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September 28, 2020
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Foot posture, mobility may be associated with worse symptoms of patellofemoral OA

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Pronated foot posture, greater midfoot mobility and lower weight-bearing ankle dorsiflexion range of motion may be associated with knee pain and disability in patients with patellofemoral osteoarthritis, according to published results.

In a cross-sectional, randomized controlled trial, researchers from La Trobe University in Melbourne, Australia, analyzed 188 patients (mean age of 59.9 years) with symptomatic patellofemoral osteoarthritis (PFOA) for associations between foot and ankle characteristics and symptoms of knee pain and function.

According to the study, foot posture was measured with the Foot Posture Index (FPI), midfoot mobility was measured with the Foot Measurement Platform and weight-bearing ankle dorsiflexion range of motion (ROM) was measured with a lunge test. Outcomes were measured with the anterior knee pain scale, knee injury and osteoarthritis outcome score as well as single step-up and double-leg sit-to-stand tasks.

Researchers found a “small significant association” between a lower weight-bearing ankle dorsiflexion ROM and higher average knee pain and greater disability. A more pronated foot posture, indicated by high FPI scores, and greater midfoot mobility were associated with an earlier onset of knee pain, “although the magnitude of these relationships was small,” the researchers wrote in the study.

“This knowledge may assist in the development of multimodal interventions to improve knee symptoms and function in individuals with PFOA,” they wrote. “For example, physical therapy interventions such as mobilization with movement may be able to increase weightbearing ankle dorsiflexion range of motion, and mechanical therapy interventions such as foot orthoses or footwear modifications may be able to improve foot function by supporting the arch (ie, addressing pronated foot posture) and/or aiding in shock attenuation (ie, addressing greater midfoot flexibility),” they added.