Functional characterization of plantar pressure patterns in gait of typically developing children using dynamic pedobarography

Sukhdeep Dulai; Ailar Ramadi; Justin Lewicke; Beth Watkins; Matthew Prowse; Albert H Vette

doi:10.1016/j.gaitpost.2020.12.018

Functional characterization of plantar pressure patterns in gait of typically developing children using dynamic pedobarography

Gait Posture. 2021 Feb:84:267-272. doi: 10.1016/j.gaitpost.2020.12.018. Epub 2020 Dec 25.

Authors

Sukhdeep Dulai¹, Ailar Ramadi², Justin Lewicke³, Beth Watkins³, Matthew Prowse¹, Albert H Vette⁴

Affiliations

¹ Glenrose Rehabilitation Hospital, Alberta Health Services, 10230 111 Avenue NW, Edmonton, Alberta, T5G 0B7, Canada; Faculty of Medicine and Dentistry, University of Alberta, W.C. Mackenzie Health Sciences Centre, 8440 112 Street NW, Edmonton, Alberta, T6G 2R7, Canada.
² Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Clinical Sciences Building, 8440 112 Street NW, Edmonton, Alberta, T6G 2B7, Canada.
³ Glenrose Rehabilitation Hospital, Alberta Health Services, 10230 111 Avenue NW, Edmonton, Alberta, T5G 0B7, Canada.
⁴ Glenrose Rehabilitation Hospital, Alberta Health Services, 10230 111 Avenue NW, Edmonton, Alberta, T5G 0B7, Canada; Department of Mechanical Engineering, University of Alberta, Donadeo Innovation Centre for Engineering, 9211 116 Street NW, Edmonton, Alberta, T6G 1H9, Canada; Department of Biomedical Engineering, University of Alberta, 1098 Research Transition Facility, Edmonton, Alberta, T6G 2V2, Canada. Electronic address: albert.vette@ualberta.ca.

PMID: 33385760
DOI: 10.1016/j.gaitpost.2020.12.018

Abstract

Background: Abnormal foot posture is a common complaint presented in pediatric and pediatric orthopedic clinics. Functional, objective assessment of foot posture, with the potential for early identification of pathologic foot deformities, has, however, been lacking to date. While quantifying functional and regional impulses via dynamic pedobarography can improve the clinical assessment of children's feet, normative values have not yet been reported or characterized.

Research question: The objectives of this study were to: (1) quantify and characterize the pattern and spectrum of foot impulses in walking-aged, typically developing children; and (2) compare these to impulses from non-disabled adults.

Methods: Foot impulses of 102 participants (52 female) in five pre-determined age groups (2-3, 4-6, 7-10, 11-14, 15-17 years) were examined using dynamic pedobarography. Each pressure map (3 per foot per child) was divided according to anatomical foot regions: the hallux, heel, medial forefoot, lateral forefoot, lesser toes (D2 to D5), and midfoot. The impulse was calculated for each region and used to generate regional percent impulses and impulse ratios to assess anteroposterior and mediolateral balance within the foot.

Results: The impulse through the midfoot was highest in the youngest age group, with a corresponding lower impulse through the medial forefoot. As age advanced, the midfoot impulse decreased (p = 0.001), and the forefoot balance shifted slightly more medially (%Medial Forefoot: p = 0.004; Medial-Lateral Forefoot Balance: p = 0.019). When compared to adults, there were no significant differences between 15-17 year old children and adults in any of the regional percent impulses and impulse ratios. This indicates that skeletal maturity of the foot by late adolescence results in functional characteristics seen in adults.

Significance: The age-standardized norms of functional and regional impulse measures in children reported in this study can be used as a comparative benchmark in the clinical assessment of children presenting with various foot deformities.

Keywords: Foot; Gait; Normative data; Pediatric; Pedobarography; Pressure distribution.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Child, Preschool
Female
Foot / physiopathology*
Gait / physiology*
Humans
Male
Pressure