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Kurtoğlu A, Çar B, Eken Ö, Demir G, Türkmen M, Setiawan E, Alotaibi MH, Elkholi SM. Pes planus level affects counter movement jump performance: A study on amateur male and female volleyball players. Medicine (Baltimore) 2024; 103:e38683. [PMID: 38905375 PMCID: PMC11191913 DOI: 10.1097/md.0000000000038683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/31/2024] [Indexed: 06/23/2024] Open
Abstract
The aim of this study was to investigate the effect of pes planus level on counter movement jump (CMJ) performance parameters in amateur female and male volleyball players. In this context, amateur volleyball players aged between 18 and 23 years actively playing in the university school volleyball team were included in the study. Pes planus levels of the participants were analyzed using the navicular drop test (NDT). My Jump Lab application was used for CMJ measurement. Within the scope of CMJ, the participants' jump height, force, relative force, power, relative power, average speed, take-off speed, impulse, and flying time were analyzed. According to the linear regression results between NDT and CMJ parameters, force in males (t = 12.93, P = .049) and average speed in females (t = -3.52, P = .017) were significantly associated with NDT. NDT was similar in men and women (P > .05). However, all CMJ parameters were highly different between genders (P < .001). In the correlation analysis between sport age and physical characteristics and CMJ parameters; height (r = .386, P = .046), weight (r = .569, P = .002), leg length (r = .389, P = .045), foot length (r =. 558, P = .005), foot width (r = .478, P = .018), force (r = .407, P = .039), impulse (r = .460, P = .018) parameters, and sport age. The results suggest that the average speed in females and force in males both significantly influenced NDT, highlighting the significance of both factors in predicting NDT scores. Moreover, all CMJ measures showed significant variations between genders, although the NDT scores did not. Furthermore, the correlation analysis demonstrated a strong correlation between a number of physical attributes and CMJ parameters, highlighting the multifaceted nature of athletic performance and indicating the possible impact of these attributes on CMJ results.
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Affiliation(s)
- Ahmet Kurtoğlu
- Faculty of Sport Science, Department of Coaching Education, Bandirma Onyedi Eylul University, Balikesir, Turkey
| | - Bekir Çar
- Faculty of Sport Science, Department of Coaching Education, Bandirma Onyedi Eylul University, Balikesir, Turkey
| | - Özgür Eken
- Department of Physical Education and Sport Teaching, Inonu University, Malatya, Turkey
| | - Gözde Demir
- Faculty of Sport Science, Department of Coaching Education, Bandirma Onyedi Eylul University, Balikesir, Turkey
| | - Musa Türkmen
- Department of Physical Education and Sport Teaching, Inonu University, Malatya, Turkey
| | - Edi Setiawan
- Department of physical education, health and recreation, Faculty of Teacher Training and Education, Universitas Suryakancana, Sukabumi, Indonesia
| | - Madawi H. Alotaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Safaa Mostafa Elkholi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Sagat P, Bartik P, Štefan L, Chatzilelekas V. Are flat feet a disadvantage in performing unilateral and bilateral explosive power and dynamic balance tests in boys? A school-based study. BMC Musculoskelet Disord 2023; 24:622. [PMID: 37525236 PMCID: PMC10391751 DOI: 10.1186/s12891-023-06752-9] [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: 02/27/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Little evidence has been provided regarding physical performance and flat-footedness in school-age children. Although flat feet may decrease the level of motor performance, findings remain inconsistent. Therefore, the main purpose of the study was to determine whether children with flat feet had poorer physical task performance, compared to normal-footed children. METHODS A total of 208 primary school boys were included in the study (107 normal-footed and 101 flatfooted boys). Flat footedness (< 42°) was determined using Clark's method. The children were tested by a set of unilateral and bilateral tests selected from the area of explosive power and dynamic balance which included: (i) countermovement jump, (ii) standing broad jump, (iii) the triple crossover hop for distance test, (iv) maximal sprinting speed over 10, 20 and 40 m and (v) the Star Excursion Balance Test. Differences were adjusted for age, body mass index, peak height velocity and physical activity. RESULTS Flat footed children exhibited significantly poorer results in bilateral standing broad jump (effect size [ES] = 0.34), unilateral standing broad jump for dominant (ES = 0.31) and non-dominant leg (ES = 0.20), the triple crossover hop for distance test for dominant (ES = 0.24) and non-dominant leg (ES = 0.23) and the Star Excursion Balance Test (ES = 0.23-0.43) and were slower in maximal sprinting speed test over 20 m (ES = 0.25) and 40 m (ES = 0.30). CONCLUSIONS This study shows that children with flat feet performed poorer in some physical performance tasks, compared to the normal feet counterparts.
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Affiliation(s)
- Peter Sagat
- GSD/Health and Physical Education Department, Sport Sciences and Diagnostics Research Group, Prince Sultan University, Riyadh, 11586, Saudi Arabia
| | - Peter Bartik
- GSD/Health and Physical Education Department, Sport Sciences and Diagnostics Research Group, Prince Sultan University, Riyadh, 11586, Saudi Arabia
| | - Lovro Štefan
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, 625 00, Czech Republic.
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Moreno-Barriga OS, Romero-Morales C, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Gómez-Salgado J, Caballero-López J, Vidal-Valverde LC, López-López D. Effects of Foot Structure Type on Core Stability in University Athletes. Life (Basel) 2023; 13:1487. [PMID: 37511860 PMCID: PMC10381840 DOI: 10.3390/life13071487] [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: 04/25/2023] [Revised: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
PURPOSE This study assessed the impact of different types of medial foot arch on postural stability and core center of gravity muscle activity among collegiate athletes. METHODS The study sample included 103 university-level athletes across various sports (soccer, rugby, basketball, volleyball, field tennis, table tennis, karate, and cheerleading) from the College of Magdalena (Colombia) who exhibited distinct types of medial foot arch: 32 high, 35 low, and 36 neutral arches. Surface electromyography (sEMG) was employed to assess conduction velocity, magnitude values, latency, and fatigue in focal muscles including the spinal erector (SE), internal oblique (IO), external oblique (EO), and rectus abdominis (AR), while measurements of static and dynamic postural control were also considered. Post hoc analysis was performed with Bonferroni correction for all electromyographically measured muscle groups, as well as for measurements of static and dynamic postural stability. Pearson's or Spearman's correlation tests were used to compare the different types of feet. RESULTS There were no substantial differences observed between the distinct types of feet in terms of focal muscle activity, static stability, or dynamics. Even though the mean values indicated higher muscle activity and stability among those with high foot arches and lower values among those with low arches compared to the neutral foot type, this observed difference was deemed statistically insignificant. We also observed a positive correlation between internal oblique muscle activity and the average power of dynamic postural stability, which remained consistent across all foot types. Our findings indicate that static instability is directly correlated with dynamic instability in the anteroposterior direction, while a clear inverse relationship was established in the lateral direction upon examining the variable correlations. CONCLUSIONS The presence of high or low foot arches did not significantly impact the activity of the muscles responsible for maintaining the body's center of gravity or postural stability among university-level athletes. This suggests the existence of neuromuscular compensation mechanisms that attempt to restore balance and compensate for any changes in postural stability caused by varying foot types. Through targeted training that emphasizes activation of the internal oblique muscle, athletes may see improved postural stability. Our findings indicate that static stabilization exercises can also prove beneficial in improving dynamic stability in the anteroposterior plane, while a more dynamic approach may be required to improve dynamic stability in the lateral plane.
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Affiliation(s)
| | | | | | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | | | | | - Daniel López-López
- Research, Health, and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, 15403 Ferrol, Spain
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Schippers P, Drees P, Gercek E, Wunderlich F, Müller D, Ruckes C, Meyer A, Klein S, Fischer S. The Controversial Definition of Normal Toe Alignment. J Clin Med 2023; 12:jcm12103509. [PMID: 37240615 DOI: 10.3390/jcm12103509] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
"Normal" and "abnormal" are frequently used in surgical planning and to evaluate surgical results of the forefoot. However, there is no objectifiable value of metatarsophalangeal angles (MTPAs) 2-5 in the dorsoplantar (DP) view with which to objectively evaluate lesser toe alignment. We aimed to determine which angles are considered to be "normal" by orthopedic surgeons and radiologists. Thirty anonymized radiographs of feet were submitted twice in randomized order to determine the respective MTPAs 2-5. After six weeks, the anonymized radiographs and photographs of the same feet without apparent affiliation were presented again. The terms "normal," "borderline normal," and "abnormal" were assigned by the observers. Viewers considered MTP-2 alignment from 0° to -20° to be normal, and below -30° abnormal; MTP-3, 0° to -15° to be normal and below -30° abnormal; MTP-4, 0° to -10° normal and below -20° abnormal. Between 5° valgus and 15° varus was the range of MTP-5 recognized as normal. High intra-observer but low interobserver reliability with overall low correlation of clinical and radiographic aspects was observed. The assessment of the terms "normal" or "abnormal" are subject to a high degree of variation. Therefore, these terms should be used cautiously.
