The Contralateral Foot in Children With Unilateral Clubfoot

Abstract

The unaffected contralateral side of patients with unilateral clubfeet has sometimes been taken as control in foot pressure measurement studies. However, it has never been shown that the pressure pattern under the contralateral foot is similar to a normal foot. Sixteen patients with unilateral clubfoot and 110 normal subjects took part in this study. All participants were aged from 4 to 8 years. Studies comprised clinical examination and foot pressure measurements in barefoot walking. Evaluations of the measurements were completed by the calculation of forces acting under 10 anatomical foot areas normalized to ground reaction force at foot-flat and push-off. Significant differences in peak pressure were observed between the control group and the contralateral foot of patients under the heel and the metatarsals 1 to 4. Significant differences in the forces at foot-flat and push-off are seen especially in the midfoot. Both sides of the patients with unilateral clubfeet exert significantly less ground reaction force than normal subjects. Different pressure and force distributions of clubfoot children on their contralateral side compared with the normal feet of the control group may indicate differences in the general control pattern generated by the central nervous system. Differences can still be observed after normalization of the forces. We therefore conclude that when foot pressure measurements are made with clubfeet, it might be advisable to use a collective of normal feet, instead of the contralateral foot, for comparison.

Pedobarographic Analysis Following Ponseti Treatment for Congenital Clubfoot

“…Our results are consistent with these sorts of asymmetries, showing differences only in peak pressure measurement between the two feet. Similar to Favre et al [8], we found the unaffected foot had increased peak pressure for the areas M1, M8, and M10, representing the area of the medial hindfoot, hallux, and third to fifth toe, with decreased pressure in the lateral midfoot area. There may also be mechanical influence of the soft tissue around the heel pad on hindfoot peak pressure [18], resulting in decreased pressure values with increasing tissue thickness.…”

“…Mean peak pressures were reduced (p \ 0.005) in all hindfoot and forefoot areas (M1, 2, 5, 6,7,8,9,10) in the clubfoot group compared with those of the control group (Table 1) (Fig. 4).…”

“…In contrast to these results, Favre et al [8] suggested that even the unaffected foot in unilaterally affected children exhibited differences in pressure and force distribution when compared to normal feet. According to these authors, a smaller ankle plantarflexion moment in the clubfoot might be compensated by the hip and knee joint of the same limb resulting in an asymmetrical gait pattern affecting pedobarographic parameters of the contralateral side.…”

Biomechanical Parameters in Children with Unilateral and Bilateral Clubfoot during Vertical Jumps

“…Extensive studies have surveyed children's locomotion by investigating the biomechanics of walking [2][3][4][5] . However, little scientific study has studied other functional abilities.…”

“…Motion analysis in congenital CF children is applied to understand the mechanics of that dysfunction, for the affected and unaffected sides [2][3][4][5] . To improve rehabilitation procedures for CF, gait and other motor skills should be evaluated.…”