Evaluation of the paediatric foot using footprints and foot posture index: A cross‐sectional study

Gijón-Noguerón, Gabriel; Marchena‐Rodriguez, Ana; Montes-Alguacil, Jesús; Evans, Angela

doi:10.1111/jpc.14558

Cited by 25 publications

(20 citation statements)

References 41 publications

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“…The foot parameters used in the study were foot length, foot width, heel width, arch length, 1–5 metatarsal width, and arch index (AI). The AI, which correlated with foot posture and morphology, and notably, with the navicular height, was measured from the subjects’ standing scans and calculated by dividing the length of the foot into three equal portions (minus the toes) and dividing the footprint in the middle third by the total footprint of all three regions [ 26 ]. The reference criteria were as follows: AI ≤ 0.21 indicating high arch, AI ≥ 0.26 suggesting a flat arch, and normal arch lies between 0.21 < AI < 0.26 [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

A comparison of foot posture and walking performance in patients with mild, moderate, and severe adolescent idiopathic scoliosis

et al. 2021

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Background Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. However, the underlying mechanisms linking spinal curvature in AIS to foot characteristics and walking performance remain unclear. Objective This study aimed to compare walking performance between adolescents with mild, moderate, and severe scoliosis and matched healthy peers with foot posture as covariates. Methods This cross-sectional study of 96 adolescents was conducted between April 2020 to October 2020 in China, with 32 healthy peers in the control group and 64 patients in the AIS group. Foot posture and morphology, plantar pressure distribution, and gait characteristics were analyzed. One-way analysis of variance with Bonferroni correction and a post hoc comparison of the mean differences between the different groups was performed. Multiple analyses of covariance adjusted for age, sex, body mass index, foot posture index (FPI), arch index (AI), and walking speed were performed. Results Of the 64 adolescents with scoliosis, 18 had mild AIS, 32 had moderate AIS, and 14 had severe AIS. The AI and FPI were much higher in the moderate and severe AIS groups (p = 0.018) and the severe AIS group (p<0.001), respectively, than in the control group. The severe AIS group had advanced and longer midstance (p = 0.014) and delayed propulsion phase (p = 0.013) than the control group. Patients with moderate and severe AIS had asymmetrical gait periods in the left and right limbs (p<0.05). Significant differences in the center-of-pressure excursion index (CPEI) were found between the moderate and severe AIS and control groups (p = 0.003). Conclusion Moderate and severe AIS significantly influenced walking performance; however, no significant differences were observed between adolescents with mild AIS and healthy controls. Thus, early intervention could target the prevention of specific functional deficits and prevent it from progressing to a severe state.

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Section: Methodsmentioning

confidence: 99%

A comparison of foot posture and walking performance in patients with mild, moderate, and severe adolescent idiopathic scoliosis

et al. 2021

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“…Foot posture index (FPI) ( Redmond et al, 2008 ) can effectively evaluate foot posture and categorize feet into three types: pronated, neutral, and supinated position, and it has been proven to be a reliable, simple, and economical method compared to conventional measures ( Evans et al, 2003 ), footprints ( Gijon-Nogueron et al, 2020 ), and automatic measurement apparatus ( Ohi et al, 2017 ). Previous studies have suggested that foot posture evaluated by FPI was closely associated with pain, function in KOA patients ( Al-Bayati et al, 2018 ), and a more pronated foot was found in the patients with medial KOA than in healthy subjects ( Abourazzak et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Asymmetries in Foot Posture and Properties of Gastrocnemius Muscle and Achilles Tendon Between Patients With Unilateral and Bilateral Knee Osteoarthritis

Chen

Shen

et al. 2021

Front. Bioeng. Biotechnol.

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Background: Asymmetrical foot posture and properties alterations of the gastrocnemius muscle (GM) and Achilles tendon (AT) were observed in knee osteoarthritis (KOA). We aimed to investigate the inter-limbs asymmetries in foot posture and the properties of GM and AT and explore the association between them.Methods: A total of 62 subjects with unilateral or bilateral KOA were included in this study: 30 patients with unilateral pain and 32 patients with bilateral pain were assigned to the bilateral group (BG) and unilateral group (UG), respectively. The relatively serious leg (RSL) and relatively moderate leg (RML) were judged according to the severity of symptoms assessed by using visual analogue scale (VAS) motion. Foot posture and asymmetrical foot posture scores were assessed based on Foot Posture index (FPI-6). Subsequently, all the participants received an assessment for properties of GM and AT, including tone/tension (Hz), stiffness (N/m), and elasticity. We calculated the asymmetry index of AT (Asy-AT) in both legs and the difference of muscle properties between medial and lateral gastrocnemius (D-MLG) in the ipsilateral limb.Results: Asymmetry of foot posture was categorized into three types including normal, asymmetry, and severe asymmetry. The percentage of subjects classified as normal was higher in the BG (62.5%) than in the UG (36.67%), p < 0.05. Tension of AT and tone of lateral gastrocnemius (LG) in RSL were higher than those in RML (15.71 ± 0.91 vs. 15.23 ± 1.01; 25.31 ± 2.09 vs. 23.96 ± 2.08, p < 0.01 and p < 0.01, respectively), and stiffness of AT in the RSL was higher than that in RML (676.58 ± 111.45 vs. 625.66 ± 111.19, p < 0.01). Meanwhile, a positive relationship was found between ipsilateral FPI and tone of MG and LG in the left leg (0.246 per degree, 95% CI: −0.001, 0.129; p = 0.054 and 0.293 per degree, 95% CI: −0.014, 0.157; p = 0.021, respectively) and right leg (0.363 per degree, 95% CI: 0.033, 0.146; p = 0.004 and 0.272 per degree, 95% CI: 0.007, −0.144; p = 0.032, respectively). Moreover, a positive link was observed between asymmetrical FPI scores and K/L grade (0.291 per degree, 95% CI: 0.018, 0.216; p = 0.022). Furthermore, a significantly greater Asy-AT(tension) was detected in the UG than that in the BG (UG vs. UG: 8.20 ± 5.09% vs. 5.11 ± 4.72%, p < 0.01). Additionally, an increased asymmetrical FPI score (i.e., more severe asymmetry) was significantly associated with increases in Asy-AT(tension) and Asy-AT(stiffness) (0.42 per degree, 95% CI: 0.533, 1.881; p = 0.001 and 0.369 per degree, 95% CI: 0.596, 2.82; p = 0.003, respectively).Conclusions: The stiffness and tension of AT and the tone of LG in RSL were higher than those in RML in KOA patients, and inter-limbs foot posture and tension of AT were more asymmetrical in unilateral KOA patients compared to patients with bilateral KOA. Notably, foot posture, as an important biomechanical factor, was significantly associated with properties of GM, AT, and K/L grade in KOA patients.

