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Hallux Valgus Surgery May Produce Early Improvements in Balance Control

Results of a Cross-Sectional Pilot Study

Saba Sadra Center for Lower Extremity Ambulatory Research, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL.

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Adam Fleischer Center for Lower Extremity Ambulatory Research, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL.
Weil Foot and Ankle Institute, Des Plaines, IL.

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Erin Klein Weil Foot and Ankle Institute, Des Plaines, IL.

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Gurtej S. Grewal Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery and Interdisciplinary Consortium on Advanced Motion Performance, Arizona Center on Aging, University of Arizona College of Medicine, Tucson, AZ.

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Jessica Knight Weil Foot and Ankle Institute, Des Plaines, IL.

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Lowell Scott Weil Sr. Weil Foot and Ankle Institute, Des Plaines, IL.

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Lowell Weil Jr. Weil Foot and Ankle Institute, Des Plaines, IL.

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Bijan Najafi Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery and Interdisciplinary Consortium on Advanced Motion Performance, Arizona Center on Aging, University of Arizona College of Medicine, Tucson, AZ.

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Background:

Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance.

Methods:

Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants. Assessments were made in the clinic using body-worn sensors.

Results:

Patients in the preoperative group generally demonstrated poorer static balance control compared with the other two groups. Despite similar age and body mass index, postoperative patients exhibited 29% and 63% less center of mass sway than preoperative patients during double-and single-support balance assessments, respectively (analysis of variance P =.17 and P =.14, respectively [both eyes open condition]). Overall, gait performance was similar among the groups, except for speed during gait initiation, where lower speeds were encountered in the postoperative group compared with the preoperative group (Scheffe P = .049).

Conclusions:

This study provides supportive evidence regarding the benefits of corrective lower-extremity surgery on certain aspects of balance control. Patients seem to demonstrate early improvements in static balance after corrective HV surgery, whereas gait improvements may require a longer recovery time. Further research using a longitudinal study design and a larger sample size capable of assessing the long-term effects of HV surgical correction on balance and gait is probably warranted. (J Am Podiatr Med Assoc 103(6): 489–497, 2013)

Corresponding author: Adam Fleischer, DPM, MPH, Center for Lower Extremity Ambulatory Research, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, 3471 Green Bay Rd, North Chicago, IL 60064. (E-mail: adam.e.fleischer@gmail.com).