Search Results
Background:
Among other adverse consequences, childhood obesity is known to influence foot structure and functionality. Yet little information is available regarding how the physiologic foot-ground interaction is altered when a localized load is carried, as occurs in the case of schoolbags. We investigated plantar contact area and pressure modifications induced by backpack carriage under actual conditions. We hypothesized that a localized load acting on the body would further increase the already excessive plantar pressure that exists with overweight and obese status.
Methods:
Seventy overweight and obese schoolchildren aged 6 to 11 years underwent two 30-sec trials on a pressure platform during a regular school day, with and without a backpack. Total and subregion contact areas along with peak plantar pressures were obtained, and results were compared with those of an equal-numbered group of normal-weight schoolchildren.
Results:
Overweight and obese children generally had larger contact areas and higher peak plantar pressures compared with their normal-weight peers. In overweight and normal-weight participants, the backpack induced a similar generalized increase in contact area and pressures. However, the largest changes were observed in the forefoot, suggesting that load action tends to modify the physiologic pressure patterns.
Conclusions:
Backpack carriage raises the already elevated peak plantar pressures in overweight children during upright stance and modifies the physiologic pressure patterns. Further investigations are needed to clarify the features of such phenomenon when dynamic activities are performed and to verify the existence of fatigue and overexertion on the foot as well as other possible negative long-term effects. (J Am Podiatr Med Assoc 103(4): 306–313, 2013)
Abstract
Objectives: To examine the effects of foot dominance and body mass on foot plantar pressures in older women of regular, overweight, and obese weights.
Methods: 96 female adults were divided into regular-weight group (68.30 ± 4.19 yr), overweight group (69.88 ± 3.76 yr), and obesity group (68.47 ± 3.67 yr) based on their body mass index scores. Footscan® plantar pressure test system was used to assess the dynamic plantar pressures, and parameters were collected from risk analysis, foot axis analysis, single foot timing analysis, and pressure analysis.
Results: (1) The local risks of lateral forefoot and midfoot, the minimum and maximum subtalar joint angles, the flexibility of subtalar joint, foot flat phase, as well as the average pressures on toes, metatarsals,, midfoot, and lateral heel, with the peak pressures on toe 2–5, metatarsal 2, metatarsal 5, midfoot, and lateral heel had significant within-subject differences. (2) The phases of initial contact and foot flat, the average pressures on toe 2–5, metatarsals, midfoot, and heels, with the peak pressures on metatarsal 1–4, midfoot, and heels exhibited significant between-subjects differences. (3) There was an interaction effect of foot dominance and body mass index on the flexibility of subtalar joint.
Conclusions: The non-dominant foot works better for stability, especially when touching on and off the ground. The dominant foot works better for propulsion but is more susceptible to pain, injury, and falls. For obese older women, the forefoot and midfoot are primarily responsible for maintaining stability, but the lateral midfoot and hindfoot are more prone to pain and discomfort.
Effect of Excessive Body Weight on Foot Arch Changes in Preschoolers
A 2-Year Follow-up Study
Background
A stable standing posture, and effective and aesthetic gait, depend heavily on correct anatomical construction of the feet, thanks to which they can play their important role. The shape and height of the foot arches are already formed in the preschool and early school years; therefore, abnormalities and disorders in children's feet, and correlations between foot formation and somatic build, are still crucial and interesting issues for orthopedists, pediatricians, physiotherapists, and podiatrists. This study deals with changes in the height of the longitudinal and transverse arches of the foot in 4- to 6-year-old children.
Methods
A total of 102 boys and 105 girls took part in a 24-month study in which their body weight, height, body mass index, and Clarke's and gamma angles were measured. The analysis also focused on correlations among sex, nutritional status, and changes in foot arch height.
Results
It was discovered that sex did not considerably affect Clarke's and gamma angle values. However, it was found that between ages 4 and 6 years, the proportion of overweight and obese boys and girls increased, and the medial longitudinal arch of the foot had a tendency to collapse in those with excessive body weight. The effect of nutritional status on the transverse arch of the foot is rather dubious.
Conclusions
In light of these findings, therapeutic programs for preventing foot deformities in children should also focus on body weight control.
Background:
Excessive body weight seems to be a risk factor for foot loading. We sought to investigate the effect of different body mass index (BMI) levels on plantar pressure distribution during walking.