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Affiliation(s)
- Philipp Schippers
- Department of Orthopedics and Traumatology, University Medical Center of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany
| | - Philipp Drees
- Department of Orthopedics and Traumatology, University Medical Center of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany
| | - Erol Gercek
- Department of Orthopedics and Traumatology, University Medical Center of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany
| | - Felix Wunderlich
- Department of Orthopedics and Traumatology, University Medical Center of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany
| | - Daniel Müller
- Department of Trauma, Hand, and Reconstructive Surgery, Goethe-Universität Frankfurt am Main, 60596 Frankfurt, Germany
| | - Christian Ruckes
- Interdisciplinary Centre for Clinical Trials Mainz, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Alexander Meyer
- Center for Orthopedics, Spine and Trauma Surgery, St. Josefs-Hospital, 65189 Wiesbaden, Germany
| | - Stefan Klein
- Department of Diagnostic and Interventional Radiology, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, 60389 Frankfurt, Germany
| | - Sebastian Fischer
- Department of Foot and Ankle Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, 60389 Frankfurt, Germany
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Wang Y, Jiang H, Yu L, Gao Z, Liu W, Mei Q, Gu Y. Understanding the Role of Children's Footwear on Children's Feet and Gait Development: A Systematic Scoping Review. Healthcare (Basel) 2023; 11:healthcare11101418. [PMID: 37239704 DOI: 10.3390/healthcare11101418] [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: 04/03/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Children's footwear plays an important role in the healthy growth of foot and gait development during the growing stage. This review aims to synthesize findings of previous investigations and to explore the biomechanical influences of different types of children's footwear on foot health and gait development, thus guiding the healthy and safe growth of children's feet and gait. Online databases were searched for potential eligible articles, including Web of Science, Google Scholar, and PubMed. In total, nineteen articles were identified after searching based on the inclusion requirements. The following five aspects of biomechanical parameters were identified in the literature, including spatiotemporal, kinematics, kinetics, electromyography (EMG), and plantar pressure distribution. Children's footwear can affect their foot health and gait performance. In addition, children's shoes with different flexibility and sole hardness have different effects on children's feet and gait development. Compared to barefoot, the stride length, step length, stride time, and step time were increased, but cadence was decreased with wearing shoes. Furthermore, the support base and toe-off time increased. Double support time and stance time increased, but single support time decreased. The hip, knee, and ankle joints showed increased range of motion in children with the rear-foot strike with larger ground reaction force as well. Future studies may need to evaluate the influence of footwear types on gait performance of children in different age groups. Findings in this study may provide recommendations for suitable footwear types for different ages, achieving the aim of growth and development in a healthy and safe manner.
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Affiliation(s)
- Yuan Wang
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
| | - Hanhui Jiang
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
| | - Lin Yu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Zixiang Gao
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Faculty of Engineering, University of Pannonia, 8200 Veszprém, Hungary
- Savaria Institute of Technology, Eötvös Loránd University, 9700 Szombathely, Hungary
| | - Wei Liu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Faculty of Engineering, University of Pannonia, 8200 Veszprém, Hungary
- Savaria Institute of Technology, Eötvös Loránd University, 9700 Szombathely, Hungary
| | - Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1010, New Zealand
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
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Boryczka-Trefler A, Kalinowska M, Szczerbik E, Stępowska J, Łukaszewska A, Syczewska M. How to Define Pediatric Flatfoot: Comparison of 2 Methods: Foot Posture in Static and Dynamic Conditions in Children 5 to 9 Years Old. Foot Ankle Spec 2023; 16:43-49. [PMID: 33605152 DOI: 10.1177/1938640021991345] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
LEVELS OF EVIDENCE Prospective cohort study.
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Affiliation(s)
- Anna Boryczka-Trefler
- Department of Rehabilitation, The Children's Memorial Health Institute, Warszawa, Poland
| | - Małgorzata Kalinowska
- Department of Rehabilitation, The Children's Memorial Health Institute, Warszawa, Poland
| | - Ewa Szczerbik
- Department of Rehabilitation, The Children's Memorial Health Institute, Warszawa, Poland
| | - Jolanta Stępowska
- Department of Rehabilitation, The Children's Memorial Health Institute, Warszawa, Poland
| | - Anna Łukaszewska
- Department of Rehabilitation, The Children's Memorial Health Institute, Warszawa, Poland
| | - Małgorzata Syczewska
- Department of Rehabilitation, The Children's Memorial Health Institute, Warszawa, Poland
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7
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Ho MT, Tan JC. The association between foot posture, single leg balance and running biomechanics of the foot. Foot (Edinb) 2022; 53:101946. [PMID: 36463612 DOI: 10.1016/j.foot.2022.101946] [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: 09/20/2020] [Revised: 10/05/2022] [Accepted: 10/28/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES A mal-aligned foot posture (high-arched and flat feet) and poor single leg balance ability have been separately associated with foot injuries during running. Therefore, clinicians assess these routinely. However, the extent to which foot posture and single-leg balance ability affect actual foot biomechanics during running is not known. This study aims to investigate the association of foot posture, single-leg balance ability, and foot biomechanics during running. METHOD This is a cross sectional study of sixty-nine participants who had their foot postures and single-leg balance ability assessed. The Foot Posture Index and Balance Error Scoring System were used. Their foot kinetics was measured as they ran on an instrumented treadmill and foot kinematics was processed using a 3D motion capture system. Multiple-regression was used to analyse the variance of foot biomechanics explained by foot posture and single-leg balance ability. RESULTS Foot posture and single-leg balance ability were found to account significantly for the variance in rearfoot eversion (24%) and forefoot dorsiflexion (7%). Two regression equations were derived, where rearfoot eversion and forefoot dorsiflexion during running may be predicted. CONCLUSION Foot posture and single-leg balance ability can predict rearfoot eversion and forefoot dorsiflexion only during running. Based on the regression equations, individuals with the same foot posture but different single-leg balance ability may exhibit different foot kinematics. However, the angular differences are small. The equations may be useful for clinicians working in places where running gait analysis equipment are not readily accessible. Further studies with larger sample sizes are required to validate these equations. In addition, further studies are necessary to investigate the effect of these two variables under different running conditions e.g. with footwear and with orthoses.
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Affiliation(s)
- Malia T Ho
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - John C Tan
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore.
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Şahin FN, Ceylan L, Küçük H, Ceylan T, Arıkan G, Yiğit S, Sarşık DÇ, Güler Ö. Examining the Relationship between Pes Planus Degree, Balance and Jump Performances in Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11602. [PMID: 36141874 PMCID: PMC9517403 DOI: 10.3390/ijerph191811602] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
The foot absorbs shocks with its arches, muscles, ligaments and joints, and bodyweight transmission and it pushes the body forward during all movement patterns. Pes planus is more important in sports activities that include balance and sports performance, such as walking, running, jumping, or transferring weight to a single lower limb. This study, conducted with this information in mind, aims to examine the effects of pes planus deformity on balance and vertical jump performance. Fifty athletes were included in the study. The presence of pes planus was evaluated according to the Feiss line. Balance measurements were performed with a Balance System SD Biodex. Vertical jump performance was recorded using an Omegawave jumping mat. The relationship between the pes planus grades of the participants and their balance and jump performances was analyzed using the Spearman correlation method. Vertical jump and Limit of stability (LOS) was significantly correlated with pes planus.
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Affiliation(s)
- Fatma Neşe Şahin
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara 06830, Türkiye
| | - Levent Ceylan
- Department of Coaching Education, Faculty of Sports Sciences, Sivas Cumhuriyet University, Sivas 58140, Türkiye
| | - Hamza Küçük
- Yasar Doğu Faculty of Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Türkiye
| | - Tülay Ceylan
- Department of Physical Education and Sport, Institute of Health Science, Sivas Cumhuriyet University, Sivas 58140, Türkiye
| | - Gökhan Arıkan
- Mehmet Arabacı School of Physical Education and Sport, Harran University, Şanlıurfa 63000, Türkiye
| | - Sevcan Yiğit
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara 06830, Türkiye
| | - Derya Çetin Sarşık
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara 06830, Türkiye
| | - Özkan Güler
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara 06830, Türkiye
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Zhao X, Gu Y, Yu J, Ma Y, Zhou Z. Do Arch Height and Arch Stiffness Relate to Physical Performance in Adult Men? J Foot Ankle Surg 2022; 61:259-263. [PMID: 34353731 DOI: 10.1053/j.jfas.2021.07.018] [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: 04/12/2020] [Revised: 10/08/2020] [Accepted: 07/11/2021] [Indexed: 02/03/2023]
Abstract
Foot arch plays an important role in bearing body weight, absorbing ground reaction forces and maintaining balance, and its structure and function are bound to have a profound effect on physical activities and sports. Arch height and arch stiffness are 2 factors that represent the structure and function of the arch. Therefore, the purpose of this study was to explore the associations of arch height and arch stiffness with physical performance. A total of 56 men (aged 49.00 ± 7.95 years, mean body mass index [BMI] 26.80 ± 3.75 kg/m2) participated in this study. A 3-dimensional laser scanner was employed to obtain foot structure information of each participant, from which the arch height index (AHI) and arch stiffness index (ASI) were computed. Physical performance measures including agility, power, and proprioception were tested in a random order. The results indicated that the stepping forward and backward and vertical jump that represent agility and force respectively were negatively and significantly associated with AHI (r = -0.27, p = .045; r = -0.35, p = .009). When adjusted for age and BMI, only height of vertical jump was found to be correlated significantly with AHI (r = -0.29, p = .040); while no significant relationships were observed between physical performance measures and ASI. Multivariate linear regression analysis showed that AHI, age, and BMI can effectively predict the height of vertical jump. This study demonstrates that there is a negative correlation between arch height and muscle power of lower limbs in adult men.
