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Martinez-Sebastian C, Gijon-Nogueron G, Ramos-Petersen L, Molina-Garcia C, Sánchez-Gómez R, Evans AM. The resting calcaneal stance position (RCSP): an old dog, with new tricks. Eur J Pediatr 2024; 183:1287-1294. [PMID: 38103102 PMCID: PMC10951039 DOI: 10.1007/s00431-023-05354-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/22/2023] [Accepted: 11/25/2023] [Indexed: 12/17/2023]
Abstract
The objective of this study was to establish the accuracy of the resting calcaneal stance position (RCSP) for the assessment of flat foot (FF) in children, aligned to the validity of the foot posture index (FPI). The RCSP cut-off point was explored, in context of both FF prevalence and the relationship between FF and body weight. A total of 205 healthy children, aged 5 to 10 years, participated in a cross-sectional study. Correlation was performed between RCSP and FPI. ROC curve technique was calculated to assess differentiation between groups. A score equal to or greater than 7 on the FPI was used as the 'gold standard' for analysis. The correlation between FPI and RCSP was significant (r = 0.63; p < 0.01). The discrimination score on the ROC curve (6 points/degrees) shows that the model can be used to identify FF through RCSP, with a sensitivity of 67% and specificity of 85% returned. Conclusion: The results of this study indicate the role of RCSP for simple, accessible and quick screening of paediatric FF. This is especially pertinent for non-podiatric healthcare professional without specialised paediatric foot knowledge. What is Known: • Most children develop a normal arch quickly, and flat feet usually resolve on their own between 2 and 6 years of age. • The measurement used to diagnose flat foot in children must be accurate, consistent, and valid to characterize the standard foot position. The Resting Calcaneal Stance Position (RCSP) is another widely used measure to evaluate the position of the flat foot in children. What is New: • The RCSP cut-off point 6 shows a sensitivity of 67% and a specificity of 85% thanks to the FPI as the Gold standard. • The RCSP is useful for health professionals who are not specialised in pediatric foot health. The RCSP is useful to detect flat foot in children.
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Affiliation(s)
- Carlos Martinez-Sebastian
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, 29071, Malaga, Andalucia, Spain
| | - Gabriel Gijon-Nogueron
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, 29071, Malaga, Andalucia, Spain
- IBIMA, University of Málaga, Malaga, Spain
| | - Laura Ramos-Petersen
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, 29071, Malaga, Andalucia, Spain.
| | - Cristina Molina-Garcia
- Department of Podiatry, Universidad Católica San Antonio de Murcia, Campus de los Jeronimos, 30107, GuadalupeMurcia, Spain
| | - Rubén Sánchez-Gómez
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Angela M Evans
- Discipline of Podiatry, College of Science, Health, and Engineering, La Trobe University, Melbourne, VIC, Australia
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Gül Y, Yaman S, Avcı D, Çilengir AH, Balaban M, Güler H. A Novel Deep Transfer Learning-Based Approach for Automated Pes Planus Diagnosis Using X-ray Image. Diagnostics (Basel) 2023; 13:diagnostics13091662. [PMID: 37175053 PMCID: PMC10178173 DOI: 10.3390/diagnostics13091662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/02/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
Pes planus, colloquially known as flatfoot, is a deformity defined as the collapse, flattening or loss of the medial longitudinal arch of the foot. The first standard radiographic examination for diagnosing pes planus involves lateral and dorsoplantar weight-bearing radiographs. Recently, many artificial intelligence-based computer-aided diagnosis (CAD) systems and models have been developed for the detection of various diseases from radiological images. However, to the best of our knowledge, no model and system has been proposed in the literature for automated pes planus diagnosis using X-ray images. This study presents a novel deep learning-based model for automated pes planus diagnosis using X-ray images, a first in the literature. To perform this study, a new pes planus dataset consisting of weight-bearing X-ray images was collected and labeled by specialist radiologists. In the preprocessing stage, the number of X-ray images was augmented and then divided into 4 and 16 patches, respectively in a pyramidal fashion. Thus, a total of 21 images are obtained for each image, including 20 patches and one original image. These 21 images were then fed to the pre-trained MobileNetV2 and 21,000 features were extracted from the Logits layer. Among the extracted deep features, the most important 1312 features were selected using the proposed iterative ReliefF algorithm, and then classified with support vector machine (SVM). The proposed deep learning-based framework achieved 95.14% accuracy using 10-fold cross validation. The results demonstrate that our transfer learning-based model can be used as an auxiliary tool for diagnosing pes planus in clinical practice.
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Affiliation(s)
- Yeliz Gül
- Department of Radiology, Elazig Fethi Sekin City Hospital, 23280 Elazig, Turkey
| | - Süleyman Yaman
- Biomedical Department, Vocational School of Technical Sciences, Firat University, 23119 Elazig, Turkey
| | - Derya Avcı
- Department of Software Engineering, Technology Faculty, Firat University, 23119 Elazig, Turkey
| | - Atilla Hikmet Çilengir
- Department of Radiology, Faculty of Medicine, Izmir Democracy University, 35140 Izmir, Turkey
| | - Mehtap Balaban
- Department of Radiology, Faculty of Medicine, Ankara Yildirim Beyazit University, 06010 Ankara, Turkey
| | - Hasan Güler
- Electrical-Electronics Engineering Department, Engineering Faculty, Firat University, 23119 Elazig, Turkey
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Loreti S, Berardi A, Galeoto G. Translation, Cross-Cultural Adaptation, and Validation of the Foot Posture Index (FPI-6)-Italian Version. Healthcare (Basel) 2023; 11:healthcare11091325. [PMID: 37174867 PMCID: PMC10178607 DOI: 10.3390/healthcare11091325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/18/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Since foot posture is one of the main predictors of lower limb musculoskeletal injuries, it is crucial to use appropriate tools to define the foot's posture. The Foot Posture Index is, therefore, a reliable method to measure foot posture and is widely known and used in clinics and research. This study aimed to translate the Foot Posture Index 6 (FPI6) into Italian and to assess its psychometric properties. Translation and cross-cultural adaptation were obtained using a popular guideline. Two examinators assessed 68 subjects, and data were collected to test intra/inter-rater reliability, internal consistency and cross-cultural validity. The Italian version of FPI6 showed excellent inter- and intra-rater reliability (ICC 0.96 and 0.97), and Cronbach's alpha coefficient was 0.9, thus showing excellent internal consistency. The FPI-6 version has proved to be reliable in terms of inter- and intra-rater reliability and can, therefore, be used in clinical practice and scientific research.
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Affiliation(s)
- Serena Loreti
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCSS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
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Molina-García C, Jiménez-García JD, Velázquez-Díaz D, Ramos-Petersen L, López-Del-Amo-Lorente A, Martínez-Sebastián C, Álvarez-Salvago F. Overweight and Obesity: Its Impact on Foot Type, Flexibility, Foot Strength, Plantar Pressure and Stability in Children from 5 to 10 Years of Age: Descriptive Observational Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040696. [PMID: 37189945 DOI: 10.3390/children10040696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Overweight (OW) and childhood obesity (OB) may cause foot problems and affect one's ability to perform physical activities. The study aimed to analyze the differences in descriptive characteristics, foot type, laxity, foot strength, and baropodometric variables by body mass status and age groups in children and, secondly, to analyze the associations of the BMI with different physical variables by age groups in children. METHODS A descriptive observational study involving 196 children aged 5-10 years was conducted. The variables used were: type of foot, flexibility, foot strength and baropodometric analysis of plantar pressures, and stability by pressure platform. RESULTS Most of the foot strength variables showed significant differences between the normal weight (NW), OW and OB groups in children aged between 5 and 8. The OW and OB groups showed the highest level of foot strength. In addition, the linear regression analyses showed, in children aged 5 to 8 years, a positive association between BMI and foot strength (the higher the BMI, the greater the strength) and negative association between BMI and stability (lower BMI, greater instability). CONCLUSIONS Children from 5 to 8 years of age with OW and OB show greater levels of foot strength, and OW and OB children from 7 to 8 years are more stable in terms of static stabilometrics. Furthermore, between 5 and 8 years, having OW and OB implies having more strength and static stability.
