Marc J Heronemus1,2, Kaitlin Rabe1,3, Irina Tolstykh4, K Douglas Gross5, Barton L Wise6, Michael C Nevitt4, Cora E Lewis7, Howard J Hillstrom8, Neil A Segal1,9. 1. Rehabilitation Medicine, The University of Kansas, Kansas City, KS, USA. 2. Physical Medicine and Rehabilitation, The University of Colorado, Aurora, CO, USA. 3. Bioengineering, The University of Texas at Dallas, Richardson, TX, USA. 4. Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA. 5. Physical Therapy, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA. 6. Internal Medicine, Rheumatology, University of California Davis, Davis, CA, USA. 7. Medicine, Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. 8. Rehabilitation Department, Hospital for Special Surgery, New York, NY, USA. 9. Epidemiology, The University of Iowa, Iowa City, IA, USA.
Abstract
BACKGROUND: Postpartum women are at increased risk for lower limb musculoskeletal disorders. Foot arch collapse following pregnancy has been reported as a mechanism for this increased risk. However, dynamic changes during gait in postpartum women have not been reported. Therefore, we assessed the association between parity and dynamic foot pronation during gait. OBJECTIVE: To determine (1) if there is an association between parity and dynamic foot pronation (center of pressure excursion index, CPEI) during gait; and (2) the extent to which there is a dose-effect of parity on foot pronation. DESIGN: The Multicenter Osteoarthritis Study (MOST) Study is a longitudinal cohort study of adults with or at risk for knee osteoarthritis (OA). SETTING: Two communities in the United States, Birmingham, Alabama and Iowa City, Iowa. INTERVENTIONS: Not applicable PARTICIPANTS: A population-based sample of 1177 MOST participants who were female, had complete CPEI and parity data and completed the baseline, 30- and 60-month visits. MAIN OUTCOME MEASURES: Odds of a one quintile decrease in CPEI by parity group and mean CPEI by parity group. RESULTS: In 1177 women, mean age was 67.7 years and mean body mass index (BMI) was 30.6 kg/m2 . As parity increased, there was significantly greater foot pronation, lower mean CPEI: 19.1 (18.2-20.1), 18.9 (18.4-19.4), 18 (17.5-18.6) to 17.5 (16.4-18.6) in the 0 to 4 and >5 children groups, respectively; (P = .002), which remained significant after adjusting for race and clinic site (P = .005). There was a positive linear trend (β = 1.08, 1.03-1.14) in odds ratios of a one quintile decrease in CPEI (greater pronation) with increasing parity level (P = .004), which remained significant after adjusting for race and clinic site (P = .01). After adjusting for age and BMI, these two associations were no longer statistically significant. CONCLUSIONS: This study indicates a positive correlation between parity and greater dynamic pronation of the feet.
BACKGROUND: Postpartum women are at increased risk for lower limb musculoskeletal disorders. Foot arch collapse following pregnancy has been reported as a mechanism for this increased risk. However, dynamic changes during gait in postpartum women have not been reported. Therefore, we assessed the association between parity and dynamic foot pronation during gait. OBJECTIVE: To determine (1) if there is an association between parity and dynamic foot pronation (center of pressure excursion index, CPEI) during gait; and (2) the extent to which there is a dose-effect of parity on foot pronation. DESIGN: The Multicenter Osteoarthritis Study (MOST) Study is a longitudinal cohort study of adults with or at risk for knee osteoarthritis (OA). SETTING: Two communities in the United States, Birmingham, Alabama and Iowa City, Iowa. INTERVENTIONS: Not applicable PARTICIPANTS: A population-based sample of 1177 MOST participants who were female, had complete CPEI and parity data and completed the baseline, 30- and 60-month visits. MAIN OUTCOME MEASURES: Odds of a one quintile decrease in CPEI by parity group and mean CPEI by parity group. RESULTS: In 1177 women, mean age was 67.7 years and mean body mass index (BMI) was 30.6 kg/m2 . As parity increased, there was significantly greater foot pronation, lower mean CPEI: 19.1 (18.2-20.1), 18.9 (18.4-19.4), 18 (17.5-18.6) to 17.5 (16.4-18.6) in the 0 to 4 and >5 children groups, respectively; (P = .002), which remained significant after adjusting for race and clinic site (P = .005). There was a positive linear trend (β = 1.08, 1.03-1.14) in odds ratios of a one quintile decrease in CPEI (greater pronation) with increasing parity level (P = .004), which remained significant after adjusting for race and clinic site (P = .01). After adjusting for age and BMI, these two associations were no longer statistically significant. CONCLUSIONS: This study indicates a positive correlation between parity and greater dynamic pronation of the feet.
Authors: Neil A Segal; David T Felson; James C Torner; Yanyan Zhu; Jeffrey R Curtis; Jingbo Niu; Michael C Nevitt Journal: Arch Phys Med Rehabil Date: 2007-08 Impact factor: 3.966
Authors: Neil A Segal; Michael C Nevitt; K Douglas Gross; Keith D Gross; Jean Hietpas; Natalie A Glass; Cora E Lewis; James C Torner Journal: PM R Date: 2013-08 Impact factor: 2.298
Authors: Howard J Hillstrom; Jinsup Song; Andrew P Kraszewski; Jocelyn F Hafer; Rajshree Mootanah; Alyssa B Dufour; Betty Shingpui Chow; Jonathan T Deland Journal: Gait Posture Date: 2012-10-26 Impact factor: 2.840