Acta Univ. Palacki. Olomuc., Gymn. 2012 42(4): 57-63 | DOI: 10.5507/ag.2012.024

The influence of valgus heel position on foot loading in a child's gait

Eliška Martinásková, Lucie Honzíková, Miroslav Janura, Zdeněk Svoboda
Faculty of Physical Culture, Palacky University, Olomouc

Background: Flat foot is a typical clinical sign in childhood, expressed as valgus positioning of the heel during vertical foot loading. This may lead to medial deviation of the foot axis and cause overloading of some foot areas.

Objective: To determine the influence of valgus position of the heel (both bilateral and unilateral) on foot loading during gait.

Methods: An experimental group consisting of children with bilateral heel valgus deformity (16 children, age 5.3 ± 1.3 years) and children with unilateral heel valgus deformity (14 children, age 5.6 ± 1.6 years). The control group comprised of 14 children (age 4.5 ± 1.2 years). For measuring foot loading during gait, the Footscan (RSScan International, Olen, Belgium) pressure plate was used. Each subject went through 8 trials of gait measurement. From each trial, 8 foot areas were evaluated. Data processing with mean values for each subject was performed by non-parametric tests (Mann-Whitney and Wilcoxon tests, Spearman correlation) in the STATISTICA programme (StatSoft, Inc., Tulsa, USA).

Results: Pressure peak and pressure impulse in the first metatarsal was greater for the bilateral valgus group (p < 0.01) in comparison to the control group. The group with unilateral valgus deformity showed greater pressure impulse in the medial heel (p < 0.05) and in the first (p < 0.01) and third metatarsal (p < 0.05) of the limb with non-valgus position of heel when compared to the limb with valgus heel position. Another significant difference (p < 0.01) between the valgus and non-valgus limb was found for the foot axis angle (non-valgus 8.2°, valgus 2.7°).

Conclusion: The results show that valgus positioning of the heel influences foot loading in children during gait. The findings of this study suggest the necessity of a complex solution to the problem of preventing further progression of pathological changes.

Keywords: calcaneus, vertical loading, gait cycle, dynamic plantography, pressure distribution

Prepublished online: December 31, 2012; Published: September 1, 2012  Show citation

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Martinásková, E., Honzíková, L., Janura, M., & Svoboda, Z. (2012). The influence of valgus heel position on foot loading in a child's gait. Acta Universitatis Palackianae Olomucensis. Gymnica42(4), 57-63. doi: 10.5507/ag.2012.024
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References

  1. Brodtkorb, T. H., Kogler, G. F., & Arndt, A. (2008). The influence of metatarsal support height and longitudinal axis position on plantar foot loading. Clinical Biomechanic, 23(5), 640-647. Go to original source...
  2. Cetin, A., Sevil, S., Karaoglu, L., & Yucekaya, B. (2011). Prevalence of flat foot among elementary school students, in rural and urban areas and at suburbs in Anatolia. European Journal of Orthopaedic Surgery & Traumatology, 21(5), 327-331. Go to original source...
  3. Chuter, V. H., & Janse de Jonge, X. A. K. (2012). Proximal and distal contributions to lower extremity injury: A rewiew of the literature. Gait & Posture, 36(1), 7-15. Go to original source...
  4. Dungl, P. et al. (2005). Ortopedie. Praha: Grada Publishing.
  5. Duval, K., Lam, T., & Sanderson, D. (2010). The mechanical relationship between the rearfoot, pelvis and low-back. Gait & Posture, 32(4), 637-640. Go to original source...
  6. Franz, J. R., Paylo, K. W., Dicharry, J., Riley, P. O., & Kerrigan, D. C. (2009). Changes in the coordination of hip and pelvic kinematics with mode of locomotion. Gait & Posture, 29(3), 494-498. Go to original source...
  7. Fubry, G. (2010). Clinical practise: static, axial, and rotational deformities of the lower extremities in children. European Journal of Pediatrics, 169(5), 529-534. Go to original source... Go to PubMed...
  8. Han, J. T., Koo, H. M., Jung, M. J., Kim, Y. J., & Lee, J. H. (2011). Differences in plantar foot pressure and COP between flat and normal feet during walking. Journal of Physical Therapy Science, 23(4), 683-685. Go to original source...
  9. Haris, G. F., Smith, P. A., & Marks, R. M. (2008). Foot and ankle motion analysis. London: CRC Press.
  10. Hoogvliet, P., van Duyl, W. A., de Bakker, J. V., Mulder, P. G. H., & Stam, H. J. (1997). A model for the relation between the displacement of the ankle and the center of pressure in the frontal plane, during one-leg stance. Gait & Posture, 6(1), 39-49. Go to original source...
  11. Kapandji, I. A. (1987). The physiology of the joints: Volume two, lower limb. Edinburgh: Churchill Livingstone.
  12. Khamis, S., & Yizhar, Z. (2007). Effect of feet hyperpronation on pelvic alignment in a standing position. Gait & Posture, 25(1), 127-134. Go to original source...
  13. Kutilek, P., & Viteckova, S. (2012). Prediction of lower extremity movement by cyclograms. Acta Polytechnica, 52(1), 51-60. Go to original source...
  14. Ledoux, W. R., & Hillstrom, H. J. (2002). The distributed plantar vertical force of neutrally aligned and pes planus feet. Gait & Posture, 15(1), 1-9. Go to original source...
  15. Lewit, K., & Lepšíková, M. (2008). Chodidlo - významná část stabilizačního systému. Rehabilitace a fyzikální lékařství, 15(3), 99-104.
  16. Perry, J., & Burnfield, J. M. (2010). Gait analysis: Normal and pathological function (2nd ed.). Thorofare, NJ: SLACK Incorporated.
  17. Schwabova, J., Zahálka, F., Komarek, V., Malý, T., Hráský, P., Gryc, T., Cakrt, O., & Zumrová, A. (2012). Uses of the postural stability test for differential diagnosis of hereditary ataxias. Journal of the Neurological Sciences, 316(1-2), 79-86. Go to original source... Go to PubMed...
  18. Valmassy, R. L. (1996). Clinical biomechanics of the lower extremities. St. Louis, MO: Mosby-Year Book, Inc.
  19. Vařeka, I., & Vařeková, R. (2005). Patokineziologie nohy a funkční ortézování. Rehabilitace a fyzikální lékařství, 12(4), 156-166.
  20. Vařeka, I., & Vařeková, R. (2009). Kineziologie nohy. Olomouc: Univerzita Palackého.
  21. Vařeka, I., & Vařeková, R. (2012). Sdružené pohyby kloubů dolní končetiny a reverze posunu kondylů femuru při zatížení. Rehabilitace a fyzikální lékařství, 19(1), 13-17.
  22. Véle, F. (2006). Kineziologie. Praha: Triton.
  23. Whittle, M. M. (1996). Gait Analysis: An introduction. Oxford: Butterworth-Heinemann.
  24. Zafiropoulos, G., Prasad, K. S. R. K., Kouboura, T., & Danis, G. (2009). Flat foot and femoral anteversion in children - a prospective study. The Foot, 19(1), 50-54. Go to original source... Go to PubMed...

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