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Affiliation(s)
- Cristina Molina-García
- Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos n°135, 30107 Murcia, Spain
| | | | - Daniel Velázquez-Díaz
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL 32803, USA
- ExPhy Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Cadiz, Spain
| | | | - Andrés López-Del-Amo-Lorente
- Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos n°135, 30107 Murcia, Spain
| | | | - Francisco Álvarez-Salvago
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaen, Spain
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, 46010 Valencia, Spain
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Effect of Spatiotemporal Parameters on the Gait of Children Aged from 6 to 12 Years in Podiatric Tests: A Cross Sectional Study. Healthcare (Basel) 2023; 11:healthcare11050708. [PMID: 36900713 PMCID: PMC10001326 DOI: 10.3390/healthcare11050708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/12/2023] [Accepted: 02/23/2023] [Indexed: 03/04/2023] Open
Abstract
The use of lower limb tests in the paediatric population is of great importance for diagnostic evaluations. The aim of this study is to understand the relationship between the tests performed on the feet and ankles, covering all of its planes, and the spatiotemporal parameters of children's gait. METHODS It is a cross-sectional observational study. Children aged between 6 and 12 years participated. Measurements were carried out in 2022. An analysis of three tests used to assess the feet and ankles (FPI, the ankle lunge test, and the lunge test), as well as a kinematic analysis of gait using OptoGait as a measurement tool, was performed. RESULTS The spatiotemporal parameters show how Jack's Test is significant in the propulsion phase in its % parameter, with a p-value of 0.05 and a mean difference of 0.67%. Additionally, in the lunge test, we studied the % of midstance in the left foot, with a mean difference between the positive test and the 10 cm test of 10.76 (p value of 0.04). CONCLUSIONS The diagnostic analysis of the functional limitation of the first toe (Jack's test) is correlated with the spaciotemporal parameter of propulsion, as well as the lunge test, which is also correlated with the midstance phase of gait.
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Horii M, Akagi R, Ogawa Y, Yamaguchi S, Kimura S, Ono Y, Watanabe S, Shinohara M, Hosokawa H, Ohtori S, Sasho T. Foot morphology and correlation with lower extremity pain in Japanese children: A cross-sectional study of the foot posture Index-6. J Orthop Sci 2023; 28:212-216. [PMID: 34716069 DOI: 10.1016/j.jos.2021.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Abnormal foot morphology in children and adolescents is a possible risk factor for lower extremity pain. Foot posture index-6 (FPI-6) is a valid and reliable tool to assess foot morphology. However, the normative data on the age distribution for FPI-6 in Asian children and adolescents are still minimal. Further, the correlation of FPI-6 with lower extremity pain is poorly understood. We aimed to investigate the normative distribution for FPI-6 and the relationship between FPI-6 scores and knee and heel pain in Japanese children. METHODS We included 2569 Japanese children, aged 9-15 years, at a single school from 2016 to 2018. We summarized the age distribution of children and their mean bilateral FPI-6 scores. Additionally, we assessed the tenderness at the apophysis or tendon insertions at the knee and heel. We performed a cross-sectional analysis to investigate the correlations between FPI-6 scores and sex, age, and knee and heel pain for the data obtained each year. RESULTS The mean FPI-6 score was 3.1 ± 2.4, 3.4 ± 2.0, and 3.2 ± 1.9 for the left foot and 3.0 ± 2.4, 3.2 ± 1.9, and 3.1 ± 1.9 for the right foot in 2016, 2017, and 2018, respectively. Boys tended to have higher scores than girls, and the FPI-6 score of the left foot was significantly higher than that of the right foot (p < 0.05). There was no correlation between FPI-6 scores and knee and heel pain. CONCLUSION Children and adolescents between 9 and 15 years of age have neutral to slightly pronated foot morphology and an average FPI-6 score of 3.0-3.4. In addition, there was no relationship between foot morphology and knee and heel pain. This normative distribution for FPI-6 in Japanese children could serve as a reference value for future research and clinical evaluation.
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Affiliation(s)
- Manato Horii
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Ryuichiro Akagi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan.
| | - Yuya Ogawa
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Satoshi Yamaguchi
- Graduate School of Global and Transdisciplinary Studies College of Liberal Arts and Sciences, Chiba University, 1-33 Yayoi, Inage-ku, Chiba, Chiba, 263-8522, Japan
| | - Seiji Kimura
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Yoshimasa Ono
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Shotaro Watanabe
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Masashi Shinohara
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Hiroaki Hosokawa
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Seiji Ohtori
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
| | - Takahisa Sasho
- Center for Preventive Medicine, Musculoskeletal Disease and Pain, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan
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Evans AM. Pediatric Flat Feet: A 2020 Guide for Clinicians to Identify the Boomerangs. J Am Podiatr Med Assoc 2022; 112:20-103. [PMID: 33956150 DOI: 10.7547/20-103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The pediatric flatfoot has long occupied a place in the medical literature, with concerns about the significance of its appearance. At the end of the first decade of the 21st century, an article in this journal provoked active debate about the pediatric flatfoot as part of development, and proposed a considered titration of presenting cases in an effort to justify treatment and appreciated the range and expected change in normal foot posture with growth. A decade later, the availability of normative pediatric foot posture data, and the prospective findings to confirm lessening flat feet with age, encourage a structured and considered approach to this frequent primary care presentation. The pragmatic concept of the "boomerang" is built on the research identifying pediatric flat feet likely to be symptomatic, thus requiring intervention, and filtering from those likely to remain asymptomatic. Differential diagnoses are advisedly considered, and gait remains the hallmark outcome. In this contemporary guide, an eight-step strategy has been developed to improve the approach to community pediatric flatfoot concerns. Furthermore, the three boomerang flat feet factors delineating symptomatic from asymptomatic flat feet, and applicable cutoff levels, are availed for practical reference and use. Given the recognized state of overdiagnosis and resulting unnecessary treatment that pervades the 21st century, it is timely for clear 20/20 vision for the presentation of pediatric flatfoot.
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Affiliation(s)
- Angela M Evans
- *La Trobe University, Discipline of Podiatry, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering
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Rambelli C, Mazzoli D, Galletti M, Basini G, Zerbinati P, Prati P, Mascioli F, Masiero S, Merlo A. Foot Assessment Clinical Scales in Charcot-Marie-Tooth Patients: A Scoping Review. Front Hum Neurosci 2022; 16:914340. [PMID: 35814949 PMCID: PMC9263827 DOI: 10.3389/fnhum.2022.914340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Charcot-Marie-Tooth disease (CMT) is a slow and progressive peripheral motor sensory neuropathy frequently associated with the cavo-varus foot deformity. We conducted a scoping review on the clinical scales used to assess foot deviations in CMT patients and analyzed their metric properties. Evidence Acquisition A first search was conducted to retrieve all scales used to assess foot characteristics in CMT patients from the Medline, Web of Science, Google Scholar, Cochrane, and PEDro databases. A second search was conducted to include all studies that evaluated the metric properties of such identified scales from the same databases. We followed the methodologic guidelines specific for scoping reviews and used the PICO framework to set the eligibility criteria. Two independent investigators screened all papers. Evidence Synthesis The first search found 724 papers. Of these, 41 were included, using six different scales: “Foot Posture Index” (FPI), “Foot Function Index”, “Maryland Foot Score”, “American Orthopedic Foot & Ankle Society's Hindfoot Evaluation Scale”, “Foot Health Status Questionnaire”, Wicart-Seringe grade. The second search produced 259 papers. Of these, 49 regarding the metric properties of these scales were included. We presented and analyzed the properties of all identified scales in terms of developmental history, clinical characteristics (domains, items, scores), metric characteristics (uni-dimensionality, inter- and intra-rater reliability, concurrent validity, responsiveness), and operational characteristics (normative values, manual availability, learning time and assessors' characteristics). Conclusions Our results suggested the adoption of the six-item version of the FPI scale (FPI-6) for foot assessment in the CMT population, with scoring provided by Rasch Analysis. This scale has demonstrated high applicability in different cohorts after a short training period for clinicians, along with good psychometric properties. FPI-6 can help health professionals to assess foot deformity in CMT patients over the years.
