|
1
|
Hadoush H, Qabook Z, Kanan SF, Almasri NA. Foot arch asymmetry and its correlations with physical fitness level and body mass index among school-aged children. J Bodyw Mov Ther 2025; 42:424-430. [PMID: 40325702 DOI: 10.1016/j.jbmt.2025.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 12/14/2024] [Accepted: 01/12/2025] [Indexed: 05/07/2025]
Abstract
PURPOSE To assess potential differences in foot arch structure between the left and right feet and how this is connected to physical fitness and BMI in school-age children. METHODS 437 children (6-16 years) participated and were divided into group 1 (n = 188, aged 6-9 yrs), and group 2 (n = 249, aged 10-16 yrs). Bilateral foot arches' absolute values were obtained using a digital pressure platform, and arches' types based on the Chippaux-Smirak-Index (CSI) (high, normal, flat arches) were identified. Physical fitness levels using the modified Zuchora test's total score and categorization level, and the BMI were determined for all children. RESULTS Abnormal foot arches were more common in the non-dominant left foot compared to the dominant right foot, with a higher occurrence of high arches than flat feet in both groups. The foot arch CSI-mean values were significantly asymmetrical, with the left foot showing higher values (0.23 ± 0.17) than the right foot (0.22 ± 0.16) (p = 0.004). Group 2 showed a notable direct relationship between children's BMI and the CSI-absolute values of both left (p = 0.009) and right (p = 0.030) foot arches. While group 1 showed a strong link between children's BMI and left-foot CSI-absolute values (p = 0.028), there was no such correlation with right-foot CSI-absolute values (p = 0.055). Nonetheless, there was no significant correlation found between the left/right foot arches CSI-absolute values and either the children's gender or their overall physical fitness scores in both groups. CONCLUSION It is recommended to pay closer attention to the health impacts associated with the non-dominant foot and high arches as the left foot is more susceptible to abnormal arches, with high arches being more prevalent than flat arches.
Collapse
Affiliation(s)
- Hikmat Hadoush
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences at Jordan University of Science and Technology, Jordan.
| | - Zaineh Qabook
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences at Jordan University of Science and Technology, Jordan
| | - Saddam F Kanan
- Department of Rehabilitation Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Nihad A Almasri
- Department of Rehabilitation Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; Department of Physiotherapy, School of Rehabilitation Sciences, University of Jordan, Jordan
| |
Collapse
|
|
2
|
Monestier L, Riva G, Latiff M, Marciandi L, Bozzi E, Pelozzi A, Pautasso A, Pilato G, Surace MF, D'Angelo F. Pediatric flexible flatfoot: Does obesity influence the outcomes of arthroereisis? World J Orthop 2024; 15:850-857. [PMID: 39318489 PMCID: PMC11417632 DOI: 10.5312/wjo.v15.i9.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/24/2024] [Accepted: 08/13/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Childhood obesity has emerged in the last decades as an important public health problem worldwide. Although relationships between obesity and flatfoot have been shown, no studies have investigated the influence of obesity on arthroereisis outcomes. AIM To evaluate correlations between childhood overweight/obesity and clinical and radiographic outcomes after subtalar arthroereisis with self-locking implants. METHODS This retrospective study included one hundred and sixty-nine pediatric patients (10-14 years old) who underwent subtalar arthroereisis (PEEK PitStop® device) for severe flexible flatfoot. Exclusion criteria were additional procedures, revision of previous corrective surgeries, rigid flatfoot with severe deformity, and neurological or post-traumatic flatfoot. Preoperative/postoperative European Foot and Ankle Society (EFAS) and visual analogue scale (VAS) scores were determined; radiographic assessment was conducted on weight-bearing foot X-rays: Kite angle, first metatarsal-talus angle, Meary angle, calcaneal pitch angle and lateral talo-calcaneal angle were analyzed. RESULTS EFAS and VAS scores improved post-operatively in the whole population. Only seven cases with complications were reported. Radiographic assessment revealed an improvement in all angles. Statistical analysis demonstrated that the impact of obesity was significant on arthroereisis outcomes: Relationships were reported between BMI and postoperative EFAS/VAS scores, postoperative calcaneal pitch angle, Kite angle, Meary angle and talo-first metatarsal angle. CONCLUSION Although arthroereisis represents a very effective and valid treatment for flatfoot both in normal weight and obese children, obesity significantly influences clinical and radiographic outcomes of arthroereisis, and obese children tend to perceive more pain and discomfort.