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Affiliation(s)
- Xiaoguang Zhao
- Researcher, Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Zhejiang, China.
| | - Yaodong Gu
- Professor, Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Zhejiang, China
| | - Jiabin Yu
- Lecturer, Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Zhejiang, China
| | - Ye Ma
- Researcher, Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Zhejiang, China
| | - Zhexiao Zhou
- Lecturer, Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Zhejiang, China
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Boryczka-Trefler A, Kalinowska M, Szczerbik E, Stępowska J, Łukaszewska A, Syczewska M. Effect of Plano-Valgus Foot on Lower-Extremity Kinematics and Spatiotemporal Gait Parameters in Children of Age 5–9. Diagnostics (Basel) 2021; 12:diagnostics12010002. [PMID: 35054169 PMCID: PMC8774692 DOI: 10.3390/diagnostics12010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
Aim of the study was to see how a definition of the flexible flat foot (FFF) influences the results of gait evaluation in a group of 49 children with clinically established FFF. Objective gait analysis was performed using VICON system with Kistler force platforms. The gait parameters were compared between healthy feet and FFF using two classifications: in static and dynamic conditions. In static condition, the ink footprints with Clarke’s graphics were used for classification, and in dynamic condition, the Arch Index from Emed pedobarograph while walking was used for classification. When the type of the foot was based on Clarke’s graphics, no statistically significant differences were found. When the division was done according to the Arch Index, statistically significant differences between flat feet and normal feet groups were found for normalized gait speed, normalized cadence, pelvic rotation, ankle range of motion in sagittal plane, range of motion of foot progression, and two parameters of a vertical component of the ground reaction force: FZ2 (middle of stance phase) and FZ3 (push-off). Some statically flat feet function well during walking due to dynamic correction mechanisms.
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Affiliation(s)
- Anna Boryczka-Trefler
- Department Rehabilitation, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warszawa, Poland
| | - Małgorzata Kalinowska
- Department Rehabilitation, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warszawa, Poland
| | - Ewa Szczerbik
- Department Rehabilitation, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warszawa, Poland
| | - Jolanta Stępowska
- Department Rehabilitation, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warszawa, Poland
| | - Anna Łukaszewska
- Department Rehabilitation, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warszawa, Poland
| | - Małgorzata Syczewska
- Department Rehabilitation, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warszawa, Poland
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Chang CH, Yang WT, Wu CP, Chang LW. Would foot arch development in children characterize a body maturation process? a prospective longitudinal study. Biomed J 2021; 45:828-837. [PMID: 34737119 DOI: 10.1016/j.bj.2021.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/14/2021] [Accepted: 10/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Flatfoot (Pes Planus), often regarded as a physiological deviation in children, is of concern to parents because there is no test to predict the development of foot arch. This study aimed to use a new diagnostic flatfoot criterion to determine 1) how the footprint index changes during the development of foot arches, 2) what factors can predict a foot arch development, and 3) whether foot arch development could be a process of body growth. MATERIALS AND METHODS 572 children were enrolled in a prospective longitudinal study of anthropometrical parameters and physical fitness twice at age of 6.7 and 8.2 years. The bimodal frequency distribution of the Chippaux-Smirak index (CSI) of the footprint was used to define flatfoot as CSI <0.58 and non-flatfoot as CSI >0.61. Body measurements and physical fitness tests were compared between children with flatfeet who developed foot arches and children who did not. RESULTS Of 263 children with flatfeet, the CSI significantly changed from 0.72 to 0.46 in 70 children who developed foot arches over 1.5 years and the others had minimal change in the index. Children with foot arch development had a lower initial CSI, improved boys' performance in one-leg balance, and less increase in girls' body height than children who remained flatfooted, whereas sex and weight were similar in both groups. CONCLUSION This longitudinal study with the bimodal distribution of the CSI investigated how the development of foot arch advances in children around age 7. A significant and unique pattern in change of the CSI suggests involvement of a maturational stage in foot arch development. Along with the improved performance in one-leg balance, the unidirectional transition from flatfoot to non-flatfoot is associated with improvement in motor control of the ankle.
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Affiliation(s)
- Chia-Hsieh Chang
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Department of Pediatric Orthopedics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Tien Yang
- Taipei City University of Science and Technology, Taipei, Taiwan
| | - Chang-Ping Wu
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Liang-Wey Chang
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
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Comparison of the immediate effects of prefabricated soft medical insoles and custom-molded rigid medical insoles on plantar pressure distribution in athletes with flexible flatfoot: a prospective study. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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KONG PUIWAH, PAN JINGWEN, FONG DANIELTP, LEOW YIXUAN, LIU YIMIN, CHAN CHICHIU, HENG MARABELLELIWEN. WITHIN-DAY AND BETWEEN-DAY RELIABILITY OF A FBG-BASED SMART SOCK SYSTEM FOR MEASURING ACTIVE TOE FLEXION DISPLACEMENT OF THE HALLUX. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519421500573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examined the test-retest reliability of hallux flexion displacement measured using a smart sock system with embedded fiber Bragg grating (FBG) sensors. Thirty female participants consisting of 15 hallux valgus (HV) patients and 15 control participants were recruited. Maximum active hallux flexion displacement was measured twice on each participant in the first visit; the same procedures were repeated 7 days later. Intraclass correlation coefficients (ICC2,1) and standard error of measurement (SEM) were applied to test within-day and between-day reliability. Paired-samples T-test was performed to compare the displacements between trials. Results showed almost perfect within-day reliability for both HV and control groups ([Formula: see text] and 0.977, respectively) with small SEM (both 0.5[Formula: see text]cm). However, fair to moderate between-day reliability was found (0.323 and 0.438, respectively). Significant differences were found between repeated measurements taken on the same day (mean [Formula: see text][Formula: see text]cm, [Formula: see text]) and on different days (mean [Formula: see text][Formula: see text]cm, [Formula: see text]), though the effect size was small. The poorer between-day reliability is likely due to the inconsistency in fitting the sock onto the foot. Future optimization of the prototype design is called for to improve the fitting consistency of wearable sensors onto patients.
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Affiliation(s)
- PUI WAH KONG
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technology University, Singapore, Singapore
| | - JING WEN PAN
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technology University, Singapore, Singapore
| | - DANIEL T. P. FONG
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - YIXUAN LEOW
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - YIMIN LIU
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - CHI CHIU CHAN
- Sino-German College of Intelligent Manufacturing, Shenzhen Technology University, Shenzhen, P. R. China
| | - MARABELLE LI-WEN HENG
- Podiatry Department, Singapore General Hospital, Diabetes & Metabolism Centre, 17 Third Hospital Avenue Singapore 168752, Singapore
- School of Human Performance & Allied Health, University of South Australia, Adelaide, SA 5000, Australia
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Camurcu Y, Ucpunar H, Karakose R, Ozcan S, Sahin V. Foot orthoses use for pediatric flexible flatfoot: comparative evaluation of quality of life for children and parents. J Pediatr Orthop B 2021; 30:282-286. [PMID: 32453124 DOI: 10.1097/bpb.0000000000000750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aimed to comparatively evaluate the quality of life scores of patients with pediatric flexible flatfoot (PFF) according to the use of foot orthoses. We also aimed to compare quality of life scores of children and their parents. Nonobese children aged between 5 and 10 years old who were diagnosed as PFF according to physical and radiological examinations were included in this cross-sectional comparative study. All children and their parents completed the Turkish translation of Oxford ankle foot questionnaire (OxAFQ) which contains four domains (physical, school and play, emotional, and footwear). Patients were grouped according to the use of foot orthoses (group I: no foot orthoses group and group II: foot orthoses group). Comparison of OxAFQ scores demonstrated no significant differences between the two groups. However, the mean emotional scores of parents were significantly lower in group II (P = 0.007). In group I, the mean emotional score of children was significantly lower compared to their parents' scores (P = 0.001). In group II, the mean physical score of children was significantly lower compared to their parents' scores (P = 0.003). According to our results, we observed no significant difference in terms of quality of life scores between children using foot orthoses and not using foot orthoses. However, we observed significantly lower emotional scores in parents whose children were using foot orthoses. We recommend that physicians should be aware of low physical scores in children with PFF and should inform parents about this situation rather than considering foot orthoses to relieve parents' concern about foot deformity.
