Tong Jasper W K, Kong Pui W
J.W.K. Tong, PhD, Allied Health Specialties, KK Women's and Children's Hospital, Singapore and Physical Education and Sports Science Academic Group, Nanyang Technological University, Singapore.
P.W. Kong, PhD, Physical Education and Sports Science Academic Group, Nanyang Technological University, 1 Nanyang Walk National Institute of Education, Singapore 637616.
Phys Ther. 2016 Aug;96(8):1216-24. doi: 10.2522/ptj.20150192. Epub 2016 Feb 18.
It is unclear at what age the medial longitudinal arch (MLA) of the foot becomes stable in children. The influence of footwear on MLA development also is unknown.
The purpose of this study was to examine the MLA development of children using a longitudinal approach. The relationship between wearing different types of footwear and MLA development also was explored longitudinally.
This was a longitudinal cohort observational study.
The MLA of 111 healthy children (mean age=6.9 years, SD=0.3) was evaluated using 3 parameters (arch index [AI], midfoot peak pressure [PP], and maximum force [MF]) extracted from dynamic foot loading measurements at baseline (t0), 10-month follow-up (t1), and 22-month follow-up (t2). Information on footwear usage was surveyed. Linear mixed modeling was used to test for differences in MLA over time.
The MLA of the children remained stable over time (AI: t0/t1/t2=0.25 [95% confidence interval (CI)=0.24, 0.26]/0.25 [95% CI=0.24, 0.26]/0.25 [95% CI=0.24, 0.26]; P=.95). When the children's sex was considered, the AI of boys decreased (higher arch) with age (0.26 [95% CI=0.24, 0.27]/0.25 [95% CI=0.24, 0.27]/0.25 [95% CI=0.23, 0.27]; P=.02). Boys also displayed a flatter MLA than girls at age 6.9 years (AI: mean difference=0.02 [95% CI=0.01, 0.04]; P=.02). At baseline, children who wore closed-toe shoes displayed the lowest MLA overall (AI: closed-toe shoes/sandals/slippers=0.26 [95% CI=0.24, 0.28]/0.24 [95% CI=0.23, 0.25]/0.25 [95% CI=0.24, 0.26]; P<.01). Children who used slippers at toddlers' age experienced a higher PP (flatter arch) in later childhood than those who wore sandals (mean difference=31.60 kPa [95% CI=1.44, 61.75]; post hoc P=.04).
Information on the type of footwear worn was self-reported and, therefore, may be subjected to recall bias.
The MLA of children remained stable from 7 to 9 years of age. The child's sex and the type of footwear worn during childhood may influence MLA development.
目前尚不清楚儿童足部内侧纵弓（MLA）在何年龄变得稳定。鞋类对MLA发育的影响也未知。
本研究旨在采用纵向研究方法探讨儿童MLA的发育情况。还纵向探究了穿着不同类型鞋类与MLA发育之间的关系。
这是一项纵向队列观察性研究。
对111名健康儿童（平均年龄=6.9岁，标准差=0.3）的MLA进行评估，使用从基线（t0）、10个月随访（t1）和22个月随访（t2）时的动态足部负荷测量中提取的3个参数（足弓指数[AI]、中足峰值压力[PP]和最大力[MF]）。对鞋类使用情况进行了调查。采用线性混合模型来测试MLA随时间的差异。
儿童的MLA随时间保持稳定（AI：t0/t1/t2=0.25[95%置信区间（CI）=0.24，0.26]/0.25[95%CI=0.24，0.26]/0.25[95%CI=0.24，0.26]；P=0.95）。考虑儿童性别时，男孩的AI随年龄降低（足弓更高）（0.26[95%CI=0.24，0.27]/0.25[95%CI=0.24，0.27]/0.25[95%CI=0.23，0.27]；P=0.02）。在6.9岁时，男孩的MLA也比女孩更扁平（AI：平均差异=0.02[95%CI=0.01，0.04]；P=0.02）。在基线时，穿包头鞋的儿童总体上MLA最低（AI：包头鞋/凉鞋/拖鞋=0.26[95%CI=0.24，0.28]/0.24[95%CI=0.23，0.25]/0.25[95%CI=0.24，0.26]；P<0.01）。幼儿期穿拖鞋的儿童在童年后期的PP（足弓更扁平）高于穿凉鞋的儿童（平均差异=31.60kPa[95%CI=1.44，61.75]；事后检验P=0.04）。
所穿鞋类类型的信息是自我报告的，因此可能存在回忆偏差。
儿童的MLA在7至9岁时保持稳定。儿童的性别以及童年时期所穿的鞋类类型可能会影响MLA的发育。