Collapse
Affiliation(s)
- Luca Monestier
- Division of Orthopedics and Traumatology, ASST Sette Laghi, Varese 21100, Lombardy, Italy
| | - Giacomo Riva
- Division of Orthopedics and Traumatology, ASST Sette Laghi, Varese 21100, Lombardy, Italy
| | - Mahfuz Latiff
- Division of Orthopedics and Traumatology, ASST Sette Laghi, Varese 21100, Lombardy, Italy
| | - Luca Marciandi
- Division of Orthopedics and Traumatology, ASST Sette Laghi, Varese 21100, Lombardy, Italy
| | - Elisa Bozzi
- Residency Program in Orthopedics and Trauma, Department of Biotechnologies and Life Sciences, University of Insubria, Varese 21100, Lombardy, Italy
| | - Alessandra Pelozzi
- Residency Program in Orthopedics and Trauma, Department of Biotechnologies and Life Sciences, University of Insubria, Varese 21100, Lombardy, Italy
| | - Andrea Pautasso
- Division of Orthopedics and Traumatology, ASST Sette Laghi, Varese 21100, Lombardy, Italy
| | - Giorgio Pilato
- Division of Orthopedics and Traumatology, ASST Sette Laghi, Varese 21100, Lombardy, Italy
- Interdisciplinary Research Centre for Pathology and Surgery of the Musculoskeletal System, Department of Biotechnology and Life Sciences, University of Insubria, Varese 21100, Lombardy, Italy
| | - Michele Francesco Surace
- Interdisciplinary Research Centre for Pathology and Surgery of the Musculoskeletal System, Department of Biotechnology and Life Sciences, University of Insubria, Varese 21100, Lombardy, Italy
- Division of Orthopedics and Traumatology, Ospedale di Cittiglio, ASST Sette Laghi, Varese 21100, Lombardy, Italy
| | - Fabio D'Angelo
- Division of Orthopedics and Traumatology, ASST Sette Laghi, Varese 21100, Lombardy, Italy
- Interdisciplinary Research Centre for Pathology and Surgery of the Musculoskeletal System, Department of Biotechnology and Life Sciences, University of Insubria, Varese 21100, Lombardy, Italy
| |
Collapse
|
|
3
|
Molina-García C, López-Del-Amo-Lorente A, Ramos-Petersen L, Martínez-Sebastián C, Jiménez-García JD, Álvarez-Salvago F, Velázquez-Díaz D. Childhood obesity and its impact on the characteristics of gait stance phases: a cross-sectional study. Eur J Pediatr 2024; 183:123-134. [PMID: 37843611 DOI: 10.1007/s00431-023-05268-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/17/2023]
Abstract
This study aimed to investigate the variations in foot type, laxity, dynamic characteristics of gait, and the characteristics of the stance phase of gait, in relation to body mass index (BMI) and groups of children of different ages. Additionally, it aimed to explore the correlations between BMI and these variables across children groups of different ages. A cross-sectional study was conducted involving 196 infants aged between 5 and 10 years old. The variables assessed included BMI, foot type, laxity, dynamic variables, and characteristics of the stance phase of gait. Significant variations were observed in foot type, laxity, certain dynamic variables, and characteristics of the stance phase of gait between normoweight (NW) and overweight/obese (OW/OB) groups among children aged between 5 and 10 years old (p ranged between 0.019 and 0.050). Moreover, BMI was also positively associated with the initial forefoot contact, heel off, total duration of the step, and forefoot contact phase of children 7 to 10 years of age (p ranged between < 0.010 and 0.040). Conclusion: Children who are OW/OB had alterations at different stages of gait. Being OW/OB is related to alterations of the phases of gait mainly from 7 to 10 years of age, and spending more time in each of the phases of walking. This could indicate that children who are OW/OB, in addition to walking slower, overload the musculoskeletal system, subjecting their joints and muscles to greater stress. What is Known: • Children who are overweight (OW) and obese (OB) can experience changes in their musculoskeletal systems, posture, and gait due to increased body mass index. • OW and OB children experience additional stress on their musculoskeletal systems, impacting posture, biomechanics, mobility, physical activity, and daily tasks. Excessive plantar loading is linked to foot pain in adults. What is New: • Body mass index was positively associated with initial forefoot contact, heel off, total duration of the step, and forefoot contact phase in children aged 7 to 10 years old. OW/OB children aged 5-6 exhibited less ankle dorsiflexion and smaller relaxed calcaneal stance position (RCSP) as compared to normal-weight children. • Obese children aged 5-6 showed less pronation excursion, suggesting altered frontal plane movement due to RCSP differences. Children aged 7-8 who are OW/OB spent more time in certain gait phases, particularly in the forefoot contact phase. Being OW/OB is linked to altered gait parameters such as initial forefoot, heel off, total step duration, and forefoot contact phase. Being OW/OB was associated with a longer forefoot contact phase, particularly in the right foot.
Collapse
Affiliation(s)
- Cristina Molina-García
- Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos nº135, Guadalupe , 30107, Murcia, Spain
| | - Andrés López-Del-Amo-Lorente
- Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos nº135, Guadalupe , 30107, Murcia, Spain
| | - Laura Ramos-Petersen
- Department of Nursing and Podiatry, University of Malaga, 29071, Málaga, Andalucía, Spain
| | | | | | - Francisco Álvarez-Salvago
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071, Jaén, Spain.
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, 46010, Valencia, Spain.