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Affiliation(s)
- Yalkin Camurcu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
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de Los Ángeles Gómez-Benítez M, Gómez-Benítez A, Ramos-Ortega J, Castillo-López JM, Bellido-Fernandez L, Munuera-Martínez PV. Fatigue in Children with Pronated Feet After Aerobic Exercises. J Am Podiatr Med Assoc 2021; 111:448135. [PMID: 33206159 DOI: 10.7547/19-058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Sports have a strong influence on current society. Foot posture has been postulated to be a risk factor for overuse injuries; however, the link between foot posture and injuries is unclear. This study aimed to determine whether children with pronated feet become more fatigued after participating in sports tests than those with normal feet. METHODS One hundred five children aged 10 to 12 years (mean ± SD age, 10.46 ± 0.78 years) participated in the sports tests, which were aerobic-type resistance exercises with six stations at which each child remained for 30 sec. The posture of the foot was evaluated via the Foot Posture Index and the plantar footprint via the arch index and the Clarke angle before and after aerobic-type resistance exercises. Perceived tiredness was evaluated with the Pictorial Children's Effort Rating Table (PCERT) and whether there was pain during or after physical activity. RESULTS The variables used to measure foot posture and the plantar arch changed more in the pronated feet, suggesting that the feet undergo more pronation after physical exercise. The neutral feet obtained a mean ± SD PCERT score of 5.46 ± 1.89 and the pronated feet a score of 7.60 ± 1.92. CONCLUSIONS Children with pronated feet showed more fatigue and foot pain during and/or after physical exercise than those with neutral feet. Foot type could be responsible for the lack of enthusiasm of children toward undertaking healthy activities, and this problem might be solved via appropriate orthopedic treatment.
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LEOW YIXUAN, HENG MARABELLELIWEN, LIU YIMIN, FONG DANIELTP, CHAN CHICHIU, KONG PUIWAH. VALIDITY OF A FBG-BASED SMART SOCK SYSTEM FOR MEASURING TOE GRIP FUNCTION IN HUMAN FOOT. J MECH MED BIOL 2020. [DOI: 10.1142/s0219519420500153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study developed a smart sock system using optical fiber technology to measure the toe grip function of individual toes. The system comprised Fiber Bragg grating (FBG) sensors incorporated into a sock garment for measuring maximum toe flexion displacements. Calibration equation of each FBG sensor was determined from 3D motion capture system on 10 female subjects. The validity of the smart sock system was checked by comparing maximum toe flexion displacement against the gold standard of 3D motion capture. The root mean squared error was 0.95 (0.57) cm across 10 toes. The magnitude of toe displacement and error was similar between the left and right feet. In conclusion, the FBG-based smart sock system can successfully measure maximum toe flexion displacements of individual toes simultaneously. This system can be developed to support the evaluation of toe grip function in clinical and field settings.
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Affiliation(s)
- YIXUAN LEOW
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - MARABELLE LI-WEN HENG
- Podiatry Department, Diabetes & Metabolism Centre, 17 Third Hospital Drive, Singapore General Hospital, Singapore 168752, Singapore
| | - YIMIN LIU
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - DANIEL T. P. FONG
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - CHI CHIU CHAN
- Sino-German College of Intelligent Manufacturing, Shenzhen Technology University, P. R. China
| | - PUI WAH KONG
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, 637616 Singapore
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Xiao S, Zhang X, Deng L, Zhang S, Cui K, Fu W. Relationships between Foot Morphology and Foot Muscle Strength in Healthy Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041274. [PMID: 32079188 PMCID: PMC7068515 DOI: 10.3390/ijerph17041274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 01/13/2023]
Abstract
The purpose of this study was to investigate if measurements of foot morphology in sitting and standing positions can predict foot muscle strength. Twenty-six healthy male adults were recruited, and their foot morphology and foot muscle strength were measured. Foot morphological variables, toe flexor strength, and metatarsophalangeal joint flexor strength were measured by using a digital caliper, Ailitech-AFG500 dynameter and metatarsophalangeal joint flexor strength tester, respectively. Partial correlation and multivariate stepwise regression were used to explore the relationships between foot morphology and toe/metatarsophalangeal joint strength. Results adjusted by age and body mass index were as follows: (1) truncated foot length in sitting and standing positions and foot width in standing position were positively correlated with the flexor strength of the first toe; (2) foot length, foot width, and truncated foot length in both positions were positively related to the flexor strength of the other toes; (3) arch height index in sitting position and differences in navicular height were negatively associated with the flexor strength of the other toes; (4) differences in foot width were negatively associated with metatarsophalangeal joint flexor strength; and (5) the multivariate stepwise regression model showed that truncated foot length in sitting position, navicular height in standing position, differences in navicular height, foot width in sitting position, and differences in foot width were significantly correlated with toe/metatarsophalangeal joint flexor strength. Simple measurements of foot morphological characteristics can effectively predict foot muscle strength. Preliminary findings provided practical implications for the improvement of the foot ability by making specific foot muscle training sessions in professional sports and by compensating the predicted muscle strength defects to prevent foot injury.
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Affiliation(s)
- Songlin Xiao
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (S.X.); (X.Z.); (L.D.); (S.Z.); (K.C.)
| | - Xini Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (S.X.); (X.Z.); (L.D.); (S.Z.); (K.C.)
| | - Liqin Deng
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (S.X.); (X.Z.); (L.D.); (S.Z.); (K.C.)
| | - Shen Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (S.X.); (X.Z.); (L.D.); (S.Z.); (K.C.)
| | - Kedong Cui
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (S.X.); (X.Z.); (L.D.); (S.Z.); (K.C.)
| | - Weijie Fu
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (S.X.); (X.Z.); (L.D.); (S.Z.); (K.C.)
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
- Correspondence: ; Tel.: +86-21-6550-7368
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Neeraj V, Puja D, Achleshwar G. A new approach for medial longitudinal arch estimation by “foot print”: A comparative study. NATIONAL JOURNAL OF CLINICAL ANATOMY 2020. [DOI: 10.4103/njca.njca_27_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Ho M, Kong PW, Chong LJY, Lam WK. Foot orthoses alter lower limb biomechanics but not jump performance in basketball players with and without flat feet. J Foot Ankle Res 2019; 12:24. [PMID: 31044012 PMCID: PMC6480506 DOI: 10.1186/s13047-019-0334-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/04/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Flat-footed individuals are believed to have poorer jump performance compared to normal-arched individuals. Foot orthoses are commonly used to support the deformed foot arch, and improve normal foot function. However, it is unclear if foot orthoses use affects jump performance in athletes. Our study aims to investigate if foot type and/or foot orthosis influence countermovement jump (CMJ) and standing broad jump (SBJ) performance and lower limb biomechanics. METHODS Twenty-six male basketball players were classified into normal-arched (n = 15) or flat-footed (n = 11) groups using the Chippaux-Smirak index, navicular drop test, and the resting calcaneal angle measurement. They performed jumps with and without prefabricated foot orthoses. We measured jump height and distance for CMJ and SBJ, respectively. Hip, knee and ankle joint angles, angular velocities, moments and powers during take-off were also measured. RESULTS For CMJ, the flat-footed group exhibited less ankle plantarflexion (F 1,24 = 8.407, p = 0.008, η p 2 = 0.259 large effect) and less hip joint power (F 1,24 = 7.416, p = 0.012, η p 2 = 0.244 large effect) than the normal-arched group. Foot orthoses reduced ankle eversion in both groups (F 1,24 = 6.702, p = 0.016, η p 2 = 0.218 large effect). For SBJ, the flat-footed group produced lower peak hip angular velocity (F 1,24 = 7.115, p = 0.013, η p 2 = 0.229 large effect) and generated lower horizontal GRF (F 1,24 = 5.594, p = 0.026, η p 2 = 0.189 large effect) than the normal-arched group. Wearing foot orthoses reduced ankle eversion (F 1,24 = 5.453, p = 0.028, η p 2 = 0.185 large effect), peak horizontal GRF (F 1,24 = 13.672, p = 0.001, η p 2 = 0.363 large effect) and frontal plane ankle moment (F 1,24 = 4.932, p = 0.036, η p 2 = 0.170 large effect). CONCLUSION Foot type and the use of foot orthoses influence take-off biomechanics, but not actual CMJ and SBJ performances in basketball players. Compared to the normal-arched individuals, flat-footed athletes generated smaller propulsion GRF and lower hip flexion velocity and power, which suggests possible compensatory movement strategies to maximise jump performance. Future studies may investigate whether these altered biomechanics, taking into consideration their respective magnitude and effect sizes, may have implications on lower limb injuries. The use of foot orthoses resulted in biomechanical changes in both the normal-arched and flat-footed groups but does not enhance jumping performance.
