Background

Abnormal foot posture is a common complaint presented in pediatric and pediatric orthopedic clinics. Functional, objective assessment of foot posture, with the potential for early identification of pathologic foot deformities, has, however, been lacking to date. While quantifying functional and regional impulses via dynamic pedobarography can improve the clinical assessment of children’s feet, normative values have not yet been reported or characterized.

Research Question

The objectives of this study were to: (1) quantify and characterize the pattern and spectrum of foot impulses in walking-aged, typically developing children; and (2) compare these to impulses from non-disabled adults.

Methods

Foot impulses of 102 participants (52 female) in five pre-determined age groups (2−3, 4–6, 7–10, 11−14, 15−17 years) were examined using dynamic pedobarography. Each pressure map (3 per foot per child) was divided according to anatomical foot regions: the hallux, heel, medial forefoot, lateral forefoot, lesser toes (D2 to D5), and midfoot. The impulse was calculated for each region and used to generate regional percent impulses and impulse ratios to assess anteroposterior and mediolateral balance within the foot.

Results

The impulse through the midfoot was highest in the youngest age group, with a corresponding lower impulse through the medial forefoot. As age advanced, the midfoot impulse decreased (p = 0.001), and the forefoot balance shifted slightly more medially (%Medial Forefoot: p = 0.004; Medial-Lateral Forefoot Balance: p = 0.019). When compared to adults, there were no significant differences between 15−17 year old children and adults in any of the regional percent impulses and impulse ratios. This indicates that skeletal maturity of the foot by late adolescence results in functional characteristics seen in adults.

Significance

The age-standardized norms of functional and regional impulse measures in children reported in this study can be used as a comparative benchmark in the clinical assessment of children presenting with various foot deformities.

中文翻译：

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动态足底气压计在典型发育中儿童的步态中足底压力模式的功能表征

背景

足部姿势异常是儿科和小儿骨科诊所常见的主诉。迄今为止，尚缺乏对脚部姿势的功能性，客观性评估，并有可能及早发现病理性足部畸形。虽然通过动态足底气压计量化功能性和区域性冲动可以改善对儿童脚的临床评估，但尚未报道或表征标准值。

研究问题

这项研究的目的是：（1）量化和表征步行年龄的典型发育中儿童的脚冲动模式和频谱；（2）将这些与非残障成年人的冲动进行比较。

方法

使用动态气压计检查了五个预定年龄组（2-3、4-6、7-10、11-14、15-17岁）中102名参与者（52名女性）的足部冲动。每个压力图（每个孩子每只脚3个）根据解剖上的脚部区域划分：拇趾，脚后跟，内侧前脚，外侧前脚，小脚趾（D2至D5）和中脚。计算每个区域的冲动，并用于产生区域冲动百分比和冲动比，以评估脚的前后和中外侧平衡。

结果

通过中足的冲动在最年轻的年龄组中最高，而通过前足内侧的冲动相应地较低。随着年龄的增长，中足冲动降低（p = 0.001），前足平衡向内的偏移略微多一些（％前足内侧：p = 0.004；内侧-前足外侧平衡：p = 0.019）。与成人相比，在15-17岁的儿童和成人之间，任何区域性的冲动百分比和冲动比率均无显着差异。这表明青春期后期足部骨骼的成熟会导致成年人的功能特征。

意义

这项研究中报告的儿童功能和区域冲动措施的年龄标准化规范可作为比较基准，用于对患有各种脚部畸形的儿童进行临床评估。