Swipe om te navigeren naar een ander artikel
Plano-valgus is a common alteration of the paediatric foot, characterized by valgus hindfoot, foot pronation and drop of the medial longitudinal arch. Despite their importance in the diagnosis and classification of plano-valgus foot condition, little information is available on functional alterations of the major joints spanning the medial longitudinal arch – i.e. midtarsal and tarso-metatarsal. Aim of the study was to provide objective description of the alterations in plano-valgus midfoot joints with respect to those in an age-matched normally-developed feet population.
Twenty adolescents (13.3 ± 0.8 years) with bilateral plano-valgus feet underwent clinical examination and were gait-analysed via a validated 4-segment foot model. This allowed to measure static foot posture, kinematics of the main foot joints, and medial longitudinal arch deformation during walking at comfortable speed. Range of motion and temporal profiles of joint rotations were compared to those from a control population of age-matched adolescents with normally-developed feet.
The plano-valgus midtarsal joint was more dorsiflexed, everted and abducted than that in the control group, and showed reduced sagittal-plane RoM (plano-valgus = 15.9 degrees; control = 22.2 degrees; P < 0.01). The tarso-metarsal joint was more plantarflexed and adducted, and showed larger frontal-plane RoM. The MLA showed larger RoM and was lower throughout the stance phase of the gait cycle.
Significant postural and kinematic alterations are present at the midtarsal and tarso-metarsal joints of adolescents with plano-valgus feet. Objective identification and quantification of plano-valgus foot alterations, via non-invasive gait-analysis, is relevant to improving the diagnosis of this condition and to evaluating the effect of conservative treatments and of surgical corrections by different techniques.
Canale ST, Beaty JH. Campbell's operative orthopaedics. Philadelphia: Elsevier Health Sciences; 2012. CrossRef
Cappello T, Song KM. Determining treatment of flatfeet in children. Curr Opin Pediatr. 1998;10:77–81. CrossRef
Evans AM, Rome K. A review of the evidence for non-surgical interventions for flexible pediatric flat feet. Eur J Phys Rehabil Med. 2011;47:69–89. PubMed
Lin CJ, Lai KA, Kuan TS, Chou YL. Correlating factors and clinical significance of flexible flatfoot in preschool children. J Pediatr Orthop. 2001;21:378–82. PubMed
Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M. Prevalence of flat foot in preschool-aged children. Pediatrics. 2006;118:634–9. CrossRef
Harris EJ, Vanore JV, Thomas JL, Kravitz SR, Mendelson SA, Mendicino RW, Silvani SH, Gassen SC. Diagnosis and treatment of pediatric flatfoot. J Foot Ankle Surg. 2004;43:341–73. CrossRef
Needleman RL. Current topic review: subtalar arthroereisis for the correction of flexible flatfoot. Foot Ankle Int. 2005;26:336–46. CrossRef
Dennis K, Cooke R, Valmassy R, Weed J. Biplane posting elevator. A new method of rearfoot post application. J Am Podiatr Med Assoc. 1985;75:272–4. CrossRef
Donatelli R, Hurlbert C, Conaway D, St. Pierre R. Biomechanical foot orthotics: a retrospective study. J Orthop Sports Phys Ther. 1988;10:205–12. CrossRef
Highlander P, Sung W, Weil L Jr. Subtalar arthroereisis. Clin Podiatr Med Surg. 2011;28:745–54. CrossRef
McCulloch MU, Brunt D, Vander Linden D. The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. J Orthop Sports Phys Ther. 1993;17(1):2–10. CrossRef
Hendry GJ, Rafferty D, Barn R, Gardner-Medwin J, Turner DE, Woodburn J. Foot function is well preserved in children and adolescents with juvenile idiopathic arthritis who are optimally managed. Gait Posture. 2013;38:30–6. CrossRef
Hösl M, Böhm H, Multerer C, Döderlein L. Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic flatfeet using the Oxford foot model. Gait Posture. 2014;39:23–8. CrossRef
Svoboda Z, Honzikova L, Janura M, Vidal T, Martinaskova E. Kinematic gait analysis in children with valgus deformity of the hindfoot. Acta Bioeng Biomech. 2014;16:89–93. PubMed
Twomey D, McIntosh AS, Simon J, Lowe K, Wolf SI. Kinematic differences between normal and low arched feet in children using the Heidelberg foot measurement method. Gait Posture. 2010;32:1–5. CrossRef
Saraswat P, MacWilliams BA, Davis RB, D'Astous JL. Kinematics and kinetics of normal and planovalgus feet during walking. Gait Posture. 2014;39:339–45. CrossRef
Kerr C, Stebbins J, Theologis T, Zavatsky A. Static postural differences between neutral and flat feet in children with and without symptoms. Clin Biomech. 2015;30:314–7. CrossRef
Kothari A, Dixon P, Stebbins J, Zavatsky A, Theologis T. The relationship between quality of life and foot function in children with flexible flatfeet. Gait Posture. 2015;41:786–90. CrossRef
Caravaggi P, Benedetti MG, Berti L, Leardini A. Repeatability of a multi-segment foot protocol in adult subjects. Gait Posture. 2011;33:133–5. CrossRef
Leardini A, Benedetti MG, Berti L, Bettinelli D, Nativo R, Giannini S. Rear-foot, mid-foot and fore-foot motion during the stance phase of gait. Gait Posture. 2007;25:453–62. CrossRef
Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. 1983;105:136–44. CrossRef
Pataky TC, Robinson MA, Vanrenterghem J. Vector field statistical analysis of kinematic and force trajectories. J Biomech. 2013;46:2394–401. CrossRef
Davids JR, Gibson TW, Pugh LI. Quantitative segmental analysis of weight-bearing radiographs of the foot and ankle for children: normal alignment. J Pediatr Orthop. 2005;25:769–76. CrossRef
Keats TE, Sistrom C. Atlas of radiologic measurement. Philadelphia: Mosby; 2001.
Montagne J, Chevrot A, Galmiche J. Techniques radiographiques. Repères et mesures. Atlas de radiologie du pied. Paris: Masson; 1980.
Vanderwilde R, Staheli LT, Chew DE, Malagon V. Measurements on radiographs of the foot in normal infants and children. J Bone Joint Surg Am. 1988;70:407–15. CrossRef
Caravaggi P, Pataky T, Goulermas JY, Savage R, Crompton R. A dynamic model of the windlass mechanism of the foot: evidence for early stance phase preloading of the plantar aponeurosis. J Exp Biol. 2009;212:2491–9. CrossRef
Angin S, Crofts G, Mickle KJ, Nester CJ. Ultrasound evaluation of foot muscles and plantar fascia in pes planus. Gait Posture. 2014;40:48–52. CrossRef
Caravaggi P, Leardini A, Crompton R. Kinematic correlates of walking cadence in the foot. J Biomech. 2010;43:2425–33. CrossRef
Evans AM, Rome K. A Cochrane review of the evidence for non-surgical interventions for flexible pediatric flat feet. Eur J Phys Rehabil Med. 2011;47:69–89. PubMed
Portinaro N, Leardini A, Panou A, Monzani V, Caravaggi P. Modifying the Rizzoli foot model to improve the diagnosis of pes-planus: application to kinematics of feet in teenagers. J Foot Ankle Res. 2014;7:754. CrossRef
Mahaffey R, Morrison SC, Drechsler WI, Cramp MC. Evaluation of multi-segmental kinematic modelling in the paediatric foot using three concurrent foot models. J Foot Ankle Res. 2013;6(1):43. CrossRef
- Effect of plano-valgus foot posture on midfoot kinematics during barefoot walking in an adolescent population
- BioMed Central