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Affiliation(s)
- Malia Ho
- Department of Podiatry, School of Health, Medical and Applied Science, Central Queensland University, Rockhampton, Queensland Australia
| | - Pui Wah Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Lowell Jia-Yee Chong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
- Li Ning Sports Science Research Center, Beijing, China
| | - Wing-Kai Lam
- Department of Kinesiology, Shenyang Sport University, Shenyang, China
- Li Ning Sports Science Research Center, Beijing, China
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20
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Prevalence of pathological flatfoot in school-age children. Foot (Edinb) 2018; 37:38-44. [PMID: 30321857 DOI: 10.1016/j.foot.2018.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/06/2018] [Accepted: 05/20/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Prevalence of pathological flatfoot has not been well defined in the literature. The objective of this study was to establish the prevalence of pathological flatfoot in school-age children and investigate the factors associated with this deformity. METHODS A total of 667 children (327 girls and 340 boys) were recruited for this cross-sectional study with multi-stage clustered random sampling. The diagnosis of flatfoot was based on clinical observations and measurements using a suggested systematic protocol. Pathological flatfoot in this study did not merely screen for structural flatfoot, it included symptomatic conditions as well as musculoskeletal risk factors predisposing a progressive flatfoot in children. RESULTS Prevalence of pathological flatfoot was 10.3% in children aged 7-14 years, but this prevalence decreased with age. There was no difference in prevalence of pathological flatfoot between the genders. Children with high BMI were more likely to have pathological flatfoot. Heel valgus (r=0.1; p=0.01) and dorsiflexion range (r=0.14; p<0.001) were both significantly associated with the presence of pathological flatfoot in children; but with only small correlations. CONCLUSIONS Pathological flatfoot was a prevalent condition in school-age children in Iran. Forty six percent of the flatfeet observed in school-age children were classified as pathological.
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Rommene I, Montassar W, Racil G, Mkaouer B, Ben Moussa AZ, Ben Salah F. Analyse cinétique de l’équilibre orthostatique chez les enfants tunisiens de 11 ans ayant les pieds plats. Sci Sports 2018. [DOI: 10.1016/j.scispo.2018.03.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dars S, Uden H, Kumar S, Banwell HA. When, why and how foot orthoses (FOs) should be prescribed for children with flexible pes planus: a Delphi survey of podiatrists. PeerJ 2018; 6:e4667. [PMID: 29682429 PMCID: PMC5907774 DOI: 10.7717/peerj.4667] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/04/2018] [Indexed: 01/21/2023] Open
Abstract
Background Flexible pes planus (flat feet) in children is a common reason parents and caregivers seek health professionals consult and a frequent reason podiatrists prescribe foot orthoses. Yet no universal agreement exists on the diagnosis of this condition, or when and how foot orthoses should be prescribed. The aim of this study was to garner consensus and agreement among podiatrists on the use of FOs for paediatric flexible pes planus. Methods A three round Delphi consensus survey was undertaken with 15 podiatry experts from Australia, New Zealand and the United Kingdom. Round One gathered consensus on the diagnosis and intervention into paediatric pes planus with specific questions on types of FOs and prescription variables used. Round Two and Three were based on answers from Round One and gathered agreement (rationale for choices) on a five point Likert scale. 70% of respondents had to agree to a statement for it to be accepted as consensus or agreement. Results Consensus and agreement was achieved for 83 statements directing the diagnosis of pes planus (using FPI-6 and/or rearfoot measures), common signs and symptoms (e.g., pain, fatigue, abnormal gait and other functional concerns) that direct when to intervene into paediatric flexible pes planus. Prefabricated orthoses were the preferred intervention where adequate control is gained with their use. When customised orthoses are prescribed, a vertical [heel] cast pour (71.4%) and minimal arch fill (76.9%) are the prescription variables of choice, plus or minus additional variables (i.e., medial heel (Kirby) skive, the use of a University of California Biomechanical Laboratory device or a medial flange) dependent on level of disorder and plane of excessive motion. Conclusions This study identified consensus and agreement on a series of diagnosis methods and interventions for the paediatric flexible pes planus. A clinical protocol was developed from the resultant consensus statements which provides clinicians with a series of evidenced-informed statements to better guide them on when, how and why FOs are used specific to this population.
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Affiliation(s)
- Sindhrani Dars
- School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Australia
| | - Hayley Uden
- School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Australia
| | - Saravana Kumar
- School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Australia
| | - Helen A Banwell
- School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Australia
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Dars S, Uden H, Banwell HA, Kumar S. The effectiveness of non-surgical intervention (Foot Orthoses) for paediatric flexible pes planus: A systematic review: Update. PLoS One 2018; 13:e0193060. [PMID: 29451921 PMCID: PMC5815602 DOI: 10.1371/journal.pone.0193060] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/02/2018] [Indexed: 11/18/2022] Open
Abstract
Background Flexible pes planus (flat feet) in children is a common presenting condition in clinical practice due to concerns amongst parents and caregivers. While Foot Orthoses (FOs) are a popular intervention, their effectiveness remains unclear. Thus, the aim of this systematic review was to update the current evidence base for the effectiveness of FOs for paediatric flexible pes planus. Methods A systematic search of electronic databases (Cochrane, Medline, AMED, EMBASE, CINHAL, SportDiscus, Scopus and PEDro) was conducted from January 2011 to July 2017. Studies of children (0–18 years) diagnosed with flexible pes planus and intervention to be any type of Foot Orthoses (FOs) were included. This review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. McMaster critical review form for quantitative studies, was used to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis of the included studies was undertaken. Results Out of 606 articles identified, 11 studies (three RCTs; two case-controls; five case-series and one single case study) met the inclusion criteria. A diverse range of pre-fabricated and customised FOs were utilised and effectiveness measured through a plethora of outcomes. Summarised findings from the heterogeneous evidence base indicated that FOs may have a positive impact across a range of outcomes including pain, foot posture, gait, function and structural and kinetic measures. Despite these consistent positive outcomes reported in several studies, the current evidence base lacks clarity and uniformity in terms of diagnostic criteria, interventions delivered and outcomes measured for paediatric flexible pes planus. Conclusion There continues to remain uncertainty on the effectiveness of FOs for paediatric flexible pes planus. Despite a number of methodological limitations, FOs show potential as a treatment method for children with flexible pes planus. PROSPERO registration number CRD42017057310.
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Affiliation(s)
- Sindhrani Dars
- School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
- * E-mail:
| | - Hayley Uden
- School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Helen A. Banwell
- School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Saravana Kumar
- School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
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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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Lobet S, McCarthy A, Hermans C, Peerlinck K, Matricali GA, Staes F, Deschamps K. Biomechanical markers and theoretical concepts related to haemophilic ankle and subtalar joint arthropathy: introducing the term ‘haemophilic tarsal pan-arthropathy’. Haemophilia 2017; 23:e250-e258. [DOI: 10.1111/hae.13202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2017] [Indexed: 12/22/2022]
Affiliation(s)
- S. Lobet
- Secteur des Sciences de la Santé; Institut de Recherche Expérimentale et Clinique; Computer Assisted Robotic Surgery (CARS); Université catholique de Louvain; Brussels Belgium
- Cliniques universitaires Saint-Luc; Service d'hématologie; Brussels Belgium
- Cliniques universitaires Saint-Luc; Service de médecine physique et réadaptation; Brussels Belgium
| | - A. McCarthy
- Katharine Dormandy Haemophilia & Thrombosis Centre; Royal Free Hospital; London UK
| | - C. Hermans
- Cliniques universitaires Saint-Luc; Service d'hématologie; Brussels Belgium
| | - K. Peerlinck
- Centre for Molecular and Vascular Biology; KU Leuven; Leuven Belgium
| | - G. A. Matricali
- Department of Development & Regeneration; KU Leuven; Leuven Belgium
- Department of Orthopaedics; Foot & Ankle Unit; University Hospitals Leuven; KU Leuven; Leuven Belgium
- Institute of Orthopaedic Research & Training; KU Leuven; Leuven Belgium
| | - F. Staes
- Department of Rehabilitation Sciences; Musculoskeletal Rehabilitation Research Group; KU Leuven; Leuven Belgium
| | - K. Deschamps
- Department of Rehabilitation Sciences; Musculoskeletal Rehabilitation Research Group; KU Leuven; Leuven Belgium
- Department of Podiatry; Artevelde University College; Ghent Belgium
- Department of Podiatry; Parnasse-ISEI; Haute Ecole Leonard de Vinci; Bruxelles Belgium
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Arévalo-Mora JF, Reina-Bueno M, Munuera PV. Influence of Children's Foot Type on Their Physical Motor Performance. J Am Podiatr Med Assoc 2017; 106:15-21. [PMID: 26895356 DOI: 10.7547/14-086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND This cross-sectional study aimed to determine whether normal, flat, or high-arched feet corresponded to better performance of certain motor tests in children. METHODS One hundred eighty-seven children (mean ± SD age, 11.15 ± 1.24 years) were recruited and divided into three groups: 96 with normal feet, 54 with high-arched feet, and 37 with low-arched feet. Nine motor trials were selected to assess motor performance: standing long jump, standing triple jump from each foot, standing vertical jump, shuttle run 10 × 5 m, standing-start 20-m sprint, static balance, dynamic balance on a beam of an inverted gym bench, and agility circuit. RESULTS There were no significant differences in the trial results between groups, although in eight of the nine trials participants in the high-arched group tended to perform better. Boys performed better than girls in all of the trials except those of balance. CONCLUSIONS These results suggest that children with a certain foot type did not achieve better motor performance in the nine trials tested.
