|Leung, Ka Wing
|Prevalence and associated factors of flat foot among 6 to 16 aged Chinese children and adolescents : a cross-sectional study
|Zhang, Ming (BME)
Foot -- Abnormalities
Hong Kong Polytechnic University -- Dissertations
|Department of Biomedical Engineering
|89 pages : color illustrations
|Flat foot in early-age children, believed by many researchers, was a transitional growing process. It appeared to be a flat foot because there was a fat pad under the medial longitudinal arch. This kind of non-pathological foot condition would disappear during grow up (J. J. Echarri & J. F. Forriol, 2003). Dare & Dodwell shared a similar view that due to ligament laxity, almost all infants and children had flat feet who were aged under 6. The medial arch would be more visible when they were growing up during the first ten years of life (M. D. Dare & R. E. Dodwell, 2014). Furthermore, over-weighted individuals were commonly seen in many developed countries and the number was growing for all ages people globally. There were about 30% of the kids in Spain were classified as obese. As for the musculoskeletal system, obesity or being overweight was another key factor promoting the acquisition of flatten arches and might lead to discomfort or pain in the lower limb as a result (Jiménez-Ormeño, Aguado, Delgado-Abellán, Mecerreyes, & Alegre, 2013). In addition to the obesity issue, gender differences in foot morphology changes were another popular topic in western countries. American boys experienced their feet growing peak at age 13 while it was age 11 for U.S. girls. In Germany, male kids' feet stopped growing at age 15 and it was 13 for girls in the country. As for Greek society, boys showed a lower arch tendency than girls throughout the ages of 13 to 17 (Xu, Li, Hong, & Wang, 2019). Delgado-Abellán, Aguado, Jiménez-Ormeño, Mecerreyes, and Alegre concluded in their study done in Spain that the growth trends of the two sexes were similar in general; however, the differences appeared at the age of 8 and 10 for boys and girls respectively (Delgado-Abellán, Aguado, Jiménez-Ormeño, Mecerreyes, & Alegre, 2014). These findings were considered close to those results in previous works in Hong Kong (China), Glasglow (UK), and Germany.
Owing to the high prevalence of flat feet in the early stage of human life, a substantial number of studies were on this topic. Some of them focused on the foot length growth patterns, some investigated the differences between the two genders in different age ranges. There were more parameters had been analyzed; BMI, width, circumference, and footprint were examples. However, among those reviewed studies, aiming at the growing pattern of the kid's arch shapes was rare.
Through studying foot arch shapes of 8955 boys and girls at the ages of 6 to 16 with 3D foot data capture system had been conducted. The results showed that Arch Index (AI) had a strong correlation with Arch Length Ratio (AHR), which was the strongest association among all parameters. And, therefore, a regression had been set up on these two variables to form an equation for clinical practice to classify different arch types by Medial Arch Length (MAL) and Arch Height (AH) for the age range of 6 to 16.
It was found that the correlation of the Arch Index (AI) and Valgus Index (VI) was the second strongest among all variables, which was easily understandable because both indexes were flat foot related. The last meaningful associations were paired up as Age and AI, Age and VI, Age and AHR, among these variable pairs possessed moderately strong correlations. While other parameters showed very weak or no correlations in this study. Finally, both sexes' foot arch started a rapid growth at age 6. It was found that girls' arch got mature at age 12 while boys' arch slowed down growth at age 13. Furthermore, throughout the growing period of age from 6 to 11, females grew faster than males. From age 12 onwards, the arch shapes of the two groups did not indicate a significant discrepancy.
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