Background Hallux valgus (HV) is lateral deviation of the great toe towards the second with subluxation of the first metatarsophalangeal joint and medial deviation of the first metatarsal (1). Increasing HV severity has been shown to negatively impact on health-related quality of life and self-reported function, and HV has been linked to increased falls risk in older adults (2). HV, in particular, is associated with poorer performance during postural stability and functional testing in older adults (3).
Objectives Despite the findings of impaired postural stability in older adults with hallux valgus, the links between functional status and postural stability, ankle proprioception are not well established in HV. One of clinical significance of this study was to determine whether impaired postural stability was caused by deficits in ankle proprioception and impaired functional status in HV subjects. Our purpose of this study was to assess postural stability and ankle proprioception in different subgroups of HV. In this study, we hypothesized that subjects with severe deformity would exhibit poorer postural stability and ankle proprioception performance compared to subjects with mild and moderate deformity in HV.
Methods Thirty-five adults diagnosed with unilateral HV according to the Manchester Oxford Foot Questionnaire deformation grade 2 and on were participated in the study. They were distributed among three groups: Mild (grade 2), moderate (grade 3), and severe deformity (grade 4). Functional status was measured with a disease specific score (the hallux valgus scale of the American Orthopaedic Foot and Ankle Society). While postural stability was measured with Pedalo Sensamove® System, ankle proprioception was measured with Biodex Balance System Pro 4.
Results Subjects in HV with severe deformity group showed poorer postural stability performance than those in HV with mild (p=0.024) and moderate (p=0.039) deformity groups. However, there was no significant difference between the groups in ankle proprioception. There was a significant correlation between postural stability and functional status (p<0.05, r=0.771) in all subjects with HV. In addition, it was found that ankle proprioception was not correlated to functional status and postural stability (p>0.05).
Conclusions It has been concluded that HV with severe deformity affects postural stability according to the results of our study. On the other hand, ankle proprioception is not as an important predictor as postural stability for rehabilitation in different subgroups of HV. Therefore subjects in HV with severe deformity should be focused on stability exercises, in particular, in addition to home – based exercise programs, foot orthoses, footwear recommendations, and patient education in their rehabilitation.
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Sadra S, Fleischer A, Klein E, Grewal GS, Knight J, Weil LS Sr, Weil L Jr, Najafi B. Hallux valgus surgery may produce early improvements in balance control: results of a cross-sectional pilot study. J Am Podiatr Med Assoc. 2013 Nov-Dec;103(6):489–97.
Disclosure of Interest None declared
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