Early detection of podiatric anomalies in children with Down syndrome

Concolino, Daniela; Pasquzzi, Antonietta; Capalbo, Giuseppe; Sinopoli, Saverio; Strisciuglio, Pietro

doi:10.1080/08035250500325108

Cited by 68 publications

(52 citation statements)

References 5 publications

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“…We hypothesised that a flat foot posture would be associated with foot-specific disability based on previous studies showing that children with DS and flat feet have reduced gait efficiency [6,41] and impaired foot function [16]. However, our findings showed that foot posture was not associated with foot-specific disability.…”

Section: Discussionmentioning

confidence: 61%

“…An explanation as to why there was a relationship between footwear width (and not length) with foot-specific disability could pertain to the ‘typical’ foot shape of children with DS. In particular, children with DS have a wider forefoot (related to the presence of hallux valgus, a greater first intermetatarsal angle or a flat foot posture) compared to children without DS [16]. Hence, children with DS are more likely to wear shoes of an inadequate width as a result of their wider forefoot.…”

Section: Discussionmentioning

confidence: 99%

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The association of foot structure and footwear fit with disability in children and adolescents with Down syndrome

Lim

Shields

Nikolopoulos

et al. 2015

Journal of Foot and Ankle Research

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BackgroundFoot deformity, flat feet, and the use of ill-fitting footwear are common in children and adolescents with Down syndrome (DS). The aim of this study was to determine whether these observations are associated with foot-specific disability in this group.MethodsA cross-sectional study design. Foot structure (foot posture determined using the Arch Index, presence of hallux valgus and lesser toe deformities) and footwear fit (determined by length and width percentage differences between the participant’s foot and footwear) were assessed in 50 participants with DS (22 females, 28 males) aged five to 18 with a mean (SD) age of 10.6 (3.9) years. Foot-specific disability was determined using the parent-reported Oxford Ankle Foot Questionnaire for Children (OxAFQ-C). Associations between foot structure and footwear fit with the four domains (Physical, School and play, Emotional and Footwear) of the OxAFQ-C were determined using multivariate regression modelling.ResultsThe mean (SD) Arch Index was 0.29 (0.08), and the prevalence of flat feet, hallux valgus and lesser toe deformities was 76%, 10% and 12% respectively. Few participants wore footwear that was too short (10%), but the use of footwear that was too narrow was common (58%). The presence of hallux valgus was significantly associated with increased disability for the OxAFQ-C School and play domain scores. The use of narrow-fitting footwear was significantly associated with increased levels of disability for the OxAFQ-C Physical, School and play, and Emotional domains. However, these variables only explained between 10% to 14% of the variance in the OxAFQ-C domain scores. There were no significant associations between foot structure and footwear fit with the OxAFQ-C Footwear domain scores.ConclusionsFlatter feet and lesser toe deformities are not associated with foot-specific disability in children and adolescents with DS. Hallux valgus is associated with foot-specific disability during school and play activities. Ill-fitting footwear (too narrow) is common and is associated with foot-specific disability. Further research is required to identify if the relationship between narrow-fitting footwear and foot-specific disability is causal, and to identify other factors associated with foot-specific disability in children and adolescents with DS.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

The association of foot structure and footwear fit with disability in children and adolescents with Down syndrome

Lim

Shields

Nikolopoulos

et al. 2015

Journal of Foot and Ankle Research

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“…In addition, smaller step length and larger step width are shown by children and adolescents with DS when compared to healthy individuals. These impairments reduce throughout life, following the improvement of postural control and movement 2,5,6,8,11,12,16,37) . In that, some change was observed during lifespan: during childhood, larger variability in gait parameters was observed 2) , and the spatiotemporal locomotor traits were consistent with the gait profile of DS patients 34) .…”

Section: Discussionmentioning

confidence: 99%

“…Affected individuals develop inappropriate patterns in an attempt to establish functional, relatively stable gait. Altered gait patterns are related to orthopedic changes that in turn have negative consequences on performance during the execution of different daily-life activities 1,11,16,17) .…”

Section: Introductionmentioning

confidence: 99%

Gait and postural control patterns and rehabilitation in Down syndrome: a systematic review

