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01-12-2013 | Research | Uitgave 1/2013 Open Access

Journal of Foot and Ankle Research 1/2013

Assessment of foot and ankle muscle strength using hand held dynamometry in patients with established rheumatoid arthritis

Journal of Foot and Ankle Research > Uitgave 1/2013
Matthew Carroll, William Joyce, Angela Brenton-Rule, Nicola Dalbeth, Keith Rome
Belangrijke opmerkingen
William Joyce, Angela Brenton-Rule, Nicola Dalbeth and Keith Rome contributed equally to this work.

Competing interests

MC, WJ, ABR, ND and KR have no competing interests to declare.

Authors’ contributions

KR designed the study. WJ collected the data. MC, KR and ND conducted the statistical analysis. MC drafted the manuscript with assistance from WJ, ABR, ND and KR. All authors approved the final manuscript.



The foot and ankle are frequently affected in patients with rheumatoid arthritis (RA). One of the negative consequences of RA on the physical function of patients is a decrease in muscle strength. However, little is known about foot and muscle strength in this population. The aim of the study was to evaluate significant differences in foot and ankle muscle strength between patients with established RA against age and sex-matched controls using hand-held dynamometry.


The maximal muscle strength of ankle plantarflexion, dorsiflexion, eversion and inversion was assessed in 14 patients with RA, mean (SD) disease duration of 22 (14.1) years, and 20 age and sex-matched control participants using hand-held dynamometry.


Significant differences were observed in muscle strength between the two groups in plantarflexion (p = 0.00), eversion (p = 0.04) and inversion (p = 0.01). No significant difference was found in dorsiflexion (p > 0.05). The patients with RA displayed a significantly lower plantarflexion-dorsiflexion ratio than the control participants (p = 0.03).


The results from this study showed that the RA patients displayed a significant decrease in ankle dorsiflexion, eversion and inversion when compared to the non-RA control group suggesting that foot and ankle muscle strength may be affected by the pathological processes in RA. This study is a preliminary step for the measurement of muscle impairments within the RA population.

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