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Affiliation(s)
- Chiara Rambelli
- Gait & Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua, Italy
| | - Davide Mazzoli
- Gait & Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy
- *Correspondence: Davide Mazzoli
| | - Martina Galletti
- Gait & Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy
| | - Giacomo Basini
- Gait & Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy
| | - Paolo Zerbinati
- Gait & Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy
- Neuro-Orthopedic Unit, Sol et Salus Hospital, Rimini, Italy
| | - Paolo Prati
- Gait & Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy
| | | | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua, Italy
| | - Andrea Merlo
- Gait & Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy
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Rogean de Jesus Alves de Baptista C, Garcia B, Cardoso J, Nascimento Elias A, Parra Buzzetti B, Claudia Mattiello-Sverzut A. Do different foot types affect the 6-min walk test capacity of younths with Charcot-Marie-Tooth neuropathy ? BMC Pediatr 2022; 22:277. [PMID: 35562696 PMCID: PMC9101939 DOI: 10.1186/s12887-022-03338-7] [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: 05/20/2021] [Accepted: 04/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study aimed to assess the gait capacity of youths with Charcot Marie Tooth disease (CMT), considering the different foot postures as a grouping variable. METHODS: The total distance, the predicted distance, and gait velocity obtained during the six-minute walking test (6MWT) were compared between participants with and without CMT. In addition, part of the CMT group completed a 12-month follow-up. The study evaluated 63 participants (CMT group = 31; Non-CMT group = 32) aged 6 to 18, both sexes. Data included anthropometric measures, foot posture index (FPI), the distance (D6), percentage of predicted distance (%D6), and walking velocity(V) in 6MWT. RESULTS The D6% presented no significant difference between the types of feet in CMT or Non-CMT (p < 0.05, Kruskal Wallis test). CMT presented reduced values of D6, %D6, and V when compared to Non-CMT. CONCLUSIONS These findings indicate that gait performance was decreased in youths with CMT in comparison to non-CMT. Contrary to what was expected, the cavus foot type did not show lower gait capacity than the flatfoot, suggesting that the types of feet alone did not determine differences in gait capacity within the CMT group.
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Affiliation(s)
- Cyntia Rogean de Jesus Alves de Baptista
- Laboratory of Musculoskeletal Structure and Function, Department of Health Science of Ribeirão Preto Medical School (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Beatriz Garcia
- Laboratory of Musculoskeletal Structure and Function, Department of Health Science of Ribeirão Preto Medical School (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Juliana Cardoso
- Rehabilitation and Functional Performance Program Ribeirão Preto Medical School (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Adriana Nascimento Elias
- Rehabilitation and Functional Performance Program Ribeirão Preto Medical School (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Paulista University and Moura Lacerda University, Ribeirão Preto, Brazil
| | - Beatriz Parra Buzzetti
- Laboratory of Musculoskeletal Structure and Function, Department of Health Science of Ribeirão Preto Medical School (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Ana Claudia Mattiello-Sverzut
- Laboratory of Musculoskeletal Structure and Function, Department of Health Science of Ribeirão Preto Medical School (FMRP-USP), Ribeirão Preto, São Paulo, Brazil. .,Rehabilitation and Functional Performance Program Ribeirão Preto Medical School (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.
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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: 5] [Impact Index Per Article: 2.5] [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.
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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
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Parmar ST, Dhanuka HR, Shetty DR. Effectiveness of Kinesio Taping and Exercises for Pronated Feet in Children with Neurodevelopmental Disorders: A Cross Over Study. Niger J Clin Pract 2022; 25:21-26. [PMID: 35046190 DOI: 10.4103/njcp.njcp_62_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Taping is widely used intervention in various conditions treated by physiotherapist. Neurodevelopmental disorders in children leading to foot abnormality is one of the major concen. As taping is one of the intervention in same the study is focusing taping on pronated feet in the selected age group. Aim The aim of this study was to investigate whether the kinesiotaping and exercise improve pronated feet in neurodevelopmental disordered (NDD) children. Patients and Methods This was a cross over study, within subjects study evaluating two treatments, kinesio tape, and exercise. Thirty subjects with age group 6-12 years diagnosed with NDD having pronated feet. Subjects were allocated in the two groups. Group 1 included subjects for taping and Group 2 included subjects for exercise. Taping was applied for two consecutive weeks for 5 days per week and then 2 weeks of the window period, which was followed by two consecutive weeks of exercise sessions for 5 days per week. The navicular drop test and Foot Posture Index were measured pre and post treatment. Foot posture index used to examine the posture of foot and navicular drop test. Results and Conclusion Group 1 (taping) and Group 2 (exercises) showed no significant results as a single entity, whereas there was a small effect seen of the intervention.
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Affiliation(s)
- S T Parmar
- Department of Paediatric Physiotherapy, SDM College of Physiotherapy, Karnataka, India
| | - H R Dhanuka
- Department of Paediatric Physiotherapy, SDM College of Physiotherapy, Karnataka, India
| | - D R Shetty
- Department of Paediatric Physiotherapy, SDM College of Physiotherapy, Karnataka, India
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Zapata KA, Trevino ME, Reyes FI, Jo CH, Sharma C. Adherence to serial casting protocols for idiopathic toe walking: A quality improvement initiative. J Pediatr Rehabil Med 2022; 15:469-476. [PMID: 36093715 DOI: 10.3233/prm-210054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE This initiative aimed to assess adherence to Scottish Rite for Children's serial casting protocol for children with idiopathic toe walking (ITW), factors related to adherence, and outcomes after education regarding the protocol. METHODS 60 patients aged 7.1±2.7 years who completed serial casting were examined at baseline phase (n = 30) and post-education phase (n = 30). Protocols include weekly serial casting for 4 to 6 weeks to achieve 10° of ankle dorsiflexion (ADF) passive range of motion (PROM) with knees extended (KE), assessing the foot posture index (FPI-6) and single leg stance (SLS). Baseline phase evaluated adherence to protocols. Education phase evaluated factors related to adherence and education regarding serial casting findings. Post-education phase evaluated the impact of the education phase. RESULTS Serial casting averaged 4.8±1.5 weeks (n = 60). ADF PROM was measured with 100% adherence. ADF PROM KE averaged -10.7° pre-cast and significantly improved to +6.5° post-cast (n = 60), and it significantly improved post-cast post-education (p = 0.04). FPI-6 and SLS adherence significantly improved post-cast post-education. FPI-6 total score averaged +5.3 at baseline and +5.8 post-cast (n = 35). CONCLUSION Education of staff in serial casting protocols improved adherence and patient outcomes. Patients with ITW and ADF PROM KE -10° benefit from serial casting to improve PROM and to allow for orthotic use post-casting.
