: 811-835. 10.1053/apmr.2002.32743.CrossRefPubMed
9.
go back to reference Burns J, Redmond A, Ouvrier R, Crosbie J: Quantification of muscle strength and imbalance in neurogenic Pes cavus, compared to health controls, using hand-held dynamometry. Foot Ankle Int. 2005, 26: 540-544.PubMed Burns J, Redmond A, Ouvrier R, Crosbie J: Quantification of muscle strength and imbalance in neurogenic Pes cavus, compared to health controls, using hand-held dynamometry. Foot Ankle Int. 2005, 26: 540-544.PubMed
10.
go back to reference Barn R, Rafferty D, Turner DE, Woodburn J: Reliability study of tibialis posterior and selected muscle EMG and multi-segment foot kinematics in rheumatoid arthritis associated with Pes planovalgus. Gait Posture. 2012, 36: 567-571. 10.1016/j.gaitpost.2012.05.008.CrossRefPubMedPubMedCentral Barn R, Rafferty D, Turner DE, Woodburn J: Reliability study of tibialis posterior and selected muscle EMG and multi-segment foot kinematics in rheumatoid arthritis associated with Pes planovalgus. Gait Posture. 2012, 36: 567-571. 10.1016/j.gaitpost.2012.05.008.CrossRefPubMedPubMedCentral
11.
go back to reference Semple R, Murley GS, Woodburn J, Turner DE: Tibialis posterior in health and disease: a review of structure and function with specific reference to electromyographic studies. J Foot Ankle Res. 2009, 2: 1-10.1186/1757-1146-2-1. 1–8CrossRef Semple R, Murley GS, Woodburn J, Turner DE: Tibialis posterior in health and disease: a review of structure and function with specific reference to electromyographic studies. J Foot Ankle Res. 2009, 2: 1-10.1186/1757-1146-2-1. 1–8CrossRef
12.
go back to reference Keenan MA, Peabody TD, Gronley JK, Perry J: Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis. J Bone Joint Surg. 1991, 73: 237-247.PubMed Keenan MA, Peabody TD, Gronley JK, Perry J: Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis. J Bone Joint Surg. 1991, 73: 237-247.PubMed
13.
go back to reference van der Leeden M, Steultjens M, Dekker JHM, Prins APA, Dekker J: Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics. Rheumatology. 2006, 45: 465-469. 10.1093/rheumatology/kei186.CrossRefPubMed van der Leeden M, Steultjens M, Dekker JHM, Prins APA, Dekker J: Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics. Rheumatology. 2006, 45: 465-469. 10.1093/rheumatology/kei186.CrossRefPubMed
14.
go back to reference Turner DE, Helliwell PS, Emery P, Woodburn J: The impact of rheumatoid arthritis on foot function in the early stages of disease: a clinical case series. BMC Musculoskelet Disord. 2006, 21: 102-107.CrossRef Turner DE, Helliwell PS, Emery P, Woodburn J: The impact of rheumatoid arthritis on foot function in the early stages of disease: a clinical case series. BMC Musculoskelet Disord. 2006, 21: 102-107.CrossRef
15.
go back to reference Matschke V, Murphy P, Lemmey AB, Maddison PJ, Thom JM: Muscle quality, architecture, and activation in cachectic patients with rheumatoid arthritis. J Rheumatol. 2010, 37: 282-284. 10.3899/jrheum.090584.CrossRefPubMed Matschke V, Murphy P, Lemmey AB, Maddison PJ, Thom JM: Muscle quality, architecture, and activation in cachectic patients with rheumatoid arthritis. J Rheumatol. 2010, 37: 282-284. 10.3899/jrheum.090584.CrossRefPubMed
16.
go back to reference Rajbhandary R, Khezri A, Panush RS: Rheumatoid cachexia: what is it and why is it important?. J Rheumatol. 2011, 38: 406-408. 10.3899/jrheum.101036.CrossRefPubMed Rajbhandary R, Khezri A, Panush RS: Rheumatoid cachexia: what is it and why is it important?. J Rheumatol. 2011, 38: 406-408. 10.3899/jrheum.101036.CrossRefPubMed
17.
go back to reference Spink M, Fotoohabadi MR, Menz HB: Foot and ankle strength assessment using hand-held dynamometry: reliability and age-related differences. Gerontology. 2010, 56: 525-532. 10.1159/000264655.CrossRefPubMed Spink M, Fotoohabadi MR, Menz HB: Foot and ankle strength assessment using hand-held dynamometry: reliability and age-related differences. Gerontology. 2010, 56: 525-532. 10.1159/000264655.CrossRefPubMed
18.
go back to reference Cooney JK, Law RJ, Matschke V, Lemmey AB, Moore JP, Ahmad Y, Jones JG, Maddison P, Thom JM: Benefits of exercise in rheumatoid arthritis. J Aging Res. 2011, 10.4061/2011/681640. article ID 681640. Cooney JK, Law RJ, Matschke V, Lemmey AB, Moore JP, Ahmad Y, Jones JG, Maddison P, Thom JM: Benefits of exercise in rheumatoid arthritis. J Aging Res. 2011, 10.4061/2011/681640. article ID 681640.
19.
go back to reference Häkkinen A, Sokka T, Kotaniemi A, Hannonen P: A randomized two-year study of the effects of dynamic strength training on muscle strength, disease activity, functional capacity, and bone mineral density in early rheumatoid arthritis. Arthritis Rheum. 2001, 44: 515-522. 10.1002/1529-0131(200103)44:3<515::AID-ANR98>3.0.CO;2-5.CrossRefPubMed Häkkinen A, Sokka T, Kotaniemi A, Hannonen P: A randomized two-year study of the effects of dynamic strength training on muscle strength, disease activity, functional capacity, and bone mineral density in early rheumatoid arthritis. Arthritis Rheum. 2001, 44: 515-522. 10.1002/1529-0131(200103)44:3<515::AID-ANR98>3.0.CO;2-5.CrossRefPubMed
20.
go back to reference Rome K, Gow PJ, Dalbeth N, Chapman JM: Clinical audit of foot problems in patients with rheumatoid arthritis treated at counties Manukau District Health Board, Auckland, New Zealand. J Foot Ankle Res. 2009, 2: 16-10.1186/1757-1146-2-16.CrossRefPubMedPubMedCentral Rome K, Gow PJ, Dalbeth N, Chapman JM: Clinical audit of foot problems in patients with rheumatoid arthritis treated at counties Manukau District Health Board, Auckland, New Zealand. J Foot Ankle Res. 2009, 2: 16-10.1186/1757-1146-2-16.CrossRefPubMedPubMedCentral
Metadata
Title
Assessment of foot and ankle muscle strength using hand held dynamometry in patients with established rheumatoid arthritis
Authors
Matthew Carroll
William Joyce
Angela Brenton-Rule
Nicola Dalbeth
Keith Rome
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2013
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-6-10

Other articles of this Issue 1/2013

Journal of Foot and Ankle Research 1/2013 Go to the issue