Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Foot Pain in Relation to the Foot Biomechanical Measures of Plantar Peak Pressures and Pressure Time Intergral.

Casey3,  Virginia A., Galica3,  Andrew M., Dufour1,  Alyssa B., McLean1,  Robert R., Hannan2,  Marian T.

Hebrew Senior Life, Boston, MA
Hebrew SL & Harvard Med Sch, Boston, MA
IFAR Hebrew SeniorLife, Boston, MA


Foot pain is a major cause of mobility limitation, however, the mechanisms that lead to foot pain are not completely understood. Small laboratory studies have shown that uneven distribution of the forces applies to the foot during normal walking result in areas of high pressure, which are associated with foot pain. Yet, these relations between plantar peak pressures and pressure-time integrals have not yet been investigated in a large, population-based sample. Thus, we examined the associations between generalized foot pain and peak pressure (PP) and pressure time integral (PTI) in men and women of the population-based Framingham Foot Study. We hypothesized that individuals reporting foot pain would exhibit higher peak pressure in specified foot areas compared to those reporting no foot pain.


Foot pressure data were obtained from 200 men and 262 women enrolled in the Framingham Foot Study. Between 2002 and 2005, plantar pressure values were collected using a Tekscan Matscan pedobarographic system (resolution of 1.4 sensels/cm2) while participants walked at a comfortable pace barefoot across the mat. Novel software was used to calculate PP and PTI from 12 segments of the right foot (toes, submetatarsal heads 1–5, medial arch and heel, lateral arch and heel). Self-reported foot pain was determined by the response to the question: "On most days, do you have pain, aching or stiffness in either foot?" Two-tailed Student's T-tests assessed differences in PP and PTI between those with and without foot pain, separately for men and women.


Study participants were 66% female with mean age of 65 years, and mean BMI of 28. In women who reported foot pain, there was significantly greater PP at the 2nd and 3rd metatarsal heads (p<0.0001) compared to those who did not report foot pain. In men, significant differences in PP were only seen at the 5th metatarsal head (p<0.001). There were no significant findings for foot pain and PTI measures in either men or women.

 Peak Pressure, N/cm2Pressure Time Integral, (N/cm2bsec
Foot RegionNo Foot PainFoot PainP Value*No Foot PainFoot PainP Value*
Femalen=187n=75 n=184n=75 
Submetatarsal head 117.8 ± 6.116.9 ± 5.80.328.3 ± 3.98.4 ± 4.10.77
Submetatarsal head 222.6 ± 4.721.0 ± 5.10.0110.8 ± 3.310.6 ± 5.00.73
Submetatarsal head 322.1 ± 4.720.4 ± 5.00.0110.5 ± 3.210.4 ± 4.60.81
Submetatarsal head 417.3 ± 5.416.5 ± ± 2.97.6 ± 2.60.65
Submetatarsal head 514.2 ± 6.113.9 ± 5.80.695.9 ± 3.26.0 ± 3.30.80
Malen=164n=36 n=164n=36 
Submetatarsal head 118.9 ± 6.319.5 ± 6.10.619.1 ± 5.19.5 ± 4.70.61
Submetatarsal head 222.9 ± 4.123.4 ± 4.50.5311.0 ± 4.411.6 ± 3.90.45
Submetatarsal head 322.8 ± 4.123.5 ± 4.50.3411.0 ± 4.811.5 ± 3.50.46
Submetatarsal head 418.9 ± 4.720.3 ± ± 3.69.2 ± 2.60.21
Submetatarsal head 515.4 ± 6.217.8 ± ± 4.87.7 ± 2.90.18
* Two-Tailed Students T-Test


In a large population-based sample, general foot pain was associated with higher PP under several of the metatarsal heads, albeit differently in men and women. Significant findings were not observed for the pressure-time integral measures. It may be that the accumulation of pressure loading over time does not cross a pain threshold as easily as peak pressure. We are unaware of differences in gait between men and women, or other reasons for different PP and reports of foot pain. Future work should investigate specific foot pain location in relation to areas of plantar pressure loading to elaborate on potential mechanisms.

To cite this abstract, please use the following information:
Casey, Virginia A., Galica, Andrew M., Dufour, Alyssa B., McLean, Robert R., Hannan, Marian T.; Foot Pain in Relation to the Foot Biomechanical Measures of Plantar Peak Pressures and Pressure Time Intergral. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1327
DOI: 10.1002/art.29093

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