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Affiliation(s)
- Karina A Zapata
- Therapy Services, Scottish Rite for Children, Dallas, TX, USA
| | - Megan E Trevino
- Therapy Services, Scottish Rite for Children, Dallas, TX, USA
| | - Fabiola I Reyes
- Neurology and Rehabilitation Medicine, Scottish Rite for Children, Dallas, TX, USA
| | - Chan-Hee Jo
- Research, Scottish Rite for Children, Dallas, TX, USA
| | - Charu Sharma
- Clinical Quality and Performance Improvement, Scottish Rite for Children, Dallas, TX, USA
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Alfaro-Santafé J, Gómez-Bernal A, Lanuza-Cerzócimo C, Alfaro-Santafé JV, Pérez-Morcillo A, Almenar-Arasanz AJ. Effectiveness of Custom-Made Foot Orthoses vs. Heel-Lifts in Children with Calcaneal Apophysitis (Sever’s Disease): A CONSORT-Compliant Randomized Trial. CHILDREN 2021; 8:children8110963. [PMID: 34828675 PMCID: PMC8621014 DOI: 10.3390/children8110963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022]
Abstract
The aim of the present research was to determine the effectiveness of relieving calcaneal apophysitis pain using “off-the-shelf” heel-lifts and custom-made orthotics. Two intervention modalities were evaluated and compared in a 12-week follow-up trial. Inclusion criteria included 9- to 12-year-old children diagnosed with calcaneal apophysitis. Children were randomly stratified into treatment A (custom-made polypropylene foot orthoses) and treatment B (“off-the-shelf” heel-lifts) groups. Treatment effectiveness was measured by algometry and the visual analogical scale (VAS). A total of 208 patients were included. The treatment A group showed an increase in threshold algometry of 53.4% (95% CI 47.1% to 59.7%) and a decrease in VAS of −68.6% (95% CI −74.5% to −62.7%) compared with the treatment B group (p < 0.001). Calcaneal apophysitis pain perception was improved in both groups, but children who used custom-made foot orthoses showed a greater improvement.
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Affiliation(s)
- Javier Alfaro-Santafé
- Department of Podiatry, Faculty of Health Sciences, Manresa University, 08242 Manresa, Spain; (J.A.-S.); (C.L.-C.); (J.-V.A.-S.); (A.P.-M.)
- R & D Department, Biomechanical Unit, Podoactiva Headquarters, 22197 Huesca, Spain;
| | - Antonio Gómez-Bernal
- Department of Podiatry, Faculty of Health Sciences, Manresa University, 08242 Manresa, Spain; (J.A.-S.); (C.L.-C.); (J.-V.A.-S.); (A.P.-M.)
- R & D Department, Biomechanical Unit, Podoactiva Headquarters, 22197 Huesca, Spain;
- Correspondence:
| | - Carla Lanuza-Cerzócimo
- Department of Podiatry, Faculty of Health Sciences, Manresa University, 08242 Manresa, Spain; (J.A.-S.); (C.L.-C.); (J.-V.A.-S.); (A.P.-M.)
- R & D Department, Biomechanical Unit, Podoactiva Headquarters, 22197 Huesca, Spain;
| | - José-Víctor Alfaro-Santafé
- Department of Podiatry, Faculty of Health Sciences, Manresa University, 08242 Manresa, Spain; (J.A.-S.); (C.L.-C.); (J.-V.A.-S.); (A.P.-M.)
- R & D Department, Biomechanical Unit, Podoactiva Headquarters, 22197 Huesca, Spain;
| | - Aitor Pérez-Morcillo
- Department of Podiatry, Faculty of Health Sciences, Manresa University, 08242 Manresa, Spain; (J.A.-S.); (C.L.-C.); (J.-V.A.-S.); (A.P.-M.)
- Departament of Podiatry, Faculty of Health Science, Campus de Los Jerónimos, Universidad Católica San Antonio de Murcia, Guadalupe, 30107 Murcia, Spain
| | - Alejandro-Jesús Almenar-Arasanz
- R & D Department, Biomechanical Unit, Podoactiva Headquarters, 22197 Huesca, Spain;
- Department of Physiotherapy, Faculty of Health and Sports Sciences, San Jorge University, 50830 Villanueva de Gállego, Spain
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Alfageme-García P, Calderón-García JF, Martínez-Nova A, Hidalgo-Ruiz S, Basilio-Fernández B, Rico-Martín S. Association between the Use of Backpack and Static Foot Posture in Schoolchildren with Static Pronated Foot Posture: A 36-Month Cohort Study. CHILDREN 2021; 8:children8090800. [PMID: 34572232 PMCID: PMC8467317 DOI: 10.3390/children8090800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
Background: Schoolchildren often spend a lot of time carrying a backpack with school equipment, which can be very heavy. The impact a backpack may have on the pronated feet of schoolchildren is unknown. Aims: The objective of this study was to evaluate the association of the backpack use on static foot posture in schoolchildren with a pronated foot posture over 36 months of follow-up. Methods: This observational longitudinal prospective study was based on a cohort of consecutive healthy schoolchildren with pronated feet from fifteen different schools in Plasencia (Spain). The following parameters were collected and measured in all children included in the study: sex, age, height, weight, body mass index, metatarsal formula, foot shape, type of shoes, and type of schoolbag (non-backpack and backpack). Static foot posture was determined by the mean of the foot posture index (FPI). The FPI was assessed again after 36 months. Results: A total of 112 participants used a backpack when going to school. Over the 36-month follow-up period, 76 schoolchildren who had a static pronated foot posture evolve a neutral foot posture. Univariate analysis showed that the schoolchildren using backpacks were at a greater risk of not developing neutral foot (odds ratio [OR]: 2.09; 95% CI: 1.08–4.09). The multivariate analysis provided similar results, where the schoolchildren using a backpack (adjusted OR [aOR]: 1.94; 95% CI: 1.02–3.82) had a significantly greater risk of not developing a neutral foot posture. Conclusions: A weak relationship was found between backpack use and schoolchildren aged from five to eleven years with static pronated feet not developing a neutral foot posture over a follow-up period of 36 months.
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Affiliation(s)
- Pilar Alfageme-García
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (B.B.-F.)
| | - Julián Fernando Calderón-García
- Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain;
- Correspondence: ; Tel.: +34-927251267
| | - Alfonso Martínez-Nova
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (B.B.-F.)
| | - Sonia Hidalgo-Ruiz
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (B.B.-F.)
| | - Belinda Basilio-Fernández
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (B.B.-F.)
| | - Sergio Rico-Martín
- Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain;
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Žukauskas S, Barauskas V, Čekanauskas E. Comparison of multiple flatfoot indicators in 5-8-year-old children. Open Med (Wars) 2021; 16:246-256. [PMID: 33623820 PMCID: PMC7885299 DOI: 10.1515/med-2021-0227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/15/2020] [Accepted: 01/13/2021] [Indexed: 12/02/2022] Open
Abstract
Background The foot posture is age dependent. The purpose of this study was to investigate the relationship between the 6-item version of the foot posture index (FPI) and other clinical, foot anthropometric, radiological measurements for the foot position in 5–8-year-old children. Methods A total of 301 participants with a mean age of 6.4 ± 1.14 years were enrolled in the study. Children were examined physically, clinically, and radiologically to measure the FPI and navicular drop (ND) test, resting calcaneal stance position (RCSP) angle, Chippaux–Smirak index (CSI), Staheli index (SI), calcaneal pitch (CP) angle, talocalcaneal angle (TCA), and the first lateral metatarsal angle. Tibial torsions, internal rotation of the hip as an indirect method of femoral anteversion, and Beighton scale were analyzed for factors associated with flatfoot prevalence. Results The study included children with normal and flexible flatfeet. Statistical analysis showed a significant FPI score correlation with other parameters (SI, CSI, RCSP, ND, CP, TMA, and TCA showed strong and moderate correlations, p < 0.001). Overall, the strongest associates are CSI (β = 0.34) and ND (β = 0.28). Other indicators have relatively small relationships with the FPI. Conclusion A positive correlation was observed between FPI-6 and ND test, CSI in 5–8-year-old children. All three prominent foot posture indicators (FPI-6, ND, and CSI) might be used as a primary or preferred tool in clinical practice.
