Ankle and subtalar motion during gait in arthritic patients

The purposes of this study were 1) to document ankle and subtalar motion during gait in 20 healthy subjects and in 25 patients with rheumatoid arthritis (RA) and 2) to determine stride characteristics with and without the use of an extended University of California Biomechanics Laboratory orthosis in RA patients with painful ankle and hindfoot deformity. An insole foot-switch system and ankle and subtalar electrogoniometers measured stride characteristics and dynamic range of motion (ROM). Arthritic patients demonstrated less ROM than healthy subjects except for ROM of hindfoot valgus. Arthritic patients also had slower gait velocity and less single limb support (SLS) time. In five new and five current orthotic wearers, a significant increase (p less than .01) in velocity and SLS time occurred with shoes and a further significant increase (p less than .01) occurred with the orthosis. Nine of 10 patients reported a decrease in ankle and hindfoot pain after using the orthosis. This study demonstrates the value of an orthosis for the treatment of arthritic patients with ankle and hindfoot pain and deformity.