Effect of Plano-Valgus Foot on Lower-Extremity Kinematics and Spatiotemporal Gait Parameters in Children of Age 5–9

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.

Assessment of flat foot using plantar arch index in young adults

Introduction and Aim: Flat foot or pes planus results from collapse of the arches of the foot. Etiology, however varies in different age groups. As anthropometric measurements are age dependent, their correlation with different foot postures should be age specific. Our study aimed at using Plantar arch Index (PAI) to identify prevalence of flat foot in a young student population and find any association of obesity with flat foot. Methods: A prospective study was conducted on 150 medical students of a medical college. Staheli’s method was used to calculate PAI after collecting the footprints of students by ink method. Results: Prevalence of type III flat foot deformity was 6%, with a male preponderance. The PAI values ranged from 0 to 1.818. No association was found between obesity and PAI. Conclusion: Obesity was not associated with flat foot in the age group 18-25 years probably indicating different etiology for acquired flat foot in this age group. Our study also suggests that simple ink print method is a simpler method to diagnose flat feet deformity clinically using PAI.

Relationship between dynamic foot-ground contact area and balance impairments in adolescents with down syndrome

PURPOSE: Down Syndrome (DS) is characterized by intellectual disability, hypotonia, and joint laxity. Physical disability can be an additional problem and manifests as reduced lower limb muscle strength and impaired balance. The objectives of this study were to characterize DS dynamic foot-ground contact area and to study its relationship with balance impairment among adolescents with DS. METHODS: Twenty-eight children and adolescents with DS and 28 non-DS adolescents/children were matched for age and sex. The Oxford Ankle Foot Questionnaire (parents’ version) was used to measure disability related to ankle/foot problems in all subjects. A pressure-sensitive mat was used to assess the contact area and arch index. Also, a Biodex balance system was used for measuring postural stability. RESULTS: There were significant differences between both groups in all domains of the Oxford Ankle Foot Questionnaire, overall contact area, and arch index (p < 0.05). Overall postural stability index was significantly decreased in subjects with DS (p < 0.05). There was a nonsignificant correlation between contact area and postural stability (p > 0.05). CONCLUSION: Adolescents with DS exhibited larger mid-foot and forefoot contact areas with respect to non-DS matched children. Impairment of balance in adolescents with DS is a multifactorial problem not related to changes in the foot contact area.

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

Background Musculoskeletal disorders, especially in the feet, are common in people with Down syndrome (DS). Evaluation of podiatric footprints is important to prevent and manage orthopedic symptoms. The reliability of a wide variety of footprint measurement methods has been evaluated in healthy people, but few studies have considered the specific morphotype features of the feet in subjects with DS. The aim of this systematic review was to identify the podometric measurement tools used to typologically classify the footprints in the population with DS. Methods The following electronic databases were searched for studies describing footprint measurement tools to assess and classify the foot types in patients with DS published from inception to December 2020: PubMed, Web of Science, CINAHL, and Scopus. Articles were initially searched by screening titles and abstracts. Potentially relevant studies were then further screened by reviewing full texts. Studies that met the inclusion criteria were included in the review. Results Of the 122 articles identified by the search strategy, 14 full texts were retained to assess for eligibility, of which 11 studies met the inclusion criteria and were included. All the studies used footprint measurement methods to classify the foot types in subjects with DS, but only two studies assessed the reliability of those methods for the population with DS. The footprint measurement tools identified were a podoscope, a pressure-sensitive mat, a PressureStatTM carbon paper, and a 3D scanner. The Arch Index was the most common footprint measurement analyzed (seven studies). Two studies used the “gold standard” indexes that include Hernández-Corvo Index, Chippaux-Smirak Index, Staheli Index, and Clarke Angle to measure footprints. Conclusions There is a need to determine the reliability and validity of the footprint measurement methods used for clinical classification of the foot types in subjects with DS. This can contribute to an early diagnosis of foot abnormalities that would help to reduce mobility impairments, improving the quality of life of patients with DS.