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Affiliation(s)
- Saidas Žukauskas
- Department of Paediatric Surgery, Lithuanian University of Health Sciences, Pramonės pr. 47-24, Kaunas, Kauno m., LT-50461, Lithuania
| | - Vidmantas Barauskas
- Department of Paediatric Surgery, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, LT-44307, Kaunas, Lithuania
| | - Emilis Čekanauskas
- Department of Paediatric Surgery Pediatric Orthopedics - Traumatology Unit, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, LT-44307, Kaunas, Lithuania
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Porcel-Gálvez AM, Barrientos-Trigo S, Fernández-García E, Allande-Cussó R, Quiñoz-Gallardo MD, Morales-Asencio JM. Development and External Validity of a Short-Form Version of the INICIARE Scale to Classify Nursing Care Dependency Level in Acute Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8511. [PMID: 33212889 PMCID: PMC7698435 DOI: 10.3390/ijerph17228511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 02/02/2023]
Abstract
Background: The increasing dependence care in patients hospitalized in acute hospitals around the world entails classification systems heeding the wide range of care dependency levels generated by the many different types of dependent patients. This article is a report of a study assessing the validity and reliability of a short-from version of the instrument (Inventario del NIvel de Cuidados mediante Indicadores de Resultados de Enfermería (INICIARE)) used to classify inpatients according to their care dependency level. Methods: The validation, carried out in a multicenter longitudinal study, included three different samples: the first sample of 1800 patients to evaluate the reliability and validity, a second of 762 patients for confirmatory factor analysis, and a third of 762 to test the short-form version. Patients over 16 years of age, admitted to medical or surgical units at 11 public hospitals, were included. Results: The final sample included 3605 patients. Patients had a mean age of 64.5 years, 60% were admitted to medical units, with severe dependency. The validation process yielded two versions of the instrument: a 40-item version, with eight factors with 83.6% of total variance explained and Cronbach's alpha values between 0.98 and 0.92, and a short-form with 26 items, with five factors and Cronbach's alpha values between 0.96 and 0.90. The Confirmatory Factor Analysis yielded a good fit model to the 40-item version (Chi Square on Degrees of Freedom CMIN/DF) = 1.335; Normed Fit Index (NFI); Tucker-Lewis Index (TLI); Comparative Fit Index (CFI) > 0.90; Standardized Residual Root Mean Square (RMSEA) = 0.02; and Standardized Residual Root Mean Square (SRMR) = 0.027) and 26-item version (Chi Square on Degrees of Freedom CMIN/DF = 1.385; NFI = 0.998; CFI = 0.999; RMSEA = 0.02; and SRMR 0.02). Both INICIARE versions obtained a high correlation between them (r = 0.96; p < 0.001). Conclusion: INICIARE has proved to be a valid and reliable instrument for the assessment of the level of care dependency of acutely hospitalized patients.
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Affiliation(s)
- Ana María Porcel-Gálvez
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (A.M.P.-G.); (E.F.-G.); (R.A.-C.)
- Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 Complex Care, Chronic and Health Outcomes, Instituto de Biomedicina de Sevilla (IBIS), 41013 Seville, Spain
| | - Sergio Barrientos-Trigo
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (A.M.P.-G.); (E.F.-G.); (R.A.-C.)
- Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 Complex Care, Chronic and Health Outcomes, Instituto de Biomedicina de Sevilla (IBIS), 41013 Seville, Spain
| | - Elena Fernández-García
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (A.M.P.-G.); (E.F.-G.); (R.A.-C.)
- Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 Complex Care, Chronic and Health Outcomes, Instituto de Biomedicina de Sevilla (IBIS), 41013 Seville, Spain
| | - Regina Allande-Cussó
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (A.M.P.-G.); (E.F.-G.); (R.A.-C.)
- Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 Complex Care, Chronic and Health Outcomes, Instituto de Biomedicina de Sevilla (IBIS), 41013 Seville, Spain
- Emergency Unit, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
| | - María Dolores Quiñoz-Gallardo
- Instituto de Investigación Biosanitaria de Granada (IBS), Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain;
| | - José Miguel Morales-Asencio
- Faculty of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain;
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Pérez-Belloso AJ, Coheña-Jiménez M, Cabrera-Domínguez ME, Galan-González AF, Domínguez-Reyes A, Pabón-Carrasco M. Influence of Dental Malocclusion on Body Posture and Foot Posture in Children: A Cross-Sectional Study. Healthcare (Basel) 2020; 8:E485. [PMID: 33202576 PMCID: PMC7711574 DOI: 10.3390/healthcare8040485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/02/2020] [Accepted: 11/12/2020] [Indexed: 11/16/2022] Open
Abstract
The number of studies that investigate the correlations between the temporomandibular system and body posture, postural control, or the distribution of plantar pressure has recently been increasing. However, most of the existing information is not conclusive. Therefore, the study objective was to evaluate if the features of dental malocclusion are correlated with body posture alterations at the lower limb level. This is a multicentre cross-sectional study with 289 children (8-14 years). Angle's molar relation was analysed at the dental level. The postural control and the plantar pressure distribution were recorded via a force platform. Correlation and inferential analysis between the Angle class and the foot's biomechanics were tested. The centre of gravity is anteriorised in Angle's Class II in both the molar class (p ≤ 0.001) and the canine class (p ≤ 0.001). Likewise, a relationship was observed between the contact surface and Angle's classes, being higher in class III than in II (p ≤ 0.001). The plantigrade phase is shortened in Angle's Class III. A relationship was found between Angle's Class II and a forward movement of the centre of gravity. No relationship was found between the Foot Posture Index and the truncated scaphoid height and the dental classification. An evident relationship between the gait typology and dental malocclusion was not found.
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Affiliation(s)
- Ana Juana Pérez-Belloso
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain; (A.J.P.-B.); (M.P.-C.)
| | - Manuel Coheña-Jiménez
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain; (A.J.P.-B.); (M.P.-C.)
- Department of Podiatry, University of Sevilla, 41009 Sevilla, Spain
| | | | | | - Antonia Domínguez-Reyes
- Faculty of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (M.E.C.-D.); (A.F.G.-G.); (A.D.-R.)
| | - Manuel Pabón-Carrasco
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain; (A.J.P.-B.); (M.P.-C.)
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Modification of Pronated Foot Posture after a Program of Therapeutic Exercises. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228406. [PMID: 33202893 PMCID: PMC7697388 DOI: 10.3390/ijerph17228406] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 01/01/2023]
Abstract
Working on the intrinsic musculature of the foot has been shown to be effective in controlling pronation. However, the potential coadjuvant effect that involving other muscle groups might have on foot posture remains unknown. The aim was, therefore, to assess whether a 9-week intrinsic and extrinsic foot and core muscle strength program influenced foot posture in pronated subjects. The participants were 36 healthy adults with pronated feet that were randomly assigned to two groups. The experimental group (n = 18) performed a strengthening exercise protocol for 9 weeks (two sessions of 40 min per week), while the control group (n = 18) did not do these exercises. After 9 weeks, the foot posture index (FPI) scores of the two groups were analyzed to detect possible changes. The FPI at the baseline was 8.0 ± 1.5. After the 9 weeks, the experimental group showed significantly reduced FPI from 8.1 ± 1.7 to 6.4 ± 2.1 (p = 0.001), while the control group had the same score as pre-intervention (FPI 8 ± 1.2, p = 1.0). The FPI scores showed no significant differences by sex. Strengthening of the intrinsic and extrinsic foot and core muscles contributed to improving foot posture in adults, reducing their FPI by 1.66 points.
