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42. Kongress der Deutschen Gesellschaft für Rheumatologie, 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 24. Wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

17.-20. September 2014, Düsseldorf

Plantar pressure distribution of pes planovalgus induced by a Juvenile Idiopathic Arthritis

Meeting Abstract

  • Josephine Merker - Fachgebiet Biomechanik im Sport, Technische Universität München; Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen, München
  • Matthias Hartmann - Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen
  • Florian Kreuzpointner - Technische Universität München, Fachgebiet für Biomechanik im Sport, München
  • Ansgar Schwirtz - Technische Universität München, Fachgebiet für Biomechanik im Sport, München
  • Johannes Peter Haas - Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 42. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 24. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Düsseldorf, 17.-20.09.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocKR.18

doi: 10.3205/14dgrh213, urn:nbn:de:0183-14dgrh2130

Published: September 12, 2014

© 2014 Merker et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Dynamic plantar pressure analysis, which measures the foot-floor contact pressure during walking, provides a quantitative functional assessment of foot deformities [1]. Frequently, patients with Juvenile Idiopathic Arthritis (JIA) have affected ankle joints, which could lead to a pes planovalgus deformity (JIA-PPV) [2]. This foot deformity is characterised by an excessive hindfoot eversion and a flattening of the medial longitudinal arch [3]. There is however little information about JIA-PPV with respect to plantar pressure distribution. The purpose of this study was to explore the influence of pes planovalgus caused by JIA on the plantar pressure characteristics.

Methods: Eleven patients with JIA-PPV (median for age: 11yr, height: 1.46m, weight: 44kg) with at least one affected ankle joint and fixed pes planovalgus (≥5° and heel valgus also on tiptoe) as well as fourteen voluntary, healthy peers (median for age: 10yr, height: 1.47m, weight: 40kg) serving as control group (CG) were included. Dynamic barefoot plantar pressure was measured at self-selected speed with a four-sensor/cm2 pressure distribution plate (Emed). The foot was divided into eleven regions of interest. Peak pressure (PP) of the following eight regions were compared using Mann-Whitney-U-test (p<0.05): medial hindfoot (MH), lateral hindfoot (LH), midfoot (M), metatarsal-phalangeal-joints (MH1 (most medial) – MH5 (most lateral)).

Results: At comparable speed (1.1-1.3m/s) JIA-PPV have either higher (seven of eight regions and total PP) or the same PP-values (MH1) as healthy feet, but statistical differences are only found in PP-values of LH (p<0.05) (Table 1 [Tab. 1]).

Conclusion: The expected tendency to a pronounced medial loading of the JIA-PPV [2] could not be confirmed. Patients have higher or same PP-loads with significant difference in lateral hindfoot than healthy feet. This might result from weak muscles of the foot. Nevertheless the findings provide important quantitative information for medical care, like orthopaedic insoles. Plantar pressure measurement as a simple and reliable method [1] should be used to monitor and quantitatively assess changes in foot deformity over time.

The authors want to thank the “Deutsche Kinderrheuma-Stiftung” and “Ironman-Hilfe Kinderrheuma” for supporting this study.


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