| | - Daniel Velázquez-Díaz
- ExPhy Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cádiz, Spain
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, 32803, USA
| |
Collapse
|
|
4
|
Children's foot parameters and basic anthropometry - do arch height and midfoot width change? Eur J Pediatr 2023; 182:777-784. [PMID: 36478295 PMCID: PMC9899181 DOI: 10.1007/s00431-022-04715-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/13/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022]
Abstract
UNLABELLED The aims of this study were as follows: (1) to assess how foot posture and morphology assessments change according to body mass index (BMI) status; (2) to determine which body composition parameter (BMI or waist circumference) correlates better with the foot posture index (FPI), arch height index (AHI), and midfoot width (MFW) in children. Foot morphometry (FPI, AHI, and MFW) and body composition (BMI and waist circumference (WC)) were assessed in a cross-sectional study of 575 children (mean age = 7.42 ± 1.67 years; 53.27% female). When comparing BMI groups, an increase of 8.3% in AHI and 13.6% in MFW (both p < 0.0001) was seen. In linear regression analyses, BMI and WC were positively associated with MFW explaining together 64.8% of its variance. Noteworthy, MFW is the most related to body composition parameters. CONCLUSION Foot morphology assessed by FPI, AHI, and MFW differs among BMI categories in children. Noteworthy, WC correlates better with foot measures than does the more commonly used BMI, and more importantly the MFW is the foot measure best explained by children's body weight. Since foot morphometry is different among different BMI groups, children would benefit from shoes with different patterns (thinner and wider), as well as a good system to adjust midfoot height. WHAT IS KNOWN • Children who are overweight and obese have flatter feet, when assessed using footprints. • Up to 72% of people have incorrectly fitted shoes. WHAT IS NEW • Children with underweight have thinner and flatter feet than children with normal weight, while children with overweight and obesity have wider and higher arched feet. • Body weight is related to foot shape, which has relevance for footwear manufacturers.
Collapse
|
|
5
|
Characteristics of paediatric foot arches according to body mass among primary school students in Wrocław, Poland. BMC Pediatr 2022; 22:656. [PMID: 36357927 PMCID: PMC9648018 DOI: 10.1186/s12887-022-03699-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
Background The purpose of this study, conducted within the framework of the project entitled ‘Let’s get the kids moving’, was to determine the associations between children’s longitudinal and transverse foot arch and their weight, gender and age. Method The pro-health initiative ‘Let’s get the kids moving’ was created by researchers of the Medical University and the Run for Health Foundation. A total of 655 children (51.5% boys) aged 7 to 10 years from primary schools in south-western Poland participated in the study. The mean age of the subjects was 8.7 ± 0.8 years. In all the children, we assessed anthropometric measurements (weight and height) and the longitudinal and transverse arch of the foot under the load of their weight. A two-dimensional foot scanner (Sensor Medica, Italy) was used to examine the plantar part of the children’s feet. Results The data collected from the 655 subjects revealed that excessive weight predisposed them to less longitudinal and transverse arching. The foot shape was not differentiated by gender or age. Conclusions Screening school-aged children’s footprints can detect abnormalities in the shape of children’s feet early on, which allows for early diagnosis of functional or structural flatfoot in children.
Collapse
|
|
6
|
Li J, Yang Z, Rai S, Li X, Jiang G, Pan X, Tang X. Effect of Insoles Treatment on School-Age Children with Symptomatic Flexible Flatfoot: A 2-Year Follow-Up Study. Indian J Orthop 2022; 56:1985-1991. [PMID: 36310549 PMCID: PMC9561439 DOI: 10.1007/s43465-022-00698-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 07/02/2022] [Indexed: 02/04/2023]
Abstract
Background Flatfoot is common among children. Symptomatic flexible flatfoot is one of the various types which needs treatment. Wearing insoles is considered one of the conservative therapies, but its effects are still uncertain. This study aims to provide evidence for the efficacy of insoles treatment among school-aged children with symptomatic flexible flatfoot. Methods Patient who were Children who were diagnosed with symptomatic flexible flatfoot and received insoles treatment in authors' institute were retrospectively included. Their ages, body mass index, pain positions, pain frequency, valgus angle, arch index and visual analogue scale (VAS) score were collected before and after insole treatment. Results A total of 32 children were included in this study. The results showed that wearing insoles for 2 years caused a significant improvement in pain frequency, valgus angle, arch index and VAS score. Conclusions This study indicated that pediatric symptomatic flexible flatfoot could be relieved by wearing insoles for 2 years. Insole treatment might be a workable option for pediatric symptomatic flexible flatfoot in children older than 6 years old.
Collapse
Affiliation(s)
- Jin Li
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Zimo Yang
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Saroj Rai
- Department of Orthopaedics and Trauma Surgery, National Academy of Medical Sciences, Mahankal, Kathmandu, 44600 Nepal
| | - Xiangrui Li
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Guoyong Jiang
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Xiaofei Pan
- Shafeile Rehabilitation Devices Co Ltd, Wuhan, 430000 China
| | - Xin Tang
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| |
Collapse
|
|
7
|
Obita G, Alkhatib A. Disparities in the Prevalence of Childhood Obesity-Related Comorbidities: A Systematic Review. Front Public Health 2022; 10:923744. [PMID: 35874993 PMCID: PMC9298527 DOI: 10.3389/fpubh.2022.923744] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background Non-communicable diseases among children are serious consequences of childhood obesity. However, less is known about the disparities in childhood obesity comorbidities burden. This review describes the salient pattern of disparities in the prevalence of childhood obesity-related non-communicable diseases and relevant inequalities in both high- and low/medium-income countries. Method A systematic literature search was performed in MEDLINE, Embase, CINAHL, PsycInfo, Scopus, and Web of Science databases by two independent reviewers. Inclusion criteria were as follows: age 2–18 years; the prevalence or incidence of childhood obesity comorbidities reported; and studies published in English from January 2010 to date. No restrictions on the setting. The prevalence data were analyzed using range and median for subgroups based on the country's development status, gender, and geographical region. Results Our search identified 6,837 articles, out of which we examined 145 full-text articles and included 54 articles in the analysis. The median prevalence of childhood obesity-related hypertension was 35.6 vs. 12.7% among middle- and low-income countries compared with high-income countries; 37.7 vs. 32.9% among boys compared with girls; and 38.6, 25.3, and 20.1% in Asia, South America, and Europe, respectively. For metabolic syndrome, the median prevalence was 26.9 vs. 5.5% among middle- and low-income countries compared with high-income countries; 55.2 vs. 12.0% among boys compared with girls; and 40.3, 25.8, and 7.7% in South America, Asia, and Europe, respectively. The prevalence of childhood obesity-related non-alcoholic fatty liver disease was 47.5 vs. 23% among middle- and low-income countries compared with high-income countries; and 52.1, 39.7, and 23.0% in Asia, South America, and Europe, respectively. The median prevalence of dyslipidemia was 43.5 vs. 63% among middle- and low-income countries compared with high-income countries; 55.2 vs. 12.0% among boys compared to girls; and 73.7 and 49.2% in Australia and Europe, respectively. Conclusion There are disparities in the prevalence of childhood obesity-related hypertension, metabolic syndrome, and non-alcoholic fatty liver disease, with middle- and low-income countries, boys, and Asian region having higher prevalence. Implementing targeted interventions for childhood obesity comorbidities should consider socioeconomic disparities and strengthening of research surveillance methods for a better understanding of non-communicable disease burden in the pediatric population. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021288607.