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Alfageme-García P, Calderón-García JF, Martínez-Nova A, Hidalgo-Ruiz S, Martínez-Álvarez M, Rico-Martín S. Backpacks Effect on Foot Posture in Schoolchildren with a Neutral Foot Posture: A Three-Year Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197313. [PMID: 33036376 PMCID: PMC7579156 DOI: 10.3390/ijerph17197313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/25/2020] [Accepted: 10/03/2020] [Indexed: 12/27/2022]
Abstract
Background: There is a paucity of data on the relationship between backpack use and foot posture in children. The aim of this study was to assess the effects of a backpack on foot posture in children with neutral foot posture during three years of follow-up. Methods: A prospective longitudinal observational study was conducted in a sample of 627 children with neutral foot. For each participant included in the study, age, sex, weight, height, body mass index, type of schoolbag (backpack or non-backpack), foot shape, metatarsal formula and type of shoes were recorded. Foot posture was described by the mean of the foot posture index (FPI) and reassessed after three years in a follow-up study. Results: The average age of the children was 8.32 ± 1.32 years. A total of 458 used a backpack when going to school. Over the three-year follow-up period, 50 children who had neutral foot developed supinated foot (n = 18) or pronated foot (n = 32). Univariate and multivariate analysis showed that the children using a backpack were at a higher risk of developing pronated foot (adjusted Odds Ratio (aOR) = 2.05, 95% IC: 1.08–3.89, p = 0.028). Backpack use was not associated with the change from neutral foot to supinated foot. Conclusions: We found a positive association between using a backpack and the risk of developing pronated but not supinated foot. Clinical trials should be conducted to analyze the effect of backpack use on the foot among schoolchildren.
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Affiliation(s)
- Pilar Alfageme-García
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain
| | - Julián Fernando Calderón-García
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
- Correspondence:
| | - Alfonso Martínez-Nova
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain
| | - Sonia Hidalgo-Ruiz
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing Departament, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain
| | - Mariana Martínez-Álvarez
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Faculty of Medicine, University of Extremadura, 06006 Badajoz, Spain
| | - Sergio Rico-Martín
- Nursing Department, University of Extremadura, 10003 Cáceres, Spain; (P.A.-G.); (A.M.-N.); (S.H.-R.); (M.M.-Á.); (S.R.-M.)
- Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
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Hegazy FA, Aboelnasr EA, Salem Y, Zaghloul AA. Validity and diagnostic accuracy of foot posture Index-6 using radiographic findings as the gold standard to determine paediatric flexible flatfoot between ages of 6-18 years: A cross-sectional study. Musculoskelet Sci Pract 2020; 46:102107. [PMID: 31989966 DOI: 10.1016/j.msksp.2020.102107] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/16/2019] [Accepted: 01/10/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Diagnosis of flexible flatfoot is usually based upon radiographic or clinical measures. Radiographic measures pose a potential risk of radiation exposure especially in Paediatric population. Clinicians need a valid, accurate, easily used, noninvasive and cost effective measure to evaluate static foot posture clinically. Although, foot posture index-6 (FPI-6) are commonly used in clinical practice, its validity and diagnostic accuracy in evaluation of paediatric flexible flatfoot have not been fully proven yet. OBJECTIVES To investigate validity and diagnostic accuracy of FPI-6 to determine Paediatric flexible flatfoot between ages of 6-18 years using radiographic findings as the gold standard measure. STUDY DESIGN Cross-sectional study. METHODS A cross-sectional study conducted on 612 participants (1224 feet) with flexible flatfoot aged 6-18 years (mean age ± standard deviation of 12.36 ± 3.39 years). The results of FPI-6 were compared to the gold standard radiographic measures and displayed on the receiver operating characteristic curve. Intra-rater reliability, sensitivity, specificity, predictive values and likelihood ratios were calculated. Posttest probability was calculated from Fagan nomogram. RESULTS FPI-6 demonstrate high intra-rater reliability (ICC = 0.96) with p value < 0.001. FPI-6 showed a sensitivity of 83.7%, a specificity of 80.4, a positive predictive value of 64.7, a negative predictive value of 92, a positive likelihood ratio of 4.62 and a negative likelihood ratio of 0.20. FPI-6 shows moderate diagnostic accuracy [AUC = 0.82; 95%CI (0.78-0.85)]. CONCLUSION FPI-6 is valid with moderate diagnostic accuracy to determine paediatric flexible flatfoot between ages of 6-18 years.
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Affiliation(s)
- Fatma A Hegazy
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
| | | | - Yasser Salem
- Department of Physical Therapy, University of North Texas Health Science Center, Texas, USA.
| | - Ashraf A Zaghloul
- Department of Health Administration and Behavioural Sciences, High Institute of Public Health, Alexandria University, Egypt.
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Cho Y, Park JW, Nam K. The relationship between foot posture index and resting calcaneal stance position in elementary school students. Gait Posture 2019; 74:142-147. [PMID: 31525651 DOI: 10.1016/j.gaitpost.2019.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 08/06/2019] [Accepted: 09/04/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Static foot assessment is commonly performed in clinical practice to classify foot type for prescribing therapeutic interventions. Foot posture index is known to be a reliable indicator for foot position. Resting calcaneal stance position angle is used widely to determine foot posture and manufacture orthoses for pediatric flat foot patients. However, the relationship between foot posture index and resting calcaneal stance position angle in elementary school students is currently unclear. RESEARCH QUESTION To investigate the relationship between foot posture index and resting calcaneal stance position angle in elementary school students. METHODS Between January 2016 and December 2017, 208 elementary school students (average age, 10.3 years; range, 8-13 years) were enrolled for this study. All students were examined physically by one practitioner to measure foot posture index and resting calcaneal stance position angle. Age, gender, and body mass index were analyzed for factors associated with flat foot prevalence. This study was conducted as a retrospective comparative study. Associations between foot posture index and resting calcaneal stance position angle were determined by Pearson's correlation analysis. RESULTS AND SIGNIFICANCE When measured by foot posture index and resting calcaneal stance position angle, the overall prevalence of flatfoot was 29% and 24% in the right foot and 26% and 23% in the left foot, respectively. Resting calcaneal stance position angle and foot posture index score showed moderate correlation in Pearson's correlation analysis (left side foot: kappa value = 0.710; right side foot: kappa value = 0.704). CONCLUSION There is a moderate correlation between foot posture index and resting calcaneal stance position angle in elementary school students. Thus, both foot posture index with proven validity and reliability and resting calcaneal stance position widely used in the manufacture of insoles can be used as important biomechanical evaluation tools for feet in clinical settings.
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Affiliation(s)
- Yongjin Cho
- Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, 27 Dongguk‑ro, Ilsandong‑gu, Goyang‑si, Gyeonggi‑do 10326, Republic of Korea.
| | - Jin-Woo Park
- Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, 27 Dongguk‑ro, Ilsandong‑gu, Goyang‑si, Gyeonggi‑do 10326, Republic of Korea.
| | - Kiyeun Nam
- Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, 27 Dongguk‑ro, Ilsandong‑gu, Goyang‑si, Gyeonggi‑do 10326, Republic of Korea.
