Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Department of Pediatric Orthopedics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Taipei City University of Science and Technology, Taipei, Taiwan.
Biomed J. 2022 Oct;45(5):828-837. doi: 10.1016/j.bj.2021.10.012. Epub 2021 Nov 2.
Flatfoot (Pes Planus), often regarded as a physiological deviation in children, is of concern to parents because there is no test to predict the development of foot arch. This study aimed to use a new diagnostic flatfoot criterion to determine 1) how the footprint index changes during the development of foot arches, 2) what factors can predict a foot arch development, and 3) whether foot arch development could be a process of body growth.
572 children were enrolled in a prospective longitudinal study of anthropometrical parameters and physical fitness twice at age of 6.7 and 8.2 years. The bimodal frequency distribution of the Chippaux-Smirak index (CSI) of the footprint was used to define flatfoot as CSI <0.58 and non-flatfoot as CSI >0.61. Body measurements and physical fitness tests were compared between children with flatfeet who developed foot arches and children who did not.
Of 263 children with flatfeet, the CSI significantly changed from 0.72 to 0.46 in 70 children who developed foot arches over 1.5 years and the others had minimal change in the index. Children with foot arch development had a lower initial CSI, improved boys' performance in one-leg balance, and less increase in girls' body height than children who remained flatfooted, whereas sex and weight were similar in both groups.
This longitudinal study with the bimodal distribution of the CSI investigated how the development of foot arch advances in children around age 7. A significant and unique pattern in change of the CSI suggests involvement of a maturational stage in foot arch development. Along with the improved performance in one-leg balance, the unidirectional transition from flatfoot to non-flatfoot is associated with improvement in motor control of the ankle.
Chinese Clinical Trial Registry (ChiCTR-OCS-14004300).
平足（扁平足）常被认为是儿童的一种生理偏差，但由于没有测试可以预测足弓的发育情况，因此家长对此较为关注。本研究旨在使用新的平足诊断标准来确定：1）足弓发育过程中足迹指数的变化情况；2）哪些因素可以预测足弓发育情况；3）足弓发育是否是身体生长的一个过程。
本前瞻性纵向研究纳入了 572 名儿童，他们在 6.7 岁和 8.2 岁时接受了两次身体测量参数和身体素质测试。使用足迹 Chippaux-Smirak 指数（CSI）的双峰频率分布来定义平足为 CSI＜0.58，非平足为 CSI＞0.61。比较了足弓发育和未发育的平足儿童之间的身体测量值和身体素质测试结果。
在 263 名患有平足的儿童中，70 名在 1.5 年内足弓发育的儿童 CSI 从 0.72 显著变化为 0.46，而其他儿童的指数变化很小。与持续平足的儿童相比，足弓发育的儿童初始 CSI 较低，男孩单腿平衡能力提高，女孩身高增长较少，而两组的性别和体重相似。
本研究采用 CSI 的双峰分布对 7 岁左右儿童足弓发育情况进行了纵向研究。CSI 变化的显著且独特模式表明，足弓发育涉及到一个成熟阶段。随着单腿平衡能力的提高，从平足到非平足的单向转变与踝关节运动控制的改善有关。
中国临床试验注册中心（ChiCTR-OCS-14004300）。