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Affiliation(s)
| | | | - Pedro V Munuera
- Department of Podiatry, University of Seville, Seville, Spain
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Association of arch height with ankle muscle strength and physical performance in adult men. Biol Sport 2017; 34:119-126. [PMID: 28566805 PMCID: PMC5424451 DOI: 10.5114/biolsport.2017.64585] [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] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/22/2016] [Accepted: 07/21/2016] [Indexed: 11/21/2022] Open
Abstract
Differences in arch height may have a certain impact on lower extremity muscle strength and physical performance. However, there is little evidence from investigation of the possible correlation of arch height with ankle muscle strength and physical performance measures. Sixty-seven participants took part in this study. Arch height index (AHI) was assessed and categorized using a 3-dimension foot scanner. Ankle muscle strength was measured employing a dynamometer. Physical performance measures including agility, force and proprioception were randomly tested. Compared to the medium AHI, the high AHI had lower plantarflexion and inversion peak torque. The high AHI also had lower peak torque per body weight value for plantarflexion and inversion at 120°/s (P = 0.026 and 0.006, respectively), and dorsiflexion at 30°/s (P = 0.042). No significant ankle muscle strength difference was observed between the low and medium AHI. Additionally, AHI was negatively correlated with eversion and inversion peak torque at 120°/s, and negatively associated with plantarflexion, eversion and inversion peak torque per body weight at both 30°/s and 120°/s (r ranged from -0.26 to -0.36, P values < 0.050). However, no significant relationship was found between arch height and physical performance measures. The results showed that high arches had lower ankle muscle strength while low arches exhibited greater ankle muscle strength. Arch height was negatively associated with ankle muscle strength but not related to physical performance. We suggest that the lower arch with greater ankle muscle strength may be an adaptation to weight support and shock absorption.
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Mueller S, Carlsohn A, Mueller J, Baur H, Mayer F. Influence of Obesity on Foot Loading Characteristics in Gait for Children Aged 1 to 12 Years. PLoS One 2016; 11:e0149924. [PMID: 26914211 PMCID: PMC4767217 DOI: 10.1371/journal.pone.0149924] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 02/05/2016] [Indexed: 11/18/2022] Open
Abstract
Background Overweight and obesity are increasing health problems that are not restricted to adults only. Childhood obesity is associated with metabolic, psychological and musculoskeletal comorbidities. However, knowledge about the effect of obesity on the foot function across maturation is lacking. Decreased foot function with disproportional loading characteristics is expected for obese children. The aim of this study was to examine foot loading characteristics during gait of normal-weight, overweight and obese children aged 1–12 years. Methods A total of 10382 children aged one to twelve years were enrolled in the study. Finally, 7575 children (m/f: n = 3630/3945; 7.0±2.9yr; 1.23±0.19m; 26.6±10.6kg; BMI: 17.1±2.4kg/m2) were included for (complete case) data analysis. Children were categorized to normal-weight (≥3rd and <90th percentile; n = 6458), overweight (≥90rd and <97th percentile; n = 746) or obese (>97th percentile; n = 371) according to the German reference system that is based on age and gender-specific body mass indices (BMI). Plantar pressure measurements were assessed during gait on an instrumented walkway. Contact area, arch index (AI), peak pressure (PP) and force time integral (FTI) were calculated for the total, fore-, mid- and hindfoot. Data was analyzed descriptively (mean ± SD) followed by ANOVA/Welch-test (according to homogeneity of variances: yes/no) for group differences according to BMI categorization (normal-weight, overweight, obesity) and for each age group 1 to 12yrs (post-hoc Tukey Kramer/Dunnett’s C; α = 0.05). Results Mean walking velocity was 0.95 ± 0.25 m/s with no differences between normal-weight, overweight or obese children (p = 0.0841). Results show higher foot contact area, arch index, peak pressure and force time integral in overweight and obese children (p<0.001). Obese children showed the 1.48-fold (1 year-old) to 3.49-fold (10 year-old) midfoot loading (FTI) compared to normal-weight. Conclusion Additional body mass leads to higher overall load, with disproportional impact on the midfoot area and longitudinal foot arch showing characteristic foot loading patterns. Already the feet of one and two year old children are significantly affected. Childhood overweight and obesity is not compensated by the musculoskeletal system. To avoid excessive foot loading with potential risk of discomfort or pain in childhood, prevention strategies should be developed and validated for children with a high body mass index and functional changes in the midfoot area. The presented plantar pressure values could additionally serve as reference data to identify suspicious foot loading patterns in children.
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Affiliation(s)
- Steffen Mueller
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Potsdam, Germany
- * E-mail:
| | - Anja Carlsohn
- University of Education Schwäbisch Gmünd, Institute of Health Sciences, Schwäbisch Gmünd, Germany
| | - Juliane Mueller
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Potsdam, Germany
| | - Heiner Baur
- Bern University of Applied Sciences, Health, Physiotherapy, Bern, Switzerland
| | - Frank Mayer
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Potsdam, Germany
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Morita N, Yamauchi J, Kurihara T, Fukuoka R, Otsuka M, Okuda T, Ishizawa N, Nakajima T, Nakamichi R, Matsuno S, Kamiie S, Shide N, Kambayashi I, Shinkaiya H. Toe flexor strength and foot arch height in children. Med Sci Sports Exerc 2016; 47:350-6. [PMID: 24895943 DOI: 10.1249/mss.0000000000000402] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of this study was to investigate the muscle strength and arch height of the foot in the standing position and the relations between these indices and physical performances involving the lower limbs in children. METHODS A total of 301 elementary school children (third grade: n = 158, age = 8.6 ± 0.5 yr; fifth grade: n = 143, age = 10.6 ± 0.5 yr; means ± SD) participated. The maximal isometric toe flexor strength (TFS) in the standing position was measured using a toe flexor dynamometer. Foot arch height was assessed as the distance between the navicular tuberosity of the foot and the floor in the standing position, and foot arch height relative to the foot length was represented by the foot arch index (FAI). For physical performance involving the lower limbs, 50-m sprint, standing broad jump, repeated side step, and rebound jump were measured. RESULTS There were no significant correlations between TFS and FAI and between relative TFS (relative TFS = TFS/body mass) and FAI. Relative TFS was significantly correlated with all physical performance tests. No significant correlations among FAI and physical performances were found, except for rebound jump ability in fifth graders. After multiple regression analyses adjusting for gender and body mass, TFS was the only significant correlating factor for all physical performances involving the lower limbs. CONCLUSIONS This study showed that TFS was associated with enhancement of some measures of lower limb physical performance in children. These results suggest that foot function should be evaluated with both the muscle strength and arch height of the foot in children.
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Affiliation(s)
- Noriteru Morita
- 1Department of Sports Education, Hokkaido University of Education, Iwamizawa, Hokkaido, JAPAN; 2Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, JAPAN; 3Future Institute for Sport Sciences, Tokyo, JAPAN; 4Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, THAILAND; 5Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, JAPAN; 6Graduate School of Education, Hokkaido University of Education, Hokkaido, JAPAN; 7Department of Teacher Training, Hokkaido University of Education, Sapporo, Hokkaido, JAPAN; and 8Hokkaido University of Science, Hokkaido, JAPAN
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Abstract
Twenty-nine male judocas and nontraining peers participated in this study. The arch of the foot (as Clarke's angular values) was measured under non-weight-bearing conditions in two-leg and one-leg stands. Postural balance was assessed by the Flamingo balance test. Judocas presented better static balance and higher arches of the foot. Significant differences in Clarke's angular values in a sitting and standing on two-leg position were found in both groups. After transition to a one-leg stand, the height of the arches of the foot in nontraining participants was still significantly decreased. Weight bearing did not affect Clarke's angular values in judokas. A correlation was found between the Flamingo test and Clarke's angle. Better balance was observed in adolescents with higher arch of the foot.
