Plantar pressure parameters associated with ankle osteoarthritis during walking and the immediate effects of an ankle brace

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Authors
Roodt, Kendyl Kathleen
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Degree
Master of Osteopathy
Grantor
Unitec Institute of Technology
Date
2018
Supervisors
McEwen, Megan
McNair, Peter
Rice, David
Type
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
Keyword
ankle joints
ankle osteoarthritis
plantar pressure
ankle braces
osteoarthritis (OA)
Citation
Roodt, K. K. (2018). Plantar pressure parameters associated with ankle osteoarthritis during walking and the immediate effects of an ankle brace. A 90-credit research thesis submitted in partial fulfilment of the requirements for the degree of Master of Osteopathy,Unitec Institute of Technology, Auckland, New Zealand.
Abstract
RESEARCH QUESTIONS: (1) Are there differences in hindfoot peak pressure, the pressure-time integral and contact time during stance phase across involved and uninvolved limbs of individuals with OA of the ankle joint? (2) Are the above-mentioned differences altered by wearing an elastic support brace? (3) Are there differences in hindfoot peak pressure, pressure-time integral and stance contact time across of the uninvolved limb of the OA group compared to a control group limb without OA of the ankle. BACKGROUND: Little is known about plantar pressure changes in the limb affected by OA compared to the uninvolved limb or healthy controls. The immediate effects of ankle braces on plantar pressure measures and ankle pain, perceived stability and comfort levels during gait in those with ankle osteoarthritis is also not known. This thesis aims to address these unknowns. METHODS: Thirty-two participants were included: 16 with ankle osteoarthritis and 16 healthy controls of a similar age and gender. A Novel pressure system was used to compare plantar pressures between the involved limb, uninvolved limb and the dominant limb of a healthy control group. An ankle brace was tested to assess its effect on plantar pressure measures in the involved limb. Perceived pain, stability and comfort levels related to walking with the brace, were measured through questionnaires. SPSS software (Version 25.0) was used for statistical analysis. Pearson correlations coefficients showed no association between body mass and plantar pressure measures. Single-factor repeated measures ANOVA with planned contrasts and independent t-tests were also performed. For all analyses the alpha level was set at 0.05. RESULTS: Contact times varied significantly across all comparisons. The control group had significantly lower pressure-time integrals than the uninvolved side of the ankle osteoarthritis group. Significant results were not seen in the remaining plantar pressure comparisons. The ankle brace increases contact time and provides comfort and stability for most of those with ankle osteoarthritis, but did not seem to affect pain. CONCLUSION: No definitive conclusions can be made about differences in plantar pressures assessed between those with ankle osteoarthritis and those without, or about the effect of an ankle brace on these measures. Subjective reports of the participants affected by ankle OA suggest that ankle braces can be used as a conservative, cost-effective way of improving stability and comfort in most of those with ankle osteoarthritis.
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