Characterization of gait in female patients with moderate to severe hallux valgus deformity

•Hallux kinematic in moderate to severe hallux valgus•Plantar pressure in moderate to severe hallux valgus deformity•Altered inner stance events in moderate to severe hallux valgus•Gait variability in moderate to severe hallux valgus deformity•Nine gait parameters have potential to describe gait in hallux valgus deformity.

BackgroundHallux valgus is one of the most common forefoot problems in females. Studies have looked at gait alterations due to hallux valgus deformity, assessing temporal, kinematic or plantar pressure parameters individually. The present study, however, aims to assess all listed parameters at once and to isolate the most clinically relevant gait parameters for moderate to severe hallux valgus deformity with the intent of improving post-operative patient prognosis and rehabilitation.MethodsThe study included 26  feet with moderate to severe hallux valgus deformity and 30  feet with no sign of hallux valgus in female participants. Initially, weight bearing radiographs and foot and ankle clinical scores were assessed. Gait assessment was then performed utilizing pressure insoles (PEDAR®) and inertial sensors (Physilog®) and the two groups were compared using a non-parametric statistical hypothesis test (Wilcoxon rank sum, P < 0.05). Furthermore, forward stepwise regression was used to reduce the number of gait parameters to the most clinically relevant and correlation of these parameters was assessed with the clinical score.FindingsOverall, the results showed clear deterioration in several gait parameters in the hallux valgus group compared to controls and 9 gait parameters (effect size between 1.03 and 1.76) were successfully isolated to best describe the altered gait in hallux valgus deformity (r2 = 0.71) as well as showed good correlation with clinical scores.InterpretationOur results, and nine listed parameters, could serve as benchmark for characterization of hallux valgus and objective evaluation of treatment efficacy.