Collapse
Affiliation(s)
- George Obita
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Ahmad Alkhatib
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| |
Collapse
|
|
8
|
Drapeau-Zgoralski V, Beauséjour M, Painchaud AS, Sarda M, Nault ML. Advanced practice physiotherapy in paediatrics: Implementation results. Paediatr Child Health 2022; 27:206-212. [PMID: 35859674 DOI: 10.1093/pch/pxac013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This study aimed to evaluate the implementation of an advanced practice physiotherapist (APP) clinic in our paediatric institution and assess APP and orthopaedic surgeon satisfaction. Methods In this retrospective cohort study, all patient records from the APP clinic's second year (March 2017 to March 2018) at CHU Sainte-Justine were reviewed. These were compared with the records of patients seen by orthopaedic surgeons within the gait clinic the year before implementing the clinic. The following data were collected: demographic, professional issuing referral, reason for referral, consultation delay, clinical impression, investigation, and treatment plan. We also documented every subsequent follow-up to rule out any diagnostic change and identify surgical patients. Clinician satisfaction was assessed by the Minnesota Satisfaction and PROBES Questionnaires along with a short electronic survey. Results Four hundred and eighteen patients were assessed by APPs and 202 by orthopaedic surgeons. APPs managed patients independently in 92.6% of cases. Nearly 86% of patients were discharged following the initial visit, and 7.4% were referred to a physiotherapist. Only 1% of APP patients eventually required surgery compared with nearly 6% in the orthopaedic group. The mean waiting time for consultation was greater in the APP group (513.7 versus 264 days). However, there was a significant reduction in mean waiting time over the last 3 months surveyed (106.5 days). Conclusions The feedback from all clinicians involved was positive, with a greater mean score on the Minnesota Satisfaction and PROBES Questionnaire for APPs. The APP gait clinic appears to be an effective triage clinic. Level of evidence III.
Collapse
Affiliation(s)
| | - Marie Beauséjour
- Research Center, CHU Sainte-Justine, Research Center-Sainte-Justine University Health Center, Montreal, Quebec, Canada
| | | | - Mélanie Sarda
- Research Center, CHU Sainte-Justine, Research Center-Sainte-Justine University Health Center, Montreal, Quebec, Canada
| | - Marie-Lyne Nault
- Surgery Department, Université de Montréal, Montreal, Quebec, Canada
| |
Collapse
|
|
9
|
Yam TTT, Fong SSM, Tsang WWN. Foot posture index and body composition measures in children with and without developmental coordination disorder. PLoS One 2022; 17:e0265280. [PMID: 35286350 PMCID: PMC8920180 DOI: 10.1371/journal.pone.0265280] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/24/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Foot posture which forms the distal supporting structure influences on postural stability. Children with developmental coordination disorder (DCD) who are more likely to be overweight or obese may present with flat foot with symptoms that affect daily activities. The aim of this study was to compare the foot posture and body composition measures between children with and without DCD. In addition, this study aimed to investigate the relationship between foot posture and fat percentage. METHODS Fifty-nine children with DCD (mean age = 8.07±1.10) and sixty-two typically developing children (mean age = 7.97±1.05) were recruited to the DCD and control group respectively. All children received a foot posture assessment and a whole-body dual-energy X-ray absorptiometry (DXA) scan. Foot Posture Index 6 (FPI-6) total scores, sub-scores and lower limb body composition measures including fat mass, lean mass, total mass, fat percentage and fat mass index were measured. RESULTS Children with DCD revealed a significantly higher FPI-6 left (1.12; 95% CI: 0.172, 2.061) and right (1.15; 95% CI: 0.218, 2.079) total score. FPI-6 sub-scores (talar head palpation and abduction/adduction forefoot on rearfoot) illustrated significant differences between children with and without DCD. Children with DCD had a significantly higher total fat mass (1247.48g; 95% CI: 121.654, 2373.304), total fat percentage (1.82%; 95% CI: 0.115, 3.525) and fat mass index (0.56kg/m2; 95% CI: 0.036, 1.069). There was a significant relationship between FPI-6 right total score and total fat percentage. CONCLUSION The findings of this study showed that children with DCD exhibited significantly more pronated foot posture and higher body composition measures compared to typically developing children. Moreover, with FPI-6 right total score significantly related to the total fat percentage, it may require more than just detecting abnormal foot structures in children with DCD but also promoting a healthy lifestyle to prevent obesity.
