Foot posture development in children aged 5 to11 years: A three-year prospective study

Nova, Alfonso Martínez; Gijón-Noguerón, Gabriel; Alfageme-García, Pilar; Montes-Alguacil, Jesús; Evans, Angela

doi:10.1016/j.gaitpost.2018.03.032

Cited by 40 publications

(35 citation statements)

References 26 publications

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“…James et al (14) also did not employ an individualized treatment, while they applied prefabricated foot orthoses. In our case, custommade foot orthoses were individually adapted as Landorf et al recommend (27).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of custom-made foot orthoses vs heel lifts in children with Calcaneal Apophysitis (Sever disease): a CONSORT-compliant randomized trial

Alfaro-Santafé

Gómez-Bernal

Lanuza-Cerzócimo

et al. 2020

Preprint

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Background: Calcaneal apophysitis (Sever disease) is a benign ailment which causes heel pain in children. Conservative treatment strategies are widely popular and the prescription of prefabricated orthoses and heel-lifts is very widespread. The aim of the present research was to determine the effectiveness to relieve calcaneal apophysitis pain using “off-the-shelf” heel-lifts and custom-made orthotics. Methods: Two intervention modalities were evaluated and compared in a 12-week follow-up randomized comparative effectiveness trial. Inclusion criteria included 9 to 12 years old boys or girls diagnosed of calcaneal apophysitis, primary exclusion criteria included children who had suffered from foot trauma on the heel or had received previous treatment. Children were stratified randomized into experimental (custom-made polypropylene foot orthoses) and control (“off-the-shelf” heel-lifts) group. The primary outcome was calcaneal apophysitis pain perception, which was assessed by the Visual Analogical Scale (VAS), the algometry threshold and the Sport Activity Pain perception. Points of measure were at baseline and after the follow-up period. Analysis was performed according to the intention-to treat principles.Results: A total of 208 patients were included. Overall, 9 patients were lost to follow-up. Experimental group showed an increase in threshold algometry by 53.4% (95% CI 47.1% to 59.7%), a decrease in VAS by -68.6% (95% CI -74.5% to -62.7%) and a 20.8 times higher probability of improvement of Sport Activity (95% CI 8.9 to 48.6), compared with control group (p <0.001).Conclusions: Calcaneal apophysitis pain perception was improved in both groups custom-made foot orthoses and heel-lifts, but the experimental group revealed significant changes compared with control group. Children who used custom-made foot orthoses had greater probabilities to improve. Physicians should consider these findings in order to prescribe the most effective treatment in the approach of the calcaneal apophysitis. Trial registration: ClinicalTrials.gov Identifier: NCT03960086.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of custom-made foot orthoses vs heel lifts in children with Calcaneal Apophysitis (Sever disease): a CONSORT-compliant randomized trial

Alfaro-Santafé

Gómez-Bernal

Lanuza-Cerzócimo

et al. 2020

Preprint

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“…In clinical settings, pain, symmetry, age and gait evaluation are better indicators of foot health than static measures (footprints or FPI). The appreciation of normal variation of foot posture in children and the prospective evidence that paediatric flat feet reduce with age can avoid unwarranted concern and intervention.…”

Section: Discussionmentioning

confidence: 99%

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

Gijón-Noguerón

Marchena‐Rodriguez

Montes-Alguacil

et al. 2019

J Paediatrics Child Health

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Aim Footprints have long been used as proxy measures of foot morphology, yet there is little consensus regarding footprints versus measures of foot posture, which address foot anatomy directly. Foot posture in children can be a confusing clinical presentation, with previous studies both supporting and refuting the relationship between childhood obesity and flat feet. The aim of this study was to determine the relationship between footprints and foot posture in children. Methods A total of 316 school children (153 boys, 163 girls) from Spain, aged 6–9 years, were assessed for both footprint (Clarke's angle (CA)), by Tecniwork Pedrograph Plate, and foot posture (foot posture index (FPI)) measures, with participants barefoot, in a relaxed standing position, on a 50‐cm elevated platform. Results A negative correlation was found between FPI and footprints (CA) (rho = −0.505 left, P < 0.001) and by gender (rho = −0.457 for the left foot in girls, P < 0.001; rho = −0.548 for the left foot in boys, P < 0.001). The children with pes cavus according to the CA (73.3%) had normal feet according to FPI, and the children with severe pes planus according to the CA (78.98%) had pronated feet according to the FPI. A χ2 test showed these results to be statistically significant (P > 0.001). Conclusions An inverse relationship between CA and FPI was identified, that is, the greater the FPI, the smaller the CA, but not all pronated foot are planus feet and not all cavus feet are supinated feet. Footprints may overestimate and misguide paediatric foot posture concerns.

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“…The FPI was assessed with the children in a relaxed stance on a bench that was 50 cm tall. The same protocol that has been reported in other studies [ 6 , 49 , 50 , 51 ] was used. The FPI reflects the multisegmental nature of the posture of the foot in all three planes and does not require the use of specialized equipment.…”

Section: Methodsmentioning

confidence: 99%

“…The foot is a functional unit of the human body that plays a key role in movement and balance [ 1 , 2 ]. The morphological and functional development of a child’s feet can be influenced by internal (sex, age and genetics) and external factors (shoes, body weight and physical activity) [ 3 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Static foot assessments are commonly performed in clinical practice to classify the foot type, identify possible etiological factors related to injury and prescribe therapeutic interventions [ 31 ]. The foot posture index (FPI) [ 25 ] is an observational assessment tool that takes into account the three-dimensional nature of the posture of the foot and has demonstrated good reliability in children [ 6 , 32 , 33 , 34 ]. The FPI is a valid tool for diagnosing pronated foot or flatfoot [ 25 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

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Backpacks Effect on Foot Posture in Schoolchildren with a Neutral Foot Posture: A Three-Year Prospective Study

Alfageme-García

Calderón‐García

Nova

et al. 2020

IJERPH

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Background: There is a paucity of data on the relationship between backpack use and foot posture in children. The aim of this study was to assess the effects of a backpack on foot posture in children with neutral foot posture during three years of follow-up. Methods: A prospective longitudinal observational study was conducted in a sample of 627 children with neutral foot. For each participant included in the study, age, sex, weight, height, body mass index, type of schoolbag (backpack or non-backpack), foot shape, metatarsal formula and type of shoes were recorded. Foot posture was described by the mean of the foot posture index (FPI) and reassessed after three years in a follow-up study. Results: The average age of the children was 8.32 ± 1.32 years. A total of 458 used a backpack when going to school. Over the three-year follow-up period, 50 children who had neutral foot developed supinated foot (n = 18) or pronated foot (n = 32). Univariate and multivariate analysis showed that the children using a backpack were at a higher risk of developing pronated foot (adjusted Odds Ratio (aOR) = 2.05, 95% IC: 1.08–3.89, p = 0.028). Backpack use was not associated with the change from neutral foot to supinated foot. Conclusions: We found a positive association between using a backpack and the risk of developing pronated but not supinated foot. Clinical trials should be conducted to analyze the effect of backpack use on the foot among schoolchildren.

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Foot posture development in children aged 5 to11 years: A three-year prospective study

Cited by 40 publications

References 26 publications

Effectiveness of custom-made foot orthoses vs heel lifts in children with Calcaneal Apophysitis (Sever disease): a CONSORT-compliant randomized trial

Effectiveness of custom-made foot orthoses vs heel lifts in children with Calcaneal Apophysitis (Sever disease): a CONSORT-compliant randomized trial

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

Backpacks Effect on Foot Posture in Schoolchildren with a Neutral Foot Posture: A Three-Year Prospective Study

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