Zago

Duarte

Grecco³

et al. 2020

J Phys Ther Sci

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To describe (1) the current knowledge on gait and postural control in individuals with Down syndrome in terms of spatiotemporal, kinematics and kinetics, and (2) relevant rehabilitation strategies. [Methods] Randomized and non-randomized clinical trials published between January 1997 and October 2019 were selected by searching four scientific databases. We included studies on patients with Down syndrome involving gait analysis or postural control. A custom data-extraction and appraisal form was developed to collect the key features of each article. The PEDro Scale was used to evaluate the methodological quality of the studies. [Results] A total of 37 out of 146 cross-sectional and longitudinal studies were included in the review. The main abnormalities included: reduction of gait velocity and step length, poor static balance with increased anteroposterior and mediolateral oscillations and a larger step width. [Conclusion] A number of compensatory patterns during movement was observed, with a direct influence on improvements in stability and postural control throughout daily life. Intensive gait training at an early age appears to produce long-term improvements in this population. Future research should focus on the interaction between the motor and cognitive function, and on the functional effects due to the exposure to an enriched environment.

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“…Foot health is an important determinant of health and social mobility (Courtenay & Murray, ), and timely access to foot care services for children and young people is key to the early detection and management of foot complications (Foley & Killeen, ). Musculoskeletal problems in children with developmental and intellectual disabilities are common and include structural foot problems (Concolino, Pasquzzi, Capalbo, Sinopoli, & Strisciuglio, ; Foley & Killeen, ; Mik, Gholve, Scher, Widmann, & Green, ; Roizen, ), joint dysfunction (Galli, Rigoldi, Brunner, Virji‐Babul, & Giorgio, ; Galli, Rigoldi, Mainardi, et al, ) and changes in foot shape (Church et al, ) and position (Galli et al, ). The pathways to musculoskeletal foot problems are complex and multifactorial, exacerbated by factors such as motor impairment (Cleaver, Hunter, & Ouellette‐Kuntz, ), fixed deformities and contractures due to spasticity (Church et al, ), secondary issues such as obesity‐related fatigue and muscle deconditioning (Rimmer et al, ), as well as individual factors such as pain experience(s) (Dubois, Capdevila, Bringuier, & Pry, ).…”

Section: Introductionmentioning

confidence: 99%

Foot care needs for children and young people with intellectual and developmental disabilities

Morrison

Barrett

Haines

2019

Brit J Learn Disabil

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Accessible Summary• We asked parents of children with intellectual and developmental disabilities to complete a survey to help us understand more about the foot problems their children have experienced.• Parents told us that foot problems were common in their children, 75% of the parents raised this as a concern. Less than half of the parents felt confident with managing these problems. Buying shoes was considered difficult.• The results from this survey tell us that foot problems in children and young people with intellectual and developmental disabilities are a concern. It is important to ensure that children have access to foot care services. AbstractBackground: Foot problems have been reported to be a very common health issue in adults with intellectual disabilities; foot problems in children and young people are, however, poorly understood. The aim of this study was to explore foot care needs of children and young people with intellectual and developmental disability.Methods: An exploratory, cross-sectional online survey was undertaken across a four-month period. A purposive snowball sampling approach was adopted. The survey tool was piloted before launch and comprised three sections. The first section elicited information relating to parent/caregiver status, diagnosis, secondary diagnoses and age of child/young person. The second domain explored foot care and sought to obtain information about foot problems, access to health services and existing knowledge about foot health. The third domain focussed on footwear. Ethical approval was granted from the host institution, and all participants provided electronic consent before completing the survey.Results: Data were collected from 49 parents/parental caregivers reporting on behalf of their children (mean age 7 years of age; SD 4.5 years of age). Parents reported foot problems to be very common (75%), and pes planus was the most frequent concern (51%). Twenty-four parents reported difficulties with finding shoes (48%). A mismatch between foot shape and the shoe (30%) or complications with orthotic devices (14%) within the shoe were highlighted. Conclusion:The results demonstrated that the burden of foot problems in children and young people with intellectual and developmental disabilities is considerable. The findings highlight the importance of access to foot care services for these children. | 5 MORRISON et al.

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Early detection of podiatric anomalies in children with Down syndrome

Abstract: The data demonstrated a greater incidence of minor orthopaedic alterations and suggest the necessity of regular podiatric examinations in the follow-up of this syndrome.

Cited by 68 publications

References 5 publications

The association of foot structure and footwear fit with disability in children and adolescents with Down syndrome

The association of foot structure and footwear fit with disability in children and adolescents with Down syndrome

Gait and postural control patterns and rehabilitation in Down syndrome: a systematic review

Foot care needs for children and young people with intellectual and developmental disabilities

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