Collapse
Affiliation(s)
- Timothy Tsz Ting Yam
- Department of Physiotherapy, School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Shirley Siu Ming Fong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong
| | - William Wai Nam Tsang
- Department of Physiotherapy, School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong
| |
Collapse
|
|
10
|
Ganeb SS, Egaila SES, Younis AA, El-Aziz AMA, Hashaad NI. Prevalence of lower limb deformities among primary school students. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-021-00082-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Lower limb deformities could affect child's quality of life and may worsen with time. This work aims to study the prevalence of lower limb deformities among primary school students in our governorate.
Methods
This cross-sectional descriptive study was carried out on 4689 students attending 12 public primary schools during the academic year 2019–2020.Complete clinical examination was done for picking of cases of genu varum, genu valgum, genu recurvatum, flat foot, pes cavus, hallux valgus, in-toeing, and lower limb discrepancy, and x-ray on both feet, pelvis, and full-length lower limb was requested.
Results
This cross-sectional descriptive study included 4689 students. The prevalence of lower limb (LL) deformities was 16.61%. One hundred twenty-three (2.62%) children had a positive history of musculoskeletal pain, 0.09% had genu varum, 0.11% had genu valgum, 0.75% had Genu recurvatum, 0.03% had LL discrepancy, 13.86% had flexible flat foot, 1.22% had rigid flat foot, 0.23% had pes cavus, 1.04 % had in-toeing, 0.06% had hallux varus, and 0.11% had hallux valgus.
Conclusions
Lower limb deformities are a considerable problem in primary school students that need early diagnosis because it could affect child’s future, health, and career. Further studies are needed to investigate spinal deformity, vit D level, calcium level, foot wear, and school bag weight as hidden factors.
Collapse
|
|
11
|
Molina-Garcia P, Miranda-Aparicio D, Ubago-Guisado E, Alvarez-Bueno C, Vanrenterghem J, Ortega FB. The Impact of Childhood Obesity on Joint Alignment: A Systematic Review and Meta-Analysis. Phys Ther 2021; 101:6134724. [PMID: 33580953 DOI: 10.1093/ptj/pzab066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/08/2020] [Accepted: 12/31/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE It has been suggested that overweight/obesity (OW/OB) impairs the normal alignment of children and adolescents' musculoskeletal system. However, to date, no study has systematically reviewed or quantified the effect of OW/OB on the development of joint malalignments in children and adolescents. The purpose of this study was to systematically review the association between OW/OB and joint alignment in children and adolescents and to quantify the evidence on whether children and adolescents with OW/OB have a higher risk of developing joint malalignments than their peers of normal weight. METHODS PubMed and Web of Science databases were systematically searched from inception to March 9, 2020. Studies investigating the association between OW/OB and joint alignment in children and adolescents were selected. Nonoriginal articles, participants with movement pattern diseases, and adolescents studied while pregnant were excluded. Two independent reviewers conducted the study selection and data extraction. Qualitative synthesis of evidence and random effect meta-analyses (risk ratio [RR]) were performed. RESULTS Seventy-three studies (5 longitudinal and 68 cross-sectional) met the inclusion criteria involving 1,757,107 children and adolescents. There was consistent evidence supporting associations of OW/OB with rounded shoulder, lumbar hyperlordosis, genu valgum, and flatfoot. Our meta-analysis showed that children and adolescents with OW/OB had a significantly higher risk of lumbar hyperlordosis (RR = 1.41), genu valgum (RR = 5.92), flatfoot (RR = 1.49), and any joint malalignment (RR = 1.68) when compared with their peers of normal weight. The presence of genu valgum and flatfoot were the most robust results. CONCLUSION Based on these findings, OW/OB is associated with the presence of joint malalignments in children and adolescents. IMPACT This is the first study that has systematically reviewed the effect of OW/OB on the development of joint malalignments in children and adolescents.
Collapse
Affiliation(s)
- Pablo Molina-Garcia
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Belgium
| | - Damian Miranda-Aparicio
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Esther Ubago-Guisado
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Celia Alvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Jos Vanrenterghem
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Belgium
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition, Karolinska Institute, Sweden
| |
Collapse
|
|
12
|
Octavius GS, Sugiarto T, Handy F, Hartanto RN. Flat foot at 5 to 6-year-old and history of delayed walking. PAEDIATRICA INDONESIANA 2020; 60:321-7. [DOI: 10.14238/pi60.6.2020.321-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Flat foot, also known as pes planus, is a common problem in daily pediatric practice. For most children, this physiologic condition gradually disappears with age. However, flat foot that persists after the age of four might have developmental coordination disorder in the future and it may relate to the history of delayed walking . Objective To determine the prevalence of delayed walking in children with pes planus compared to children with normal foot curvature and to assess for a possible association between flat foot and history of delayed walking. Methods This cross-sectional study was done in 120 children aged 5-6 years. Foot curvature was evaluated by wet footprint test. Inclusion criteria include children in 3 playgroups in Tangerang from January to August 2018, in children aged 5-6 years. Children with history of neurologic diseases, genetic disorders, chronic diseases, disorders of the lower extremities except pes planus, and obesity were excluded. Grading of pes planus refers to Olivier et al. criteria and evaluation of delayed walking at 18-month-old was done through history taking from their parents. Results Of 120 children, 41 (34.2%) had pes planus while 11 (9.2%) had a history of delayed walking. Of those 11 children, 9 had pes planus. Most children with pes planus had grade I (78%). There was a significant association between pes planus and delayed walking (OR=10.8; 95%CI 2.2 to 52,9; P=0.001;). Conclusion In 5-6-year-old children, there is a significant association between pes planus grade 2 & 3 and history of delayed walking early in life. Wet footprint test screening for children with a history or signs of delayed walking may be used to identify pes planus in order to implement treatment in a timely manner.