Correlation of Obesity and Flat-Foot in Haemophilic Adolescents in Karad

BACKGROUND Haemophilic patients are more prone to obesity, due to physical inactivity which is a predisposing factor for structural and functional deformities. In obese people, long term loading has negative impact on lower limb and foot, which causes deformities like flat-foot. In foot, the primary component responsible for absorption and dissipation of forces is medial longitudinal arch and in flat-foot this arch is collapsed. Flat-foot causes pain and discomfort during weight bearing activities. In Haemophilic patients, obesity and flat-foot lead to further postural complications. As no study has been conducted on this topic before, we decided to study on this. The objectives of this study were to assess obesity, flat-foot and co relate obesity and flat-foot in Haemophilic adolescents. METHODS Height and weight of participants were measured to calculate BMI. Total 36 participants were chosen for this study. The subjects were assessed for flat-foot by using Staheli’s Plantar Arch Index. Footprints were taken to calculate the plantar index. The Staheli’s Plantar Arch Index was measured by dividing the width of central region by width of heel region on footprint, which was calculated as: a line tangent to the medial edge of forefoot and heel region, then a perpendicular line was drawn medially to laterally from mid - point of tangent line in central region of footprint (A) and similarly another perpendicular was drawn from heel region (B). The plantar index was then calculated by dividing value A with value B. RESULTS Flat-foot was seen in 25 % population having BMI between 33 - 35. Our data also suggested that age affects the medial arch of foot, the elder population showed increased percentage of flat-foot than the younger group. Individuals with type A haemophilia had increased percentage of flat-foot when compared with type B haemophiliacs, as type A haemophilia is considered severe type. CONCLUSIONS The results show that there is high prevalence of flat-foot in haemophilic patients, this requires rehabilitation and can help prevent further complications. KEY WORDS Haemophilia, Obesity, Flat-foot

An Analysis of Arches of Foot: A Comparison between Ink Foot Print Method and Custom Made Podoscope Device Method

The present study aimed to assess the validity of the podoscopic images compared with ink footprint methods (comparing the two different methods using the same parameters). Objective: The evaluation of the reliability and accuracy of arch angle (AA) is the purpose of this paper's study. It includes Chippaux-Smirak Index (CSI), Staheli Index (SI), and Arch Index (AI) by comparing footprints obtained from ink footprint and custom-made podoscopic footprints. Methods: Measurements of AA, CSI, SI, and AI are obtained from ink footprints and custom-made podoscope among 416 healthy participants (aged 21 to 65). Accuracy and reliability were calculated for all the footprint indices obtained using the two methods. Minimal detectable change and the Standard error (SE) of measurement were also calculated. Results: SPSS Statistical software (version 20) at 95% confidence interval was used to execute and observe the statistical analysis. Descriptive analysis was used to calculate the Mean and standard deviations (SD). The intrarater reliability of ink footprints and podoscopic footprints were analyzed using Intraclass correlation (IC) executed at 95% confidence intervals (CIs). Reliability of the podoscopic method was interpreted when the values (≥0.75) as excellent, (0.4-0.74) as moderate, and (0-0.39) as poor. Our study reported that AA, CSI, SI, and AI obtained from the ink footprints and podoscope had high intrarater reliability and reproducible. The podoscope was designed in a lightweight manner for transportation purposes and utilized in under-served and rural areas. This custom-made device may be utilized in orthopedics, and it can also be used to collect data and for diagnostic purposes.

SPECIFIC FEATURES OF VARIANT ANATOMY AND MORPHOMETRIC CHARACTERISTICS OF THE PALATAL VAULT IN ADULTS WITH DIFFERENT GNATHIC AND DENTAL TYPES OF ARCHES

Cone-beam computed tomograms of 68 people (age — 21–35) with physiological occlusion and various gnathic dental arches were analyzed by a method developed for identifying the palatal arch index, taken as a height (depth)-to-width dimension ratio. The results of the study revealed that palatal parameters are determined by main variants (types) of the palatal vault. In case of the mesopalatal type of the arch (index value — 35–45%), the width parameters exceeded the depth values by an average of 2.4 times, while the divergence angle of alveolar processes was 116.7 ± 5.6°. The dolichopalatal type of the arch (index value – above 45%) featured domination of the width parameters over the depth-related ones, by an average of 1.8 times, while the alveolar processes divergence angle made up 127.6 ± 6.1°. As far as the brachypalatal type of the arch is concerned (index value — below 35%), the width parameters exceeded the depth parameters by 4.0 times on average, the divergence angle of the alveolar processes being 113.5 ± 5.3°. The obtained data can be used in clinical orthodontics when diagnosing pathologies of the palatal vault, as well as to interpret data from additional methods of examination and to choose the right treatment for issues related to the dental arch shape and size.