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“…Therefore, this study aimed to investigate and compare the validity and diagnostic accuracy of CA and FPI-6 against radiographic findings as a criterion standard measure to determine flexible flatfoot in adolescents aged 12-18 years. Based upon the aforementioned information and the previous studies, 1,35 the main hypothesis of this study was that FPI-6 is more valid and diagnostically accurate in determining flatfoot in adolescents.…”

Section: Introductionmentioning

confidence: 87%

“…[31][32][33] FPI-6 has been validated in adults 34 and Paediatric population. 14 Gijon-Nogueron et al, in 2019 35 had concluded that compared with FPI-6, CA overestimates and misguides paediatric foot posture, while other researchers found CA to be a practical, reliable, and sensitive measure. 15,20,36,37 However, the diversity of the methodologies used and the circumstances for each study makes comparisons between the results of these previous studies difficult, leading to an ongoing debate among researchers and clinicians.…”

Section: Introductionmentioning

confidence: 99%

Comparing Validity and Diagnostic Accuracy of Clarke’s Angle and Foot Posture Index-6 to Determine Flexible Flatfoot in Adolescents: A Cross-Sectional Investigation

Hegazy¹,

Aboelnasr²,

Abuzaid³

et al. 2021

JMDH

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Objective Clinically, the foot posture index-6 (FPI-6) and Clarke’s angle (CA) are widely utilized to assess static foot posture; however, due to scarcity of scientific evidence, clinicians continue to debate the validity and diagnostic accuracy of these measures in children and adolescents. This study aimed to evaluate and compare the validity and diagnostic accuracy of the FPI-6 and CA in determining adolescents’ flexible flatfoot between ages of 12 and 18 years, considering radiographic investigation as a reference standard measure. Design Cross-sectional study. Setting Governmental hospitals. Participants and Methods A sample of 460 people (920 feet) with flexible flatfoot between the ages of 12 and 18 (15.23 ± 0.84 years) was enrolled in the study. The findings of the investigated measures were compared to the reference standard radiographic measure and plotted on the receiver operating characteristic (ROC) curve. The area under the ROC curve (AUC) was determined as a measure of FPI-6 and CA diagnostic accuracy. Intra-rater reliability, sensitivity, specificity, predictive values, and likelihood ratios of FPI-6 and CA were calculated and compared. The post-test probability of flatfoot was determined using the Fagan nomogram. Results CA had a substantially higher intra-rater reliability (ICC=0.99) than the FPI-6 (ICC=0.96), with p-value of 0.001. CA has greater sensitivity (98%) than FPI-6, as well as a superior specificity (99%), positive predictive value (98%), negative predictive value (98.9%), positive likelihood ratio (97), and a lower negative likelihood ratio (0.02). CA had such an area under ROC curve of 0.98 with a 95% confidence interval of 0.95–1.00, while FPI-6 had an area under ROC curve of 0.80 with a 95% confidence interval of (0.77–0.85). Conclusion FPI-6 and Clarke’s angle are both valid and diagnostically accurate clinical tests for flatfoot detection, with Clarke’s angle outperforming FPI-6 in adolescents aged 12 to 18 years with a normal BMI.

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Evaluation of the paediatric foot using footprints and foot posture index: A cross‐sectional study

Cited by 25 publications

References 41 publications

A comparison of foot posture and walking performance in patients with mild, moderate, and severe adolescent idiopathic scoliosis

A comparison of foot posture and walking performance in patients with mild, moderate, and severe adolescent idiopathic scoliosis

Comparison of the Asymmetries in Foot Posture and Properties of Gastrocnemius Muscle and Achilles Tendon Between Patients With Unilateral and Bilateral Knee Osteoarthritis

Comparing Validity and Diagnostic Accuracy of Clarke’s Angle and Foot Posture Index-6 to Determine Flexible Flatfoot in Adolescents: A Cross-Sectional Investigation

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