Collapse
|
|
13
|
Abich Y, Mihiret T, Yihunie Akalu T, Gashaw M, Janakiraman B. Flatfoot and associated factors among Ethiopian school children aged 11 to 15 years: A school-based study. PLoS One 2020; 15:e0238001. [PMID: 32841276 PMCID: PMC7447044 DOI: 10.1371/journal.pone.0238001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/06/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Foot health of a child plays a pivotal role in their participation in play, locomotive activities, healthy lifestyle, somatic development, and weight management. The burden of flatfoot among children in Ethiopia is not known. The objective of this study was to analyze the structure of the medial foot arch using Staheli plantar arch index and investigate its associated factors among larger sample school children, aged 11-15 years in Ethiopia. METHODS A school-based cross-sectional study was conducted among children aged 11-15 years from eleven randomly selected primary schools. The sample size was determined proportionally across school strength and governmental and private schools to ensure variety within the sample. Data collection consisted of physical measurements, footprint-based measures whilst full weight-bearing, and a structured questionnaire on foot pain, footwear type, and physical activity. Data were analyzed descriptively and through uni- and multivariate logistic regression model. RESULTS A total of 823 children participated. The overall prevalence of flatfoot was 17.6% with a significant difference between age, gender, type of school, BMI, and type of footwear. Being younger (OR 3.3, 95% CI 1.6-6.7), male (OR 1.6, 95% CI 1.0-2.4), experiencing foot pain (OR 1.9, 95% CI 1.0-3.5), wearing closed shoe (OR 4.4, 95% CI 1.6-11.9), overweight (OR 3.8, 95% CI 1.2-8.7), obese (OR 4.2, 95% CI 2.5-10.9), and low level of physical activity (OR 2.1, 95% CI 1.0-4.6) were significantly associated with flatfoot. Children who were overweight, obese, and also experiencing foot pain have a 2.8 (95% CI 1.62-5.94) and 4.1 (95% CI 2.85-8.31) times greater chance of having flatfoot respectively. The prevalence of flatfoot among 560 normal weight children was 17.5%. CONCLUSIONS The findings of this study demonstrated that the overall prevalence and the prevalence of flatfoot among normal-weight children are almost the same. There is a definite need to develop a screening algorithm for diagnosis and treatment indication for this children's lower extremity disorder.
Collapse
Affiliation(s)
- Yohannes Abich
- Department of Physiotherapy, College of Medicine and Health Sciences & Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Tewodros Mihiret
- Department of Physiotherapy, College of Medicine and Health Sciences & Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Moges Gashaw
- Department of Physiotherapy, College of Medicine and Health Sciences & Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Balamurugan Janakiraman
- Department of Physiotherapy, College of Medicine and Health Sciences & Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
|
14
|
Prevalence of Lower Extremities’ Postural Deformities in Overweight and Normal Weight School Children. IRANIAN JOURNAL OF PEDIATRICS 2019. [DOI: 10.5812/ijp.89138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
|
15
|
Letter to the editor on "Does the long-term use of medial arch support insole induce the radiographic structural changes for pediatric flexible flat foot? - A prospective comparative study". Foot Ankle Surg 2019; 25:703. [PMID: 31320208 DOI: 10.1016/j.fas.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/02/2019] [Indexed: 02/04/2023]
|
|
16
|
Gijon-Nogueron G, Martinez-Nova A, Alfageme-Garcia P, Montes-Alguacil J, Evans AM. International normative data for paediatric foot posture assessment: a cross-sectional investigation. BMJ Open 2019; 9:e023341. [PMID: 30987983 PMCID: PMC6500282 DOI: 10.1136/bmjopen-2018-023341] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The foot posture index (FPI) is an observational tool designed to measure the position of the foot. The objective of this study was to establish international reference data for foot posture across childhood, and influence of body mass index (BMI) on paediatric foot posture. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS The dataset comprised 3217 healthy children, aged from 3 to 15 years. Contributing data were acquired from Spain, UK and Australia. INTERVENTIONS Foot posture was described by means and z-score of the FPI and the height and weight of each subject was measured and the BMI was calculated. RESULTS The foot posture of 3217 children were reviewed. A pronated (FPI ≥+6) foot posture was found in 960 (29.8%) children, a normal (FPI 0 to +6) foot posture in 1776 (55.2%) and a highly pronated (FPI +10) foot posture was found in 127 children (3.9%) (range -4 to +12 FPI). Less than 11% were found to have a supinated foot type (n=354). Approximately 20% of children were overweight/obese, but correlation between BMI and FPI was weak and inverse (r=-0.066, p<0.01), refuting the relationship between increased body mass and flatfeet. CONCLUSIONS This study confirms that the 'flat' or pronated foot is the common foot posture of childhood, with FPI score of +4 (3) the average finding. Trend indicated a less flatfoot with age, although non-linear. A wide normal range of foot posture across childhood is confirmed.