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Martinelli N, Spreafico A, Tramacere I, Marcolli D, Valli F, Curci D. Prevalence and Associated Factors of Sever's Disease in an Athletic Population. J Am Podiatr Med Assoc 2019; 109:351-356. [PMID: 31599666 DOI: 10.7547/17-105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Sever's disease is a common cause of pain in growing kids. Many papers reported in the literature discuss this pathologic condition, but no consensus regarding its etiology has been found among researchers. The aim of the present study was to describe the epidemiologic profile and associated factors of 430 athletic children in a population-based sample of soccer (29.5%), basketball (48.1%), and volleyball (22.3%) players aged 6 to 14 years. METHODS Every athlete was evaluated through physical examination, the Foot Posture Index (FPI), the Oxford Ankle Foot Questionnaire, and a custom-made sports questionnaire. RESULTS These data show that body mass index, sex, terrain type, sports discipline, and FPI should not be considered as risk factors for calcaneal apophysitis, whereas a significantly higher risk has been found in younger individuals (P < .01), in those with fewer training sessions per week (P = .02), and in those with shorter training sessions (P < .01). CONCLUSIONS The prevalence of Sever's disease in the athletic children evaluated in the present study was higher in younger and less active patients, whereas no differences were registered by sex, FPI, body mass index, terrain type, or sports discipline.
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Affiliation(s)
- Nicolò Martinelli
- Department of Ankle and Foot Surgery, IRCCS Instituto Ortopedico Galeazzi, Milan, Italy
| | | | - Irene Tramacere
- Department of Statistics, Carlo Besta Neurological Institute, Milan, Italy
| | | | | | - Domenico Curci
- Department of Pediatric Orthopedics, IRCCS IRCCS Instituto Ortopedico Galeazzi, Milan, Italy
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Baptista CRD, Nascimento-Elias AH, Garcia B, Testa A, Domingues PC, Martinez EZ, Marques W, Mattiello-Sverzut AC. Physical function and performance measures of children and adolescents with Charcot-Marie-Tooth disease. Physiother Theory Pract 2019; 37:73-80. [PMID: 31046526 DOI: 10.1080/09593985.2019.1603257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This study aimed to verify whether there are differences in foot type, physical function, and performance between children and adolescents with Charcot-Marie-Tooth disease (CMT) and their healthy counterparts, and whether an interval of 6 months, from the initial assessment, reveals any significant changes on physical performance and other specific physical measures of the lower limbs. Subjects and Methods: Participants between 6 and 17 years of age, with CMT (CMT group n = 40), were compared to healthy participants (Control group, n = 49). Twenty participants with CMT completed the follow-up. We collected anthropometric, goniometric (ankle and knee), and dynamometric (inversion, eversion, plantar flexors, dorsiflexors, knee, hip extensors) measures, agonist/antagonist ratios, feet alignment (Foot Posture Index - FPI), muscle power (Long Jump), Pediatric Balance Scale (PBS), and 10-meter walk test (10MWT). Results: Compared to Control, CMT showed reduced passive range of motion (ROM), weakness in all evaluated muscles, increased agonist/antagonist ratios, predominance of varus and lower performance (PBS and Long Jump). After 6 months, CMT measures did not change. Conclusion: The cross-sectional analysis showed reduced ROM, strength, power, and distal muscle imbalance, as well as secondary limitations (PBS and 10MWT) in children and adolescents with CMT. These biomechanical and functional alterations did not change at the 6-month follow-up.
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Affiliation(s)
- Cyntia Rogean De Baptista
- Department of Health Sciences, Ribeirão Preto Medical School - University of São Paulo , São Paulo, Ribeirão Preto, Brazil
| | - Adriana H Nascimento-Elias
- Department of Health Sciences, Ribeirão Preto Medical School - University of São Paulo , São Paulo, Ribeirão Preto, Brazil
| | - Beatriz Garcia
- Department of Health Sciences, Ribeirão Preto Medical School - University of São Paulo , São Paulo, Ribeirão Preto, Brazil
| | - Amanda Testa
- Department of Health Sciences, Ribeirão Preto Medical School - University of São Paulo , São Paulo, Ribeirão Preto, Brazil
| | - Paula Calori Domingues
- Department of Health Sciences, Ribeirão Preto Medical School - University of São Paulo , São Paulo, Ribeirão Preto, Brazil
| | - Edson Zangiacomi Martinez
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo (USP) , Brazil
| | - Wilson Marques
- Department of Neurosciences and Neurobehavioral Sciences, Ribeirão Preto Medical School, University of São Paulo (USP) , Brazil
| | - Ana Claudia Mattiello-Sverzut
- Department of Health Sciences, Ribeirão Preto Medical School - University of São Paulo , São Paulo, Ribeirão Preto, Brazil
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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: 26] [Impact Index Per Article: 5.2] [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.
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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
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25
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Influence of Shoe Characteristics on the Development of Valgus Foot in Children. J Clin Med 2019; 8:jcm8010085. [PMID: 30642069 PMCID: PMC6352257 DOI: 10.3390/jcm8010085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 11/16/2022] Open
Abstract
For thousands of years, shoes have been worn to protect the feet from injury, and the proper choice and use of footwear are directly relevant to foot health, especially that of children. The aim of this study was to evaluate the association between shoe-related factors (type and frequency of use) and the prevalence of valgus foot in children. This analytical cross-sectional observational study was carried out on a population of children in the first, second or third year of primary education, to analyzing the frequency and type of shoes worn, and to determining the presence or not of valgus foot. The sample consisted of 132 children (of 642 potential subjects), with an average age of 7.53 years (Standard Deviation (SD) 0.80), which was composed of 61 boys (46.2%) and 71 girls (53.8%). The overall prevalence of valgus foot was 45.5% (n = 60). The use of boots 2⁻5 days a week was significantly associated, in both sexes, with a lower prevalence of valgus in the left foot (30.5%, p = 0.009). The use of boots could be associated with a lower presence of valgus, depending on the frequency of wear.
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26
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Validation of normalized truncated navicular height as a clinical assessment measure of static foot posture to determine flatfoot in children and adolescents: A cross sectional study. Foot (Edinb) 2018; 37:85-90. [PMID: 30326417 DOI: 10.1016/j.foot.2018.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 04/11/2018] [Accepted: 05/17/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Reliability of clinical measures of static foot posture has been widely debated. However, validity of these measures has not been fully established especially in a pediatric population. The purpose of the study was to investigate reliability and validity of normalized truncated navicular height (NTNH) in assessment of static foot posture to determine flatfoot in children and adolescents using radiographic measures as a criterion gold standard measure. METHODS A sample of 612 participants aged 6-18 years (12.3±3.3) were enrolled in the study. Clinical assessment of static foot posture using NTNH was compared to the gold standard radiographic measures. Reliability, validity and diagnostic accuracy were investigated. The optimal cutoff point for flatfoot using NTNH was calculated. RESULTS NTNH demonstrated sensitivity of 98.4%, high positive predictive (PV +) value of 89.2%. The positive likelihood ratio was 19 and the negative likelihood ratio was 0.02. The area under the receiver operating curve (AUC) was 0.96 indicating high validity and diagnostic accuracy of NTNH. The optimal cutoff point for diagnosing flatfoot was NTNH≤0.195. CONCLUSION NTNH is a valid and diagnostically accurate clinical measure of static foot posture in children and adolescents.
