Functional Evaluation and Pain Symptomatology of the Foot and Ankle in Individuals with Severe Obesity - Controlled Transversal Study

Rev Bras Ortop (Sao Paulo). 2021 Apr;56(2):235-243. doi: 10.1055/s-0040-1713757. Epub 2020 Oct 29.

Abstract

Objective The present study aims to evaluate the prevalence of foot and ankle pain complaints, radiographic parameters, and functional performance in subjects with severe obesity (body mass index [BMI] > 40) who are candidates to bariatric surgery. Methods Forty severely obese patients were evaluated at a bariatric surgery outpatient facility. These severely obese subjects (BMI > 40) were divided into two subgroups: those with BMI < 50 (n = 24) and BMI > 50 (n = 16). These patients were compared with a control group of 42 volunteers with a mean BMI value of 24. The following parameters were assessed: foot pain (according to the visual analog scale [VAS]), functional performance (according to the American Orthopeadic Foot and Ankle Society [AOFAS] scale, including forefoot, midfoot and hindfoot domains), age, gender, hallux metatarsal-phalangeal angle, hallux intermetatarsal angle, talocalcaneal angle, calcanean pitch angle and Meary angle. Results Incidence of foot pain was higher in the severely obese group compared with the control group ( p < 0.0001; odds ratio [OR]: 4.2). Functional performance according to the AOFAS scale was lower in obese subjects compared with the control group ( p < 0.0001; OR for hindfoot, 4.81; OR for midfoot, 3.33). Conclusion The incidence of foot pain was higher in the group of severely obese patients compared with the control group. According to the AOFAS scale, functional forefoot, midfoot and hindfoot performance was worse in severely obese individuals.

Keywords: AOFAS scale; foot; obesity; pain.