Collapse
Affiliation(s)
- Gabriel Gijon-Nogueron
- Nursing and Podiatry, Universidad de Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | | | | | | | - Angela Margaret Evans
- Podiatry, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
| |
Collapse
|
|
17
|
Prevalence of pathological flatfoot in school-age children. Foot (Edinb) 2018; 37:38-44. [PMID: 30321857 DOI: 10.1016/j.foot.2018.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/06/2018] [Accepted: 05/20/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Prevalence of pathological flatfoot has not been well defined in the literature. The objective of this study was to establish the prevalence of pathological flatfoot in school-age children and investigate the factors associated with this deformity. METHODS A total of 667 children (327 girls and 340 boys) were recruited for this cross-sectional study with multi-stage clustered random sampling. The diagnosis of flatfoot was based on clinical observations and measurements using a suggested systematic protocol. Pathological flatfoot in this study did not merely screen for structural flatfoot, it included symptomatic conditions as well as musculoskeletal risk factors predisposing a progressive flatfoot in children. RESULTS Prevalence of pathological flatfoot was 10.3% in children aged 7-14 years, but this prevalence decreased with age. There was no difference in prevalence of pathological flatfoot between the genders. Children with high BMI were more likely to have pathological flatfoot. Heel valgus (r=0.1; p=0.01) and dorsiflexion range (r=0.14; p<0.001) were both significantly associated with the presence of pathological flatfoot in children; but with only small correlations. CONCLUSIONS Pathological flatfoot was a prevalent condition in school-age children in Iran. Forty six percent of the flatfeet observed in school-age children were classified as pathological.
Collapse
|
|
18
|
Banwell HA, Paris ME, Mackintosh S, Williams CM. Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review. J Foot Ankle Res 2018; 11:21. [PMID: 29854006 PMCID: PMC5975578 DOI: 10.1186/s13047-018-0264-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/11/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Flexible flat foot is a normal observation in typically developing children, however, some children with flat feet present with pain and impaired lower limb function. The challenge for health professionals is to identify when foot posture is outside of expected findings and may warrant intervention. Diagnoses of flexible flat foot is often based on radiographic or clinical measures, yet the validity and reliability of these measures for a paediatric population is not clearly understood. The aim of this systematic review was to investigate how paediatric foot posture is defined and measured within the literature, and if the psychometric properties of these measures support any given diagnoses. METHODS Electronic databases (MEDLINE, CINAHL, EMBASE, Cochrane, AMED, SportDiscus, PsycINFO, and Web of Science) were systematically searched in January 2017 for empirical studies where participants had diagnosed flexible flat foot and were aged 18 years or younger. Outcomes of interest were the foot posture measures and definitions used. Further articles were sought where cited in relation to the psychometric properties of the measures used. RESULTS Of the 1101 unique records identified by the searches, 27 studies met the inclusion criteria involving 20 foot posture measures and 40 definitions of paediatric flexible flat foot. A further 18 citations were sought in relation to the psychometric properties of these measures. Three measures were deemed valid and reliable, the FPI-6 > + 6 for children aged three to 15 years, a Staheli arch index of > 1.07 for children aged three to six and ≥ 1.28 for children six to nine, and a Chippaux-Smirak index of > 62.7% in three to seven year olds, > 59% in six to nine year olds and ≥ 40% for children aged nine to 16 years. No further measures were found to be valid for the paediatric population. CONCLUSION No universally accepted criteria for diagnosing paediatric flat foot was found within existing literature, and psychometric data for foot posture measures and definitions used was limited. The outcomes of this review indicate that the FPI - 6, Staheli arch index or Chippaux-Smirak index should be the preferred method of paediatric foot posture measurement in future research.
Collapse
Affiliation(s)
- Helen A. Banwell
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia 5001 Australia
- School of Health Sciences, University of South Australia, Adelaide, South Australia 5001 Australia
| | - Maisie E. Paris
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia 5001 Australia
| | - Shylie Mackintosh
- School of Health Sciences, University of South Australia, Adelaide, South Australia 5001 Australia
| | - Cylie M. Williams
- School of Health Sciences, University of South Australia, Adelaide, South Australia 5001 Australia
- Allied Health, Peninsula Health, Frankston, VIC 3199 Australia
- School of Primary and Allied Health, Monash University, Frankston, VIC 3199 Australia
| |
Collapse
|
|
19
|
Yin J, Zhao H, Zhuang G, Liang X, Hu X, Zhu Y, Zhang R, Fan X, Cao Y. Flexible flatfoot of 6-13-year-old children: A cross-sectional study. J Orthop Sci 2018; 23:552-556. [PMID: 29500001 DOI: 10.1016/j.jos.2018.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 01/23/2018] [Accepted: 02/07/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND This cross-sectional study aims to investigate the flexible flatfoot (FFF) prevalence and related factors in school-aged children. METHODS A total of 1059 children aged 6-13 years were included. Dynamic footprints according to the FootScan system were collected from both feet. The relationship of FFF with age, gender, side, and body mass index (BMI) was investigated. RESULTS FFF percentage decreased from 39.5% at 6 years to 11.8% at 12 years and reached a plateau at 12-13 years. Overweight (OR 1.35, 95%CI 1.03-1.77, P = 0.03) and obese (OR 2.43, 95%CI 1.81-3.26, P＜0.01) showed a positive correlation with percentage of FFF children. No correlation was found between FFF prevalence and gender or side. CONCLUSIONS FFF prevalence decreases with age and reaches a plateau at 12-13 years. Moreover, FFF prevalence is positively correlated with increased BMI and body height.
