Plantar pressure distribution patterns during gait in patients with liver cirrhosis

Purpose: Peripheral neuropathies, changes in body composition, presence of ascites which means pathologic fluid accumulation in peritoneal cavity, leg edema and lower extremity muscle mass loss are possible factors that may alter plantar pressure distribution in patients with liver cirrhosis. Our aim was to determine the changes in plantar loading characteristics during walking in patients with cirrhosis using dynamic pedobarographic measurements and to compare the results with a healthy control group. Methods: Twenty-one patients with liver cirrhosis (10 females and 11 males, median age 38 years) and 21 healthy controls (11 females and 10 males, median age 36 years) were included in the study. Barefoot plantar pressure distribution during gait was measured on 10 regions as follows: Hindfoot, midfoot, 1st, 2nd, 3rd, 4th and 5th metatarsal heads, big toe, second toe and toes 3, 4, 5 using an EMED-M® pressure plate. The data of peak pressure (Newton/cm2) and Force-Time-Area Integral (Ns/cm2) were used for the analysis. Results: Peak pressure on the left first metatarsal head and the second toe were significantly lower in patient group (p=0.025 and p=0.020, respectively). Force-Time-Area Integral on midfoot was significantly higher in patient group on both left and right foot (p=0.007 and p=0.017, respectively). Conclusion: Force-Time-Area Integral, which provides more sensitive information about risk of tissue damage, was higher on midfoot of both feet in patients with cirrhosis suggesting that feet of the patients need special attention in daily clinical practice.