Methods:
In total, 163 women aged 45 to 65 years (mean ± SD: age, 57.4 ± 5.3 years; BMI, 27.0 ± 5.3) participated in the study. The women were divided, on the basis of BMI, into a normal-weight, overweight, or obese group. The study used the four following plantar pressure parameters (PPPs): contact percentage, absolute pressure impulse, relative pressure impulse, and absolute peak pressure, which were recorded in ten foot regions using a pressure measurement system.
Results:
The normal-weight group, compared with the overweight and obese groups, had significantly lower absolute PPP values. In the hallux, second through fifth metatarsals, midfoot, and heel regions, we observed significant between-group differences in the two absolute PPPs (peak pressure and pressure impulse) (P < .001). Between-group differences in the relative PPPs were found in the fourth metatarsal, midfoot, and medial heel (relative impulse) and in the second metatarsal (contact percentage) (P < .001).
Conclusions:
Higher BMI values correspond to a higher load on the foot during walking in women. The relative foot load in obese women is characterized by a pressure increase in the lateral forefoot and midfoot and by a pressure decrease in the medial heel.
Background:
Planovalgus foot prevalence estimates vary widely (0.6%–77.9%). Among the many factors that may influence planovalgus foot development, much attention has been given to body mass index, especially that of children's feet; factors related to psychomotor development have been less studied. We sought to determine the presence of planovalgus foot in children and its association with anthropometric parameters and psychomotor development.
Methods:
A case-control study was conducted in Málaga, Spain, 2012–2013, of 104 schoolchildren (mean ± SD age, 7.55 ± 0.89 years; 45.2% were boys). Age, sex, body mass index, presence of valgus (valgus index, by pedigraphy), and personal history related to psychomotor development of the lower limbs (presence/absence of crawling, age at onset of crawling, age at onset of walking, use of mobility aids) were evaluated.
Results:
Of the children with obesity, 53.7% had valgus deformity in the left hindfoot (odds ratio [OR], 6.94; 95% confidence interval [CI], 2.72–17.70; P < .0001). In the right foot, the corresponding values were 54.5% (OR, 9.08; 95% CI, 3.38–24.36; P < .0001). Multivariate logistic regression showed an increased risk of left planovalgus foot in boys, in children with overweight or obesity, and in those who began walking later. For the right foot, the same risk factors applied except age at onset of walking.
Conclusions:
These results corroborate data from previous studies, which report an association between overweight and obesity and the onset of planovalgus foot in children. In addition, we identify a new risk factor: age at onset of walking.
Background:
This study sought to assess the prevalence of flat feet in primary school children and to find correlations among arch height, ankle dorsiflexion range of motion (ROM), and obesity level.
Methods:
The 400 children aged 10 to 12 years who took part in the study had their body height, weight, and fat percentage measured. Based on these measurements, body mass index was calculated and weight status was categorized for all of the participants. The height of the longitudinal arch of the foot was measured on a computerized podoscope and given in Clarke's angles. Dorsiflexion ROM was assessed with the child in the nonweightbearing sitting position with the knees 90° flexed. The arithmetic mean and standard deviation were implemented to analyze the data. Intergroup differences were assessed by Mann-Whitney U, Kruskal-Wallis, and post hoc Tukey tests. Significance was accepted at P = .05.
Results:
Flat feet were found in 36% of participants; limited ROM was found in both feet in 25% of participants and in one foot in 12%. No significant differences in dorsiflexion ROM in children with high-arched, normal, and flat feet were revealed. Excessive body weight was disclosed in 21% of participants. Overweight and obese children had significantly lower foot arches and notably smaller ankle dorsiflexion ROM than those with normal weight.
Conclusions:
Ankle dorsiflexion ROM is similar in children with high-arched, normal, and flat feet. However, limited dorsiflexion ROM is more often found in children with excessive weight.
Background
We sought to evaluate the influence of obesity level on the medial longitudinal arch (MLA) of the foot in 7- to 12-year-old children.
Methods
The study group consisted of 925 children (450 girls and 475 boys). All of the children were subjected to podoscopic foot examination and measurement of weight, height, three skinfolds, fat weight, and fat-free body weight.
Results
The most common type of MLA was high-arched foot, which was observed in the left foot of 523 children (56.5%) and in the right foot in 592 children (64%). In almost all of the age groups, high-arched foot was the most common disorder. High-arched foot was more common in girls than in boys, and boys displayed a higher percentage of flatfoot. Also, sex-related differences were more prominent in urban children. There was a strongly positive correlation between obesity level and MLA in the examined group.
