Self-perceived foot function and pain in children and adolescents with flexible flatfeet – Relationship between dynamic pedobarography and the foot function index
Hösl, M., Böhm, H., Oestreich, C., Dussa, C. U., Schäfer, C., Döderlein, L., et al. (2020).
Gait & Posture, 77, 225–230.
https://gyazo.com/0ee215f556e7032821a4314b4c1daf05
Highlights
•Dynamic pedobarography and the FFI were evaluated in a clinical sample of pediatric flatfeet. •Pedobarography was correlated the disability and pain domain of the FFI. •More associations could be found with respect to perceived disability than for pain.
•Peak pressures and forces are more important than area related measurements.
abst
Abstract Background There is considerable debate as to which parameters to include in the assessment of paediatric flatfeet. Dynamic pedobarography is an objective, dynamic method to measure foot function. Information about its associations to patient-reported measures may help to focus on the most relevant parameters. Research Question What is the association between the Foot Function Index and pedobarographic assessments in flatfeet of children and adolescents? Methods A consecutive clinical case series of 51 participants with idiopathic flexible flatfeet aged 7-17 years underwent barefooted pedobarography during gait and completed the Foot Function Index Questionnaire. Pedobarographic data categorized into values related to area, peak pressure or force with respect to the hind-, mid- and forefoot were extracted. To test the associations between the Foot Function Index and pedobarographic assessments, bivariate partial correlations were tested and contact times served as co-variate. Results Several significant associations between peak pressure or forces beneath the hindfoot, midfoot and hallux to self-perceived function were found (|rho| = 0.28-.46, P < 0.05). In particular, reduced peak forces and pressures underneath the hindfoot and hallux, a lateral shift (smaller medio-lateral ratios) of hindfoot pressure and force and a medial shift (larger medio-lateral ratios) of midfoot pressure seem to be negatively associated with foot-related disability. Overall, less evidence was noted for associations to pain scores. Area related outcomes (including the arch index) contained no information for function while a larger BMI was the strongest thread for disability (rho = 0.42, P = 0.002) and pain (r = 0.31, P = 0.027). Significance When using pedobarography for the assessment of flexible flatfeetof children and adolescents, less attention should be paid to area related measurements which do not provide information about self-perceived function or disability. Instead, peak pressures or forces in the hind- or midfoot or beneath the hallux may be focussed. Weight reductions are potentially an effective strategy to reduce or prevent symptoms. 抽象的な背景小児用フラットフィートの評価に含めるパラメーターについては、かなりの議論があります。ダイナミックペドバログラフィーは、足の機能を測定する客観的でダイナミックな方法です。患者から報告された測定値との関連付けに関する情報は、最も関連性の高いパラメーターに焦点を当てるのに役立ちます。研究の質問フットファンクションインデックスと小児および青年の平足でのペドバログラフィー評価との関連は何ですか？方法7〜17歳の特発性柔軟扁平足を有する51人の参加者の連続した臨床症例シリーズは、歩行中に裸足のペドバログラフィーを受け、足機能指数アンケートを完了した。後足、中足、および前足に関して、面積、ピーク圧、または力に関連する値に分類された小児圧地図データが抽出されました。足機能指数と小児圧迫評価との関連性をテストするために、二変量部分相関がテストされ、接触時間が共変量として扱われました。結果ピーク圧力または後足、中足、母uxの下の力と自己知覚機能との間にいくつかの有意な関連性が見つかりました（| rho | = 0.28-.46、P <0.05）。特に、後足と母uxの下のピーク力と圧力の低下、後足の圧力と力の横方向のシフト（より小さな中外側比）と中足の圧力の内側シフト（より大きな中外側比）は、足に負の関連があるようです関連の障害。全体として、疼痛スコアとの関連については、より少ない証拠が認められた。面積関連の結果（アーチインデックスを含む）には機能に関する情報が含まれていませんが、より大きなBMIは障害（rho = 0.42、P = 0.002）および痛み（r = 0.31、P = 0.027）の最も強いスレッドでした。重要性小児および青年の柔軟なフラットフィートの評価にペドバログラフィーを使用する場合、自己認識機能または障害に関する情報を提供しない地域関連の測定値にあまり注意を払うべきではありません。代わりに、後足または中足または母hallの下のピーク圧または力に焦点を合わせることができます。減量は、症状を軽減または予防するための潜在的に効果的な戦略です。 Keywords
2.3. Data-analysis 足圧計の解析方法（アニマの奴では厳しい。。） Data was analyzed off-line with the Novel multimask software using a 10 area masking process (Fig. 2) . In detail: boundaries between the heel and midfoot and the midfoot and forefoot were defined as 45 % and 73 % of the length. The lateral and medial sections of the heel and midfoot were defined by an axis that was drawn from the center of the heel to the center of the second toe. The first, second and lateral metatarsal heads were separated by straight lines which were drawn parallel to the foot axis which divided the forefoot region vertically from the medial lateral side into sections of 30 %, 25 %, and 45 %. Each trial was visually checked and manually corrected if necessary, to ensure that the anatomical structure fit the segments.