Quantitative assessment of plantar pressure patterns in relation to foot deformities in people with hereditary motor and sensory neuropathies.
Bente E Bloks, Lise M Wilders, Jan Willem K Louwerens and 3 others
PMID 37194095WHAT IT FOUND
Plantar pressure patterns differ clearly across four foot deformity categories in Charcot-Marie-Tooth disease.
Root mean square deviation and fifth metatarsal head pressure ratio best distinguish severity and varus deformity, offering objective measures for clinical evaluation and surgical monitoring.
Key findings
01Root mean square deviation (RMSD) of plantar pressure from healthy norms increased with deformity severity, being highest in uncorrectable varus.
02The fifth metatarsal head pressure ratio effectively discriminated between healthy controls and all HMSN subgroups, and specifically between varus deformities.
03Correctable and uncorrectable varus subgroups showed significantly increased pressure under the lateral foot and midfoot compared to healthy controls.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study excluded 7 feet due to severe equinus deformities that prevented footprint analysis, meaning the most severe cases are underrepresented. Sample sizes for the uncorrectable varus (9 feet) and valgus (12 feet) subgroups were small. Each foot was analyzed independently despite 14 people having different deformities in each foot, which ignores the biomechanical influence of the contralateral limb. Deformity classification was categorical based on clinical exam, not a continuous scale, potentially losing granularity in pressure patterns. Differences in walking velocity between HMSN patients and controls may have partially influenced pressure distributions, though velocity did not differ among HMSN subgroups.
Declared interests
The authors declare no competing interests. Funding was provided by the Stichting Charcot-Marie-Tooth Nederland and the Stichting VSB Fonds.
The easy way to misread this
Do not assume these pressure patterns prove a specific intervention works; this study describes the biomechanical signature of deformities in a cross-sectional cohort. It proposes measures for evaluating surgery, but does not itself test surgical outcomes or the efficacy of orthotics.