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The relationship between quality of life and foot function in children with flexible flatfeet. Gait Posture 2015; 41:786-90. [PMID: 25771182 DOI: 10.1016/j.gaitpost.2015.02.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/19/2015] [Accepted: 02/21/2015] [Indexed: 02/02/2023]
Abstract
Flat feet in children are common, and at times symptomatic, but the relationship between function and symptoms or impairment is still unclear. We undertook a prospective, observational study comparing children with paediatric flexible flat foot (PFF) and children with neutral feet (NF) using three dimensional gait analysis (3DGA). It was hypothesised that children with PFF would demonstrate differences in both spatio-temporal parameters of gait and foot and ankle kinematics compared to the NF group and that these differences would correlate with impaired quality of life (QoL). The kinematic differences were expected to be most marked in hindfoot coronal plane motion and forefoot sagittal and transverse plane motion. Eighty-three children between the ages of 8 and 15 were recruited in this study: Forty-two were classified as having PFF and forty-one as NF. Each child underwent 3DGA and completed the Oxford Ankle Foot Questionnaire for Children (OxAFQ_C). Reduced OxAFQ_C physical domain scores in the PFF children were associated with slower walking speed (p=0.014) and reduced normalised stride length (p=0.008). PFF children also demonstrated significantly increased hindfoot eversion and forefoot supination during gait. Significant differences between groups were not observed for other foot and ankle joint motions. Increased maximum hindfoot eversion and increased forefoot supination correlated strongly with lower QoL scores in PFF children. These data further our understanding of the functional characteristics that lead to impaired QoL in PFF children. These findings will help guide the surveillance and management of children with this ubiquitous condition.
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Chang CH, Chen YC, Yang WT, Ho PC, Hwang AW, Chen CH, Chang JH, Chang LW. Flatfoot diagnosis by a unique bimodal distribution of footprint index in children. PLoS One 2014; 9:e115808. [PMID: 25551228 PMCID: PMC4281062 DOI: 10.1371/journal.pone.0115808] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 11/27/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND More than 1000 scientific papers have been devoted to flatfoot issue. However, a bimodal distribution of flatfoot indices in school-aged children has never been discovered. The purposes of this study were to establish a new classification of flatfoot by characteristic in frequency distribution of footprint index and to endue the classification with discrepancy in physical fitness. METHODS/PRINCIPAL FINDINGS In a longitudinal survey of physical fitness and body structure, weight bearing footprints and 3 physical fitness related tests were measured in 1228 school-aged children. Frequency distribution of initial data was tested by Kolmogorov-Smirnov test for normality and a unique bimodal distribution of footprint index was identified. The frequency distribution of footprint index manifests two distinct modes, flatfoot and non-flatfoot, by deconvolution and bootstrapping procedures. A constant intersection value of 1.0 in Staheli's arch index and 0.6 in Chippaux-Smirak index could distinguish the two modes of children, and the value was constant in different age, sex, and weight status. The performance of the one leg balance was inferior in flatfoot girls (median, 4.0 seconds in flatfoot girls vs. 4.3 seconds in non-flatfoot girls, p = 0.04, 95% CI 0.404-0.484). DISCUSSION The natural bimodality lends itself to a flatfoot classification. Bimodality suggests development of the child's foot arch would be a leap from one state to another, rather than a continuous growth as body height and weight. The underlying dynamics of the human foot arch and motor development will trigger research prospects.
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Affiliation(s)
- Chia-Hsieh Chang
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
- Department of Pediatric Orthopedics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Chen Chen
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Wen-Tien Yang
- Taipei Chengshih University of Science and Technology, Taipei, Taiwan
| | - Pei-Chi Ho
- Department of Pediatric Orthopedics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Ai-Wen Hwang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Hung Chen
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Jia-Hao Chang
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan
| | - Liang-Wey Chang
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
- * E-mail:
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Banwell HA, Mackintosh S, Thewlis D. Foot orthoses for adults with flexible pes planus: a systematic review. J Foot Ankle Res 2014; 7:23. [PMID: 24708560 PMCID: PMC4108129 DOI: 10.1186/1757-1146-7-23] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 03/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Foot orthoses are widely used in the management of flexible pes planus, yet the evidence to support this intervention has not been clearly defined. This systematic review aimed to critically appraise the evidence for the use of foot orthoses for flexible pes planus in adults. METHODS Electronic databases (Medline, CINAHL, Cochrane, Web of science, SportDiscus, Embase) were systematically searched in June 2013 for randomised controlled, controlled clinical and repeated measure trials where participants had identified flexible pes planus using a validated and reliable measure of pes planus and the intervention was a rigid or semi-rigid orthoses with the comparison being a no-orthoses (shoes alone or flat non-posted insert) condition. Outcomes of interest were foot pain, rearfoot kinematics, foot kinetics and physical function. RESULTS Of the 2,211 articles identified by the searches, 13 studies met the inclusion criteria; two were randomised controlled trials, one was a controlled trial and 10 were repeated measure studies. Across the included studies, 59 relevant outcome measures were reported with 17 calculated as statistically significant large or medium effects observed with use of foot orthoses compared to the no orthoses condition (SMD range 1.13 to -4.11). CONCLUSIONS No high level evidence supported the use of foot orthoses for flexible pes planus. There is good to moderate level evidence that foot orthoses improve physical function (medial-lateral sway in standing (level II) and energy cost during walking (level III)). There is low level evidence (level IV) that foot orthoses improve pain, reduce rearfoot eversion, alter loading and impact forces; and reduce rearfoot inversion and eversion moments in flexible pes planus. Well-designed randomised controlled trials that include appropriate sample sizes, clinical cohorts and involve a measure of symptom change are required to determine the efficacy of foot orthoses to manage adult flexible pes planus.
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Affiliation(s)
- Helen A Banwell
- International Centre for Allied Health Evidence (iCAHE) School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
| | - Shylie Mackintosh
- International Centre for Allied Health Evidence (iCAHE) School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
- Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5001, Australia
| | - Dominic Thewlis
- Biomechanics and Neuromotor Lab. School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
- Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5001, Australia
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Shibuya N, Kitterman RT, LaFontaine J, Jupiter DC. Demographic, physical, and radiographic factors associated with functional flatfoot deformity. J Foot Ankle Surg 2014; 53:168-72. [PMID: 24418401 DOI: 10.1053/j.jfas.2013.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Indexed: 02/03/2023]
Abstract
In 1 of our previous studies, the occurrence of self-reported flatfoot was associated with self-reported increased age, male gender, Asian and African American races, veteran status, poor health, increased body mass index, callus, bunion, hammertoe, and arthritis. However, we had to rely on survey data to identify these risk factors, and the accuracy of the survey results was unknown. Therefore, we decided to identify the risk factors associated with flatfeet using objectively and more accurately measured data. A total of 94 patients were enrolled in the present study. The demographic data and physical and radiographic examination results were recorded by the investigators in the clinic. The data were then analyzed to identify the factors unique to flatfoot, measured and defined using a plantar pressure measurement system during natural gait. We learned that a painful tibialis posterior tendon was associated with flatfoot. The calcaneal inclination angle was also decreased in the flatfoot group. The talar declination, intermetatarsal, hallux abductus, and calcaneal cuboid angles, and static calcaneal stance eversion were elevated in the flatfoot group compared with the non-flatfoot group. Systematic evaluation of these associated factors will help in the understanding of the functional status of the flatfoot deformity.
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Affiliation(s)
- Naohiro Shibuya
- Associate Professor, Department of Surgery, Texas A&M University Health Science Center College of Medicine, College Station, TX; and Acting Chief, Section of Podiatry, Department of Surgery, Central Texas Veterans Health Care System, Scott and White Health Care System, Temple, TX.
| | - Ryan T Kitterman
- Third Year Podiatric Medicine and Surgery Resident, Scott and White Memorial Hospital, Texas A&M Health Science Center College of Medicine, Temple, TX
| | - Javier LaFontaine
- Associate Professor, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Daniel C Jupiter
- Associate Professor of Surgery, Department of Surgery, Texas A&M University Health Science Center, College of Medicine; and Research Scientist I, Scott and White Memorial Clinic and Hospital, Temple, TX
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Hösl M, Böhm H, Multerer C, Döderlein L. Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic flatfeet using the Oxford Foot Model. Gait Posture 2014; 39:23-8. [PMID: 23796513 DOI: 10.1016/j.gaitpost.2013.05.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Treatment of asymptomatic flexible flatfeet is a subject of great controversy. The purpose of this study was to examine foot function during walking in symptomatic (SFF) and asymptomatic (ASFF) flexible flatfeet. Thirty-five paediatric and juvenile patients with idiopathic flexible flatfeet were recruited from an orthopaedic outpatient department (14 SFF and 21 ASFF). Eleven age-matched participants with typically developing feet served as controls (TDF). To study foot function, 3D multi-segment foot kinematics and ankle joint kinetics were captured during barefoot gait analysis. Overall, alterations in foot kinematics in flatfeet were pronounced but differences between SFF and ASFF were not observed. Largest discriminatory effects between flatfeet and TDF were noticed in reduced hindfoot dorsiflexion as well as in increased forefoot supination and abduction. Upon clinical examination, restrictions in passive dorsiflexion in ASFF and SFF were significant. During gait, the hindfoot in flatfeet (both ASFF and SFF) was more everted, but less flexible. In sagittal plane, limited hindfoot dorsiflexion of ASFF and SFF was compensated for by increased forefoot mobility and a hypermobile hallux. Concerning ankle kinetics, SFF lacked positive joint energy for propulsion while ASFF needed to absorb more negative ankle joint energy during loading response. This may risk fatigue and overuse syndrome of anterior shank muscles in ASFF. Hence, despite a lack of symptoms flatfoot deformity in ASFF affected function. Yet, contrary to what was expected, SFF did not show greater deviations in 3D foot kinematics than ASFF. Symptoms may rather depend on tissue wear and subjective pain thresholds.
