Effects of plantar static pressure distribution in subject with bilateral hallux limitus: a detailed case-control study

Abstract

Background: Hallux limitus (HL) is defined as the restriction of dorsiflexion (DF) in the first metatarsophalangeal joint (IMTFJ) under closed kinetic chain conditions, where the distal segment is fixed and the foot is in contact with the ground. This biomechanical condition compromises the Windlass mechanism during the propulsive phase of gait, generating pain and functional disability. Therefore, the aim of this research was to examine the aspect of foot shape linked to distribution of static plantar pressure in individuals with bilateral HL compared to subjects with normal foot. Methods: A total of 90 subjects participated in this case-control study, divided into two groups: 45 individuals with bilateral HL and 45 healthy individuals without any known foot pathology. A portable pressure platform was used to measure each subject’s static plantar pressure. Results: Individuals with HL showed significantly increased contact surface in the forefoot (left: 36.67±8.30 vs. 28.91±7.94 cm2) and heel (left: 30.85±7.70 vs. 24.55±7.17 cm2; right: 31.01±7.98 vs. 25.71±7.64 cm2), and higher medium peak pressure in the left foot (HL: 27.90±5.41 kPa vs. control: 22.58±6.57 kPa) (P<0.001). Conclusions: Individuals with bilateral HL showed altered static plantar pressure distribution and increased contact surface in the forefoot and heel compared to healthy controls. Limitations include sex imbalance between groups and lack of dynamic data. These findings may reflect compensatory adaptations and support the need for tailored interventions to improve foot function in this population.