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27
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Martínez-Nova A, Gijón-Noguerón G, Alfageme-García P, Montes-Alguacil J, Evans AM. Foot posture development in children aged 5 to11 years: A three-year prospective study. Gait Posture 2018; 62:280-284. [PMID: 29604617 DOI: 10.1016/j.gaitpost.2018.03.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 03/06/2018] [Accepted: 03/23/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The paediatric flatfoot is a common presentation but it is unclear whether the condition will resolve on its own as the child gets older or whether treatment is required. Therefore, the study objective was to evaluate paediatric foot posture, and anthropometry, in children at two time points, three years apart. MATERIAL AND METHODS A sample of 1032 healthy children (505 boys, 527 girls; aged 5-11 years) was recruited for foot posture index (FPI) and anthropometry assessment (weight, height and body mass index, BMI). Assessment was repeated when the children were aged 8 years to 14 years. Paired t-tests, Anova, frequency tables and a multiple regressions were conducted. RESULTS Initially, approximately 70% had a neutral FPI range, 20% pronated, 3% highly pronated, and 4% supinated. Initial mean FPI was 3.6 ± 2.8, being higher in boys 3.7 ± 2.8 than in girls 3.4 ± 2.7 (p = 0.034). All FPI categories changed over time, with supinated and neutral FPI increased by 19.5% and 4.7% respectively. In contrast, pronated and highly pronated FPI reduced by 10.6% and 55.6% respectively. Regression showed only 1% FPI change was explained by increased height. FPI scores were significantly reduced after three years (3.57 to 3.33; p < 0.001). CONCLUSION Children's foot posture shifts toward neutral as age increases. There is minimal relationship with weight, height or BMI. Appreciation of developing foot posture could reduce over diagnosis and unnecessary treatment of paediatric flatfeet.
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Affiliation(s)
| | | | | | | | - Angela Margaret Evans
- Discipline of Podiatry, College of Science, Health, and Engineering, La Trobe University, Australia.
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Marchena-Rodríguez A, Moreno-Morales N, Ramírez-Parga E, Labajo-Manzanares MT, Luque-Suárez A, Gijon-Nogueron G. Relationship between foot posture and dental malocclusions in children aged 6 to 9 years: A cross-sectional study. Medicine (Baltimore) 2018; 97:e0701. [PMID: 29742725 PMCID: PMC5959429 DOI: 10.1097/md.0000000000010701] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to determine the association, if any, between foot posture and dental malocclusions in the anteroposterior plane, in children.The study population consisted of 189 children (95 boys and 94 girls) aged 6 to 9 years. In every case, previous informed consent was requested and obtained from the parent/guardian and the study was approved by the Ethics Committee of the University of Málaga (CEUMA 26/2015H).This observational, descriptive, cross-sectional analysis is based on a study population (STROBE). Qualified personnel conducted a podiatric and dental examination of each child, recording the Clarke angle and the foot posture index (FPI) as an outcomes measure in the feet, and also dental malocclusions, according to Angle classification.A significant correlation was observed for the FPI scores (for right foot) as well as the Clarke angle (for right foot), in relation to dental malocclusions as determined by Angle classification (P < .001). Of all the supinated feet analyzed, 38.46% were Class II according to Angle classification, and none were Class III. Of the pronated feet, 48.57% were Class III, 42.85% were Class I, and 8.57% were Class II.The Clarke angle decreases with the progression from Class I to III, whereas the FPI increases with that from Class I to III. These findings suggest there is a relation between the Clarke angle and FPI, on the one hand, and dental malocclusion on the other.
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29
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Diaz-Miguel S, Lopezosa-Reca E, Benhamu-Benhamu S, Ortega-Avila AB, García-De-La-Peña R, Gijon-Nogueron G. Structural differences in the lower extremities in children aged 7-9 years, caused by playing football: A cross-sectional study. Foot (Edinb) 2018; 34:78-82. [PMID: 29414117 DOI: 10.1016/j.foot.2017.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Physical activity during childhood can be beneficial in the long term. However, this practice can influence the child's physiological development. The aim of this study was to determine whether the practice of soccer, in moderation, could be a risk factor for the inadequate development of the lower limb. METHODS The study group was composed of 115 children, of whom 59 (mean age 8.03±0.89years) practised soccer 3 times a week and had a positive Physical Activity Questionnaire for Adolescents (PAQ-A) score, while a further 56 (mean age 7.96±0.87years) did not perform any additional physical activity and had a negative PAQ-A score. A foot posture analysis, based on the foot posture index (FPI), the valgus index, the orientation of the subtalar joint (STJ) and the Q angle of the knee, was carried out. RESULTS For the group of soccer players, the following results were obtained: FPI 4.79±2.38 (R) and 3.95±2.31 (L); valgus index 13.56°±1.66° (R) and 13.42°±1.48° (L); STJ test 79% pronated; Q angle 13.13°±2.06° (R) and 13.18°±1.93° (L). For the non-players, the corresponding values were: FPI 3.62±2.82 (R) and 3.74±2.77 (L); valgus index 12.76°±1.71° (R) and 12.84°±1.72° (L); STJ test 50% pronated; Q angle 13.87°±3.01° (R) and 13.86°±2.94° (L). CONCLUSION There is a degree of difference between the two groups, but the values do not vary greatly from those considered normal for this age group. Any alterations in this respect can be assumed to be caused at older ages than those analysed.
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30
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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: 52] [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.
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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
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31
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Carvalho BKGD, Penha PJ, Penha NLJ, Andrade RM, Ribeiro AP, João SMA. The influence of gender and body mass index on the FPI-6 evaluated foot posture of 10- to 14-year-old school children in São Paulo, Brazil: a cross-sectional study. J Foot Ankle Res 2017; 10:1. [PMID: 28670344 PMCID: PMC5488407 DOI: 10.1186/s13047-016-0183-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 12/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is marked by changes to the body, including the feet. The Foot Posture Index (FPI-6) stands out from other foot type classification methods as valid, reliable, and multidimensional. However, the current literature differs according to age group, with little consolidation of normative data in school children, largely due to the influence of such factors as sex, age and body mass index (BMI). Thus, this study assesses foot posture in adolescents according to age, sex and BMI. METHODS The study evaluated 1.394 adolescents from Amparo and Pedreira regions in São Paulo, Brazil. Subjects were positioned barefoot on a wooden base and each foot was assessed by FPI-6 criteria. Each criterion was scored on a scale of -2 to +2, negative for supinated and positive for pronated posture. Initially the data were assessed for normality using the Shapiro-Wilk test and descriptive statistics were calculated. To investigate and compare the scores of FPI-6 with regards to age and body mass index, analysis of variance (ANOVA) was used, followed by post hoc Tukey. To compare the FPI-6 with regard to gender, an independent student t test was used. All data were analyzed using SPSS version 21.0 and the 5% significance level. RESULTS Boys had higher scores than girls (p = 0.037) for the right foot, and the group with normal BMI values scored higher than the obese group (p = 0.001). For the left foot, 11- and 13-year-olds differed (p = 0.024) with respect to age in general. The overweight and obese group scored lower than the normal BMI group (p = 0.039; p = 0.001, respectively). CONCLUSIONS Overall, the feet in this study were classified as normal, with a tendency to pronation, particularly in boys. There were differences between the 11 and 13 year groups and, with regard to BMI, there were higher scores for the group with normal BMI. Therefore, a higher BMI in adolescence is not indicative of a pronated foot type.
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Affiliation(s)
- Barbarah Kelly Gonçalves de Carvalho
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil
| | - Patrícia Jundi Penha
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil.,Department of Physical Therapy, Faculty of Human Sciences and Health, Pontifícia Universidade Católica de São Paulo, São Paulo, Brazil
| | - Nárima Lívia Jundi Penha
- Investigator in the Musculoskeletal Evaluation Laboratory, Department of Physical Therapy, Speech and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | - Rodrigo Mantelatto Andrade
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil.,Department of Physical Therapy, Faculty of Human Sciences and Health, Pontifícia Universidade Católica de São Paulo, São Paulo, Brazil
| | - Ana Paula Ribeiro
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil.,Department of Physical Therapy, Faculty of Medicine, University of Santo Amaro, São Paulo, Brazil
| | - Sílvia Maria Amado João
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil
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