Collapse
Affiliation(s)
- Jichao Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China; Xi'an Hospital Of Traditional Chinese Medicine, China.
| | - Hongmou Zhao
- Foot and Ankle Surgery Department, Honghui Hospital of Xi'an Jiaotong University College of Medicine, China.
| | - Guihua Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China.
| | - Xiaojun Liang
- Foot and Ankle Surgery Department, Honghui Hospital of Xi'an Jiaotong University College of Medicine, China.
| | - Xinglv Hu
- Xi'an Hospital Of Traditional Chinese Medicine, China.
| | - Yi Zhu
- The Second Affiliated Hospital of Hainan Medical University, China.
| | - Rongqiang Zhang
- Public Health of Department of Shaanxi University of Chinese Medicine, China.
| | - Xiaochen Fan
- Foot and Ankle Surgery Department, Honghui Hospital of Xi'an Jiaotong University College of Medicine, China.
| | - Yi Cao
- Foot and Ankle Surgery Department, Honghui Hospital of Xi'an Jiaotong University College of Medicine, China.
| |
Collapse
|
|
20
|
Uden H, Scharfbillig R, Causby R. The typically developing paediatric foot: how flat should it be? A systematic review. J Foot Ankle Res 2017; 10:37. [PMID: 28814975 PMCID: PMC5558233 DOI: 10.1186/s13047-017-0218-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND All typically developing children are born with flexible flat feet, progressively developing a medial longitudinal arch during the first decade of their lives. Whilst the child's foot is expected to be flat, there is currently no consensus as to how flat this foot should be. Furthermore, whilst feet are observed to decrease in flatness with increasing age, it is not known how flat they should be at each age increment. The objective of this systematic review is to define the postural characteristics of the 'typically' developing paediatric foot. METHODS The PRISMA protocol was applied to compare all data currently published describing the typical development of the paediatric foot. The Epidemiological Appraisal Instrument (EAI) was used to assess the risk of bias of the included studies. RESULTS Thirty four epidemiological papers pertaining to the development of the paediatric foot were graphically compared. Sixteen different foot posture assessments were identified of which footprint based measures were the most reported outcome. CONCLUSION Firstly, the use of the term normal in relation to foot posture is misleading in the categorisation of the paediatric foot, as indeed a flat foot posture is a normal finding at specific ages. Secondly, the foot posture of the developing child is indeed age dependent and has been shown to change over time. Thirdly, no firm conclusion could be reached as to which age the foot posture of children ceases to develop further, as no two foot measures are comparable, therefore future research needs to consider the development of consensus recommendations as to the measurement of the paediatric foot, using valid and reliable assessment tools.
Collapse
Affiliation(s)
- Hayley Uden
- School of Health Sciences, University of South Australia, Adelaide, South Australia, 5001 Australia
| | - Rolf Scharfbillig
- School of Health Sciences, University of South Australia, Adelaide, South Australia, 5001 Australia
| | - Ryan Causby
- School of Health Sciences, University of South Australia, Adelaide, South Australia, 5001 Australia
| |
Collapse
|
|
21
|
Han Y, Duan D, Zhao K, Wang X, Ouyang L, Liu G. Investigation of the Relationship Between Flatfoot and Patellar Subluxation in Adolescents. J Foot Ankle Surg 2017; 56:15-18. [PMID: 27989338 DOI: 10.1053/j.jfas.2016.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Indexed: 02/03/2023]
Abstract
Patellar subluxation is common in adolescents, and a variety of factors are related to this condition, with valgus of the knee joint an important factor. The results of many studies suggest that flatfoot can cause an abnormality of the lower limb power line. Structural abnormalities of the foot caused by the high stresses exerted by body weight can lead to structural deformity of the knee and can also cause knee valgus. Screening for foot problems can help determine the risk of patellar subluxation, and early intervention can lessen the incidence of this condition. The purpose of the present study was to investigate the effects of flatfoot on the structure and function of the knees and, especially, the risk of patellar subluxation. A total of 72 participants were recruited for this cross-sectional study. The mean age at examination was 15.4 ± 4.0 (range 9 to 22) years. The measured parameters were heel valgus angle, arch index, and quadriceps angle (Q-angle). Overall, the mean values of the heel valgus angle, arch index, and Q-angle were 5.9° ± 2.4° (range 1° to 11°), 0.33 ± 0.07 (range 0.23 to 0.46), and 19.1° ± 3.5° (range 9° to 26°), respectively. The Q-angle was directly associated with the heel valgus angle (r = 0.818, p < .001) and arch index (r = 0.655, p < .001). We found that flatfoot can affect the morphology of the knee joint and increase the risk of patellar subluxation.
Collapse
Affiliation(s)
- Yu Han
- Orthopaedic Resident, Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Deyu Duan
- Orthopaedic Professor, Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Kangcheng Zhao
- Orthopedist, Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohong Wang
- Orthopedist, Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Ouyang
- Orthopedist, Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guanjie Liu
- Orthopaedic Resident, Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|