Assessment of Footcore System in Subjects With Kneeosteoarthritis: A Cross-Sectional Study

Introduction. To characterise the components of the foot core system which included posture, toe grip strength, navicular drop, and plantar sensation in individuals with clinically diagnosed KOA and to explore the correlation with knee related symptoms and function. Materials and Methods. This cross-sectional study included 109 individuals with clinically diagnosed knee osteoarthritis. The outcome measures included the WOMAC score, the grip strength test, the FPI test, the navicular drop test, and Semmes-Weinstein monofilaments. Descriptive statistics were used to summarise participant characteristics and foot core system measures. Correlation analyses were performed to examine associations between toe grip strength, navicular drop, and WOMAC scores. Results. A total of 109 participants with clinically diagnosed knee osteoarthritis were included for the study. The mean age of the participants was 57.4 ±6.67 years, and 52.3% were females. Pronated foot posture was observed in 46.8% of affected limbs and 49.5% of unaffected limbs, 38.5% and 36.7% has neutral posture respectively while supinated posture was observed in 14.7% and 13.8% limbs. Mean toe grip strength was 4.13±1.55 kg, and mean WOMAC score was 45.95 ±13.31, indicating moderate pain and functional limitations. Plantar sensory testing showed preserved deep pressure sensation in 75.2% of participants, diminished protective sensation in 17.4%, and diminished light touch sensation in 7.3%. Navicular drop showed no significant correlation with WOMAC scores on either side (p>0.05), while a weak positive correlation was observed between toe grip strength and navicular drop on the unaffected side (r=0.225, p=0.014). Overall, foot core system impairments were common among individuals with knee osteoarthritis, although these alterations showed limited association with knee pain and functional disability. Conclusions. Individuals with knee osteoarthritis demonstrated a high prevalence of pronated foot posture and measurable alterations in components of the foot core system including toe grip strength and plantar pressure sensations. However, no clinically meaningful associations were observed between foot assessment, knee related symptoms and functional status as measured by WOMAC in the clinical evaluation of individuals with knee osteoarthritis. Further longitudinal studies are required to determine the clinical significance of these findings.