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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Matthew Carroll, Priya Parmar, Nicola Dalbeth, Mark Boocock, Keith Rome
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12891-015-0596-0) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

MC proposed the study protocol, which was elaborated and specified by KR, ND & PP. MC and KR screened all the references and extracted the data. MB served as arbitrator in case of discrepancies during extraction. PP supported the data extraction process. All authors interpreted the results. All authors read and approved the final manuscript.



Gait analysis is increasingly being used to characterise dysfunction of the lower limb and foot in people with inflammatory arthritis (IA). The aim 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.


An electronic literature search was performed on Medline, CINAHL, SportsDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index. Effect sizes with 95 % confidence intervals (CI) were calculated as the standardised mean difference (SMD). Meta-analysis was conducted if studies were homogenous.


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), decreased cadence (SMD −0.97, −1.49 to −0.45), decreased stride length (SMD −1.66, −1.84 to −1.49), decreased 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 may consider a standardised analytical approach to gait analysis that will provide clinicians and researchers with objective evidence of foot function in people with IA.
Additional file 1: Table S1. Description of search strategy. Details of specific search terms used and the order in which the search tool place.
Additional file 2: Table S2. Excluded studies. Details of the publications excluded, the reason for exclusion and the reference list of the excluded studies.
Additional file 3: Table S3. Spatiotemporal gait analysis parameters acquired by included studies. Details of the data acquisition method and the specific spatiotemporal parameters that were measured by studies assessing spatiotemporal gait parameters.
Additional file 4: Table S4. Kinematic gait parameters measured and methods of data acquisition. Details of the specific kinematic parameters, measured the biomechanical model used to determine kinematic parameters.
Additional file 5: Table S5. Kinetic gait analysis parameters acquired by included studies. Details of kinetic gait parameters measured.
Additional file 6: Table S6. Plantar pressure parameters acquired by included studies. Details of the specific regions of the foot where plantar pressure was measured and the method by which plantar pressure was acquired.
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