Galli M, Cimolin V, Pau M, Costici P, Albertini G
Bioengineering Department, Politecnico di Milano, Milano, Italy; IRCCS 'San Raffaele Pisana', San Raffaele SpA, Roma, Italy.
J Intellect Disabil Res. 2014 Mar;58(3):269-76. doi: 10.1111/jir.12007. Epub 2013 Jan 4.
In patients with Down syndrome (DS) one of the most common abnormalities is flat foot which can interfere significantly with normal daily activities, such as gait. The aim of this study was to quantitatively assess the relationship between the flat foot and the gait alterations in DS children.
Twenty-nine patients with DS and 15 non-affected subjects were assessed using 3D Gait Analysis, using an optoelectronic system, force platforms and video recording. The degree of flat foot was assessed using the arch index and kinematic and kinetic parameters were identified and calculated from 3D Gait Analysis for each study participant.
Data showed that ankle plantarflexion moment and ankle power during terminal stance were significant to differentiate the patients with and without flat feet: their peak values were significantly lower for the patients with flat foot. In addition, the research for correlation demonstrated that the higher the arch index value, the lower the peak of ankle moment and of the generated ankle power during terminal stance and the minimum of absorbed ankle power.
Children with flat foot displayed a less functional gait pattern in terms of ankle kinetics than children without flat foot, suggesting that the presence of flat foot may lead to a weaker efficient walking. Then, the increasing flat foot tended to result in lower push-off ability, leading to a less functional walking.
在唐氏综合征（DS）患者中，最常见的异常之一是扁平足，这会严重干扰正常的日常活动，如步态。本研究的目的是定量评估DS儿童扁平足与步态改变之间的关系。
使用光电系统、测力平台和视频记录，通过三维步态分析对29例DS患者和15名未受影响的受试者进行评估。使用足弓指数评估扁平足程度，并从三维步态分析中识别和计算每个研究参与者的运动学和动力学参数。
数据显示，终末支撑期的踝关节跖屈力矩和踝关节功率对于区分有无扁平足的患者具有重要意义：扁平足患者的峰值明显更低。此外，相关性研究表明，足弓指数值越高，终末支撑期踝关节力矩峰值和产生的踝关节功率峰值越低，吸收的踝关节功率最小值也越低。
与没有扁平足的儿童相比，扁平足儿童在踝关节动力学方面表现出功能较差的步态模式，这表明扁平足的存在可能导致有效行走能力较弱。然后，扁平足程度增加往往会导致蹬离能力降低，从而导致行走功能下降。