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Affiliation(s)
- Matthias Hösl
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229 Aschau i. Chiemgau, Germany.
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Nakhostin-Roohi B, Hedayati S, Aghayari A. The effect of flexible flat-footedness on selected physical fitness factors in female students aged 14 to 17 years. JOURNAL OF HUMAN SPORT AND EXERCISE 2013. [DOI: 10.4100/jhse.2013.83.03] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Müller S, Carlsohn A, Müller J, Baur H, Mayer F. Static and dynamic foot characteristics in children aged 1-13 years: a cross-sectional study. Gait Posture 2012; 35:389-94. [PMID: 22118730 DOI: 10.1016/j.gaitpost.2011.10.357] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Revised: 09/03/2011] [Accepted: 10/30/2011] [Indexed: 02/02/2023]
Abstract
The aim of this study was to acquire static and dynamic foot geometry and loading in childhood, and to establish data for age groups of a population of 1-13 year old infants and children. A total of 10,382 children were recruited and 7788 children (48% males and 52% females) were finally included into the data analysis. For static foot geometry foot length and foot width were quantified in a standing position. Dynamic foot geometry and loading were assessed during walking on a walkway with self selected speed (Novel Emed X, 100Hz, 4 sensors/cm(2)). Contact area (CA), peak pressure (PP), force time integral (FTI) and the arch index were calculated for the total, fore-, mid- and hindfoot. Results show that most static and dynamic foot characteristics change continuously during growth and maturation. Static foot length and width increased with age from 13.1±0.8cm (length) and 5.7±0.4cm (width) in the youngest to 24.4±1.5cm (length) and 8.9±0.6cm (width) in the oldest. A mean walking velocity of 0.94±0.25m/s was observed. Arch-index ranged from 0.32±0.04 [a.u.] in the one-year old to 0.21±0.13 [a.u.] in the 5-year olds and remains constant afterwards. This study provides data for static and dynamic foot characteristics in children based on a cohort of 7788 subjects. Static and dynamic foot measures change differently during growth and maturation. Dynamic foot measurements provide additional information about the children's foot compared to static measures.
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Affiliation(s)
- Steffen Müller
- University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Germany.
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Benedetti MG, Ceccarelli F, Berti L, Luciani D, Catani F, Boschi M, Giannini S. Diagnosis of flexible flatfoot in children: a systematic clinical approach. Orthopedics 2011; 34:94. [PMID: 21323297 DOI: 10.3928/01477447-20101221-04] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The goal of this study was to provide measures of symptoms and signs in a consecutive case series of children with flexible flatfoot based on a systematic clinical approach. Fifty-three children (age range, 10-14 years) previously diagnosed with flexible flatfoot were evaluated by a structured interview and clinical assessment. Most patients had foot symptoms (65.3% of feet) and functional limitation (68.3%). Symptoms included a sensation of discomfort (11.3%), such as early tiredness or difficulties during prolonged standing or walking, and pain (54%), mostly located in the plantar aspect of the foot (28.7%) and the medial hindfoot (18.8%). Body mass index was positively correlated to the presence of symptoms and their severity. Even if an enlarged footprint was present in 93.1% of feet, objective assessment evidenced the presence of heel valgus only in 83% of feet. Forefoot adduction was present in 22% of feet. Jack's test provided varus correction in only 54% of feet. Internal knee rotation was the most common associated disalignment, present in 43.6% of limbs. Symptoms were significantly correlated to knee alignment, and functional limitation was correlated to heel valgus. Standing balance on 1 leg was significantly correlated to footprint grading severity. A systematic clinical approach to assess children with flexible flatfoot should always be recommended for the correct diagnosis and the associated treatment management based on symptoms, functional limitation, and foot dysfunction. Functional assessment by specific tests should be included in the examination, as evidence exists that morphology and function are not necessarily related.
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Han JT, Koo HM, Jung JM, Kim YJ, Lee JH. Differences in Plantar Foot Pressure and COP between Flat and Normal Feet During Walking. J Phys Ther Sci 2011. [DOI: 10.1589/jpts.23.683] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jin Tae Han
- Department of Physical Therapy, College of Science, Kyungsung University
| | - Hyun Mo Koo
- Department of Physical Therapy, College of Science, Kyungsung University
| | - Jae Min Jung
- Department of Physical Therapy, Graduate School of Rehabilitation Science, Daegu University
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40
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DeSilva JM, Throckmorton ZJ. Lucy's flat feet: the relationship between the ankle and rearfoot arching in early hominins. PLoS One 2010; 5:e14432. [PMID: 21203433 PMCID: PMC3010983 DOI: 10.1371/journal.pone.0014432] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Accepted: 12/01/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In the Plio-Pleistocene, the hominin foot evolved from a grasping appendage to a stiff, propulsive lever. Central to this transition was the development of the longitudinal arch, a structure that helps store elastic energy and stiffen the foot during bipedal locomotion. Direct evidence for arch evolution, however, has been somewhat elusive given the failure of soft-tissue to fossilize. Paleoanthropologists have relied on footprints and bony correlates of arch development, though little consensus has emerged as to when the arch evolved. METHODOLOGY/PRINCIPAL FINDINGS Here, we present evidence from radiographs of modern humans (n = 261) that the set of the distal tibia in the sagittal plane, henceforth referred to as the tibial arch angle, is related to rearfoot arching. Non-human primates have a posteriorly directed tibial arch angle, while most humans have an anteriorly directed tibial arch angle. Those humans with a posteriorly directed tibial arch angle (8%) have significantly lower talocalcaneal and talar declination angles, both measures of an asymptomatic flatfoot. Application of these results to the hominin fossil record reveals that a well developed rearfoot arch had evolved in Australopithecus afarensis. However, as in humans today, Australopithecus populations exhibited individual variation in foot morphology and arch development, and "Lucy" (A.L. 288-1), a 3.18 Myr-old female Australopithecus, likely possessed asymptomatic flat feet. Additional distal tibiae from the Plio-Pleistocene show variation in tibial arch angles, including two early Homo tibiae that also have slightly posteriorly directed tibial arch angles. CONCLUSIONS/SIGNIFICANCE This study finds that the rearfoot arch was present in the genus Australopithecus. However, the female Australopithecus afarensis "Lucy" has an ankle morphology consistent with non-pathological flat-footedness. This study suggests that, as in humans today, there was variation in arch development in Plio-Pleistocene hominins.
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Affiliation(s)
- Jeremy M DeSilva
- Department of Anthropology, Boston University, Boston, Massachusetts, United States of America.
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Shibuya N, Jupiter DC, Ciliberti LJ, VanBuren V, La Fontaine J. Characteristics of adult flatfoot in the United States. J Foot Ankle Surg 2010; 49:363-8. [PMID: 20537928 DOI: 10.1053/j.jfas.2010.04.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Indexed: 02/03/2023]
Abstract
Many factors have been suggested to cause flatfoot deformity. The purpose of this study was to identify risk factors for flatfoot deformity, which itself can be a causative factor for other foot and ankle pathologies. The National Health Interview Survey (Podiatry Supplement) from 1990 was analyzed to determine associations of various demographic factors and other foot and ankle pathologies with self-reported flatfoot deformity. We found statistically significant (P <or= .05) associations of flatfoot with age, male gender, BMI, white-collar occupation, veteran status, bunion, hammertoe, calluses, arthritis, and poor health. Treatment and prevention of flatfoot may have an effect on an individual's overall health and occurrence of other foot and ankle pathologies.
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Affiliation(s)
- Naohiro Shibuya
- Department of Surgery, Texas A&M Health Science Center, College of Medicine, Temple, TX 76502, USA.
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