Conclusions
These results suggest that the type of foot arch is influenced by parameters such as age, sex, and obesity level. High-arched foot seemed to be the most frequent pathologic abnormality in the examined group, and flatfoot, which was predominant in boys and obese children, diminished with age. High-arched foot was a more common MLA type than flatfoot regardless of obesity level assessed on the basis of body mass index and sum of three skinfolds.
Background:
The influence of childhood obesity on shape and structure of the pediatric foot remains poorly understood. The purpose of this work was to determine associations between obesity and pediatric foot dimensions.
Methods:
A retrospective analysis of pediatric foot dimensions (foot length [FL] and foot width [FW]) in 3,713 children aged 3 to 18 years was undertaken. Logistic regression was used to determine relationships between FL, FW, and weight category.
Results:
Compared with obese peers, typical weight (FL, P < .05 [odds ratio (OR)] = .83; FW, P < .05 [OR = .56]) and underweight (FL, P < .05 [OR = .76]; FW, P < .05 [OR = .41]) boys had significantly shorter and narrower feet. Overweight (FL, P = .02 [OR = .88]; FW, P = .02 [OR = .72]), typical weight (FL, P < .05 [OR = .77]; FW, P < .05 [OR = .47]), and underweight (FL, P < .05 [OR = .70]; FW, P < .05 [OR = .33]) girls had significantly shorter and narrower feet.
Conclusions:
These findings suggest that obesity is an important determinant of pediatric foot dimensions. Given the current prevalence of obesity in children and young people, these findings may have population-wide implications for pediatric foot health.
Background:
Anthropometric status can influence gait biomechanics, but there is relatively little published research regarding foot and ankle characteristics in the obese pediatric population. We sought to compare the structural and functional characteristics of the foot and ankle complex in obese and non-obese children.
Methods:
Twenty healthy children (ten obese and ten normal weight) were recruited for a cross-sectional research study. Anthropometric parameters were measured to evaluate active ankle dorsiflexion, arch height (arch height index, arch rigidity index ratio, and arch drop), foot alignment (resting calcaneal stance position and forefoot-rearfoot alignment in unloaded and loaded positions), and foot type (malleolar valgus index). Independent t tests determined significant differences between groups for all assessed parameters. Statistical significance was set at P < .0125.
Results:
Compared with non-obese participants, obese participants had significantly greater arch drop (mean ± SD: 5.10 ± 2.13 mm versus 2.90 ± 1.20 mm; P =.011) and a trend toward lower arch rigidity index ratios (mean ± SD: 0.92 ± 0.03 versus 0.95 ± 0.02; P = .013). In addition, obese participants had significantly less active ankle dorsiflexion at 90° of knee flexion versus non-obese participants (mean ± SD: 19.57 ± 5.17 versus 29.07 ± 3.06; P < .001). No significant differences existed between groups for any other anthropometric measurements.
Conclusions:
The decreased active ankle dorsiflexion in the obese group can increase foot contact for a longer period of the stance phase of gait. Obese participants also presented with a more flexible foot when bearing weight. (J Am Podiatr Med Assoc 102(1): 5–12, 2012)
Background: It is important to determine the plantar pressure distribution of schoolchildren by applying static and dynamic foot analyses using a pedobarography device. However, it is difficult to obtain clear interpretations from results that can be explained by a large number of plantar pressure variables. The aim of this study was to use principal component analysis (PCA) to predict the main components for reducing the size of big data sets, provide a practical overview, and minimize information loss on the subject of plantar pressure assessment in youths.
Methods: In total, 112 schoolchildren were included in the study (mean ± SD: age, 10.58 ± 1.27 years; body mass index, 18.86 ± 4.33). During the research, a pedobarography device was used to obtain plantar pressure data. Each foot was divided into six anatomical regions and evaluated. Global and regional plantar pressure distributions, load and surface areas, pressure-time integrals, weight ratios, and geometric foot properties were calculated.
Results: The PCA yielded ten principal components that together account for 81.88% of the variation in the data set and represent new and distinct patterns. Thus, 137 variables affecting the subject were reduced to ten components.
Conclusions: The numerous variables that affect static and dynamic plantar pressure distributions can be reduced to ten components by PCA, making the research results more concise and understandable.
