Comparative study of plantar footprints in youth with Down syndrome

Footprint measurement methods for the assessment and classification of foot types in subjects with Down syndrome: a systematic review

Background

Musculoskeletal disorders, especially in the feet, are common in people with Down syndrome (DS). Evaluation of podiatric footprints is important to prevent and manage orthopedic symptoms. The reliability of a wide variety of footprint measurement methods has been evaluated in healthy people, but few studies have considered the specific morphotype features of the feet in subjects with DS. The aim of this systematic review was to identify the podometric measurement tools used to typologically classify the footprints in the population with DS.

Methods

The following electronic databases were searched for studies describing footprint measurement tools to assess and classify the foot types in patients with DS published from inception to December 2020: PubMed, Web of Science, CINAHL, and Scopus. Articles were initially searched by screening titles and abstracts. Potentially relevant studies were then further screened by reviewing full texts. Studies that met the inclusion criteria were included in the review.

Results

Of the 122 articles identified by the search strategy, 14 full texts were retained to assess for eligibility, of which 11 studies met the inclusion criteria and were included. All the studies used footprint measurement methods to classify the foot types in subjects with DS, but only two studies assessed the reliability of those methods for the population with DS. The footprint measurement tools identified were a podoscope, a pressure-sensitive mat, a PressureStat^TM carbon paper, and a 3D scanner. The Arch Index was the most common footprint measurement analyzed (seven studies). Two studies used the “gold standard” indexes that include Hernández-Corvo Index, Chippaux-Smirak Index, Staheli Index, and Clarke Angle to measure footprints.

Conclusions

There is a need to determine the reliability and validity of the footprint measurement methods used for clinical classification of the foot types in subjects with DS. This can contribute to an early diagnosis of foot abnormalities that would help to reduce mobility impairments, improving the quality of life of patients with DS.

Discordance of the Evaluation of the Plantar Footprint in Kidney Transplant

BACKGROUND

The measures used for the diagnosis of biomechanical pathologic disorders are variable. The aim of this study was to determine the concordance between the Clarke angle and the Chippaux-Smirak and Staheli indices in evaluation of the footprints of kidney transplant patients.

METHODS

An observational prevalence study was performed in kidney transplant patients in the University Hospital Complex A Coruña from 1981 through 2014. After obtaining patient informed consent and ethics committee approval, sociodemographic (age and sex) and anthropometric (body mass index) variables and comorbidity (Charlson Comorbidity Index score) were assessed for each patient, and a podiatric medical examination was performed of the footprint through a pedigree (Chippaux-Smirak index, Staheli index, and Clarke angle). A descriptive analysis of all of the variables was performed; for agreement, the kappa index and the Bland-Altman method were used.

RESULTS

We found a predominance of male sex (65.6%) and a high level of overweight (43.3%) in the sample. The highest concordance between the indices studied is presented by the Chippaux-Smirak index, with a kappa index of 0.86 for the left foot and 0.76 for the right foot.

CONCLUSIONS

High agreement was attained among observers in measurements of the footprints of kidney transplant patients.

Evaluation of podiatric disorders in a sample of children with intellectual disabilities: an analytical cross-sectional study

BACKGROUND

Intellectual disabilities (IDs) usually derive from neurodevelopmental disabilities. They limit intellectual functioning and cause adaptive behaviors and orthopedic problems. These disabilities have harmful effects on health, everyday practical skills and social functioning, and they diminish quality of life. The goal of our research was to perform podiatric evaluations on schoolchildren with and without ID and ascertain their records of foot disorders.

DESIGN AND SETTING

Analytical cross-sectional study conducted at a podiatric clinic in the city of Piedras Blancas, province of Asturias, Spain.

METHODS

An analytical cross-sectional study on 82 schoolchildren affected by ID, compared with 117 healthy schoolchildren, was conducted at a podiatric clinic. Demographic data, clinical characteristics and measurements relating to podiatric examinations were recorded among the participants who completed all phases of the tool that was used in the study process.

RESULTS

Almost 90% of the schoolchildren with and without ID presented foot disorders relating to smaller toes, nail disorders, flat feet or lower-limb alterations.

CONCLUSIONS

The participants showed elevated prevalence of foot disorders. Podiatric evaluations are a significant means for preventing the appearance of medical conditions and/or foot problems, and they also improve general health.

The Relationship between Shoe Fitting and Foot Health of Persons with Down Syndrome: A Case Control Study

Background: Down syndrome is the most common chromosomal abnormality and a cause of intellectual disability. It is also associated with orthopaedic and musculoskeletal problems of the locomotive apparatus, especially of the feet. These problems are believed to have a harmful effect on health, social functioning, and mobility. In addition, these persons generally don’t have access to podiatric health services, even when their foot problems are well known, because of limited access to healthcare facilities. The goal of our research was to evaluate and compare the foot health status of study participants with and without Down syndrome and to determine whether inadequate footwear is being used with normalized reference values. Methods: A total of 105 participants with and without Down syndrome, with a mean age of 35.71 (SD = 12.93) years, were enrolled in the study. They self-reported demographic data and their clinical characteristic data were recorded. Measurements of their foot and shoe fitting were taken at all stages of the research process. Ninety-two percent of the participants with Down syndrome had foot problems. Results: Only 12 (24%) participants with Down syndrome used bilateral shoes that met the requirements of their feet compared to their controls (50 participants, 90.9% for the right foot; 46 participants, 83.6% for the left foot). Participants with Down syndrome presented statistically significant differences with respect to controls and wore incorrectly sized shoe. Conclusions: Evaluation of foot length and width may prevent development of foot deformities, as well as to improve general health.