Researchers at the University of Auckland and Auckland University of Technology in New Zealand reported that patients with inflammatory arthritis, like rheumatoid arthritis, adopt a gait pattern that avoids pain (antalgic). The study was published in the journal BMC Musculoskeletal Disorders and is entitled “Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis”.
Inflammatory arthritis corresponds to a group of diseases characterized by inflammation of the joints and often other tissues. This group includes medical conditions like rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, gout and systemic lupus erythematosus (lupus), among others. Inflammatory arthritis is characterized by pain, swelling, warmth and tenderness in the joints, as well as morning stiffness. The disorder causes lower limb and foot pain, and reduced mobility, functional disability, joint deformity and altered gait strategy. Many inflammatory forms of arthritis are autoimmune diseases, in which the body’s own immune system overreacts and attacks healthy tissues.
Gait analysis has been increasingly used to assess dysfunction of the lower limbs and feet in patients with inflammatory arthritis. In this study, researchers conducted a systematic review of the literature to analyze gait parameters in patients with inflammatory arthritis and healthy controls.
Researchers selected 36 studies from their analysis, of these the majority was focused on gait parameters in rheumatoid arthritis patients. The team found that the gait pattern in rheumatoid arthritis patients was characterized by a decrease in walking speed, stride length, ankle power and an increase in double limb support time and peak plantar pressures at the forefoot. The walking speed was also found to be reduced in patients with gout and psoriatic arthritis, but not in ankylosing spondylitis patients. No studies were found concerning systemic sclerosis or systemic lupus erythematosus.
The team concluded that significant differences can be observed in gait parameters between patients with inflammatory arthritis and healthy controls. Patients with rheumatoid arthritis, in particular, were found to adopt an antalgic gait as a mechanism of pain avoidance. The team reported that the small sample sizes, poor data reporting and heterogeneity across the different inflammatory arthritis conditions limited the interpretation of the findings.
The authors suggest that future studies should consider a standardized analytical approach when evaluating gait parameters in patients with inflammatory arthritis in order to generate objective data regarding their foot function.