Subtalar Arthroereisis for Flexible Flatfoot in Children—Clinical, Radiographic and Pedobarographic Outcome Comparing Three Different Methods

Subtalar arthroereises (STA) is a minimally invasive and reversible surgery to correct symptomatic flexible flatfoot (FFF) in children. Various techniques were described either applying expandable sinus tarsi implants or lateral calcaneus stop screws. Studies comparing the outcome of STA with different devices are rare. This retrospective single-center cohort study analyzes the results of STA using three different implants. 113 STA were performed in 73 consecutive patients (28 females). Mean age at surgery was 10.8 years (range 5–16). Mean follow-up was 29.0 months (range 1–111). In 21 feet the non-absorbable Kalix® endorthesis and in 56 feet the absorbable Giannini endorthesis were applied. Subtalar extraarticular screw arthroereises (SESA) was conducted in 36 feet. Clinical, radiographic and pedobarographic parameters were analyzed. No intraoperative complications were observed. All three procedures achieved comparable improvements of the clinical, radiographic and pedobarographic parameters. The mean foot function index (FFI) improved from 36.4 (range 12–63) to 22.8 (range 2–55). The mean preoperative calcaneal inclination angle and the lateral talocalcaneal angle improved from 9.5° (range 0–22) and 42.3° (range 21–62) to 12.8° (range 0–26) and 37.6° (range 15–56), respectively. Pedobarographically determined values of the arch index, the medial midfoot contact area and the medial forefoot peak pressure decreased. In contrast to SESA (1/36, 3%), a higher incidence of implant-related complications was observed using Kalix® (6/21, 29%) and Giannini (10/56, 8%) sinus tarsi implants. Peroneal muscle contractures only occurred in the SESA group (4/36, 11%). Premature removal due to treatment-related complications was necessary in 6/21 Kalix® implants (29%), 4/56 Giannini implants (7%) and 4/36 SESA implants (11%). Implant choice for treatment of painful FFF in children with STA seems to play a subordinate role. Clinical, radiographic and pedobarographic outcomes are comparable between the applied implants. Surgeons and patients should be aware of the different spectrum of implant-related complications. Treatment can be reliably monitored by radiation-free pedobarography providing dynamic information about the deformity.

Paediatric flat foot and foot dimension in Central Anatolia

Background Information on the foot structures of Central Anatolian children is limited. Foot structures of children aged 6–10 years were shown to be different according to sex and increasing age. Objective This study aimed to compare the foot anthropometric values by age and sex and collect the foot anthropometric data to reveal the relationship between pes planus and pes cavus in the arches of children according to age. Methods Footprints of 335 children (180 boys and 155 girls) aged 6–10 years were taken by the pedigraph method and evaluated using 18 different parameters. The TFL (Truncated foot length), FL (foot length), Arch Index, Chippaux Smirak Index, Staheli Arc Index, and foot rotation values of the children were examined. To examine the relationship between the parameters, normality values were examined. Independent samples t-test was used to analyze sex differences in terms of foot size and shape. Results Correlations between other parameters were determined using the correlations analysis method. TFL, metatarsal circumference, and FL were strongly correlated with age in the children. Foot rotation increased with body mass index in the girls compared to that in the boys. According to the evaluation results with the classification made with the Staheli arch index, 63.3% pes planus, 9.8% pes cavus and 27.7% of the normal arch structure were identified. Conclusions Planning shoe production accordingly will contribute to the development of healthy feet in children. This article focused on foot structures of in Central Anatolia and to identify early foot deformities in children. This study found that the length of the TFL was smaller in boys than in girls.