Gait characteristics associated with the foot and ankle in inflammatory arthritis

Gait analysis is being used to characterise dysfunction of the lower limb and foot in people with inflammatory arthritis (IA) to a greater degree than in the past. The goal of the systematic review was to evaluate the spatiotemporal, foot and ankle kinematic, kinetic, peak plantar pressure and muscle activity parameters between patients with inflammatory arthritis and healthy controls. Thirty six studies with quality ranging from high to low met the inclusion criteria. The majority of studies reported gait parameters in Rheumatoid arthritis (RA). The gait pattern in RA was characterised by decreased walking speed (SMD 95% CI -1.57, -2.25 to -0.89), reduced cadence (SMD -0.97, -1.49 to -0.45), shorter stride length (SMD -1.66, -1.84 to -1.49), reduced ankle power (SMD -1.36, -1.70 to -1.02), increased double limb support time (SMD 1.03, 0.84 to 1.22), and peak plantar pressures at the forefoot (SMD 1.11, 0.76 to 1.45). Walking velocity was reduced in psoriatic arthritis and gout with no differences in ankylosing spondylitis. No studies have been conducted in polymyalgia rheumatica, systemic sclerosis or systemic lupus erythematosus.

The review identified the majority of studies reporting gait adaptations in RA, but limited evidence relating to other IA conditions. Poor data reporting, small sample sizes and heterogeneity across IA conditions limit the interpretation of the findings. Future studies could consider a standardised analytical approach to gait analysis that will give clinicians and researchers objective evidence of foot function in patients with IA.

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