Foot posture in school children from the Western Cape: Differences between footwear use, gender and race

[摘要] ENGLISH ABSTRACT : The feet of children are sensitive to external forces as the ligaments, muscles and bones are still in the process of maturing. The arch develops naturally within the first ten years of life. This research study reports on the factors affecting foot posture and plantar pressure parameters by describing the differences between boys and girls, age groups, and race in South-Africa, as well as the differences between South-African and German children.A cross-sectional descriptive study where quantitative data were collected was used as the primary research method for this research study. Stratified randomised samples were selected consisting of 516 South-African children and 214 German children between the ages of six to eighteen years old. Testing equipment utilised include a manufactured foot calliper, as well as an EMED-SF® pressure plate. A barefoot scale was used to quantify the footwear habits of participants. A physical activity questionnaire developed specifically for older children (PAQ-C) and for adolescence (PAQ-A), were used to evaluate the physical activity level of the participants.Within the South-African sample, no significant differences were found in foot posture between boys and girls. Younger children had significantly lower arches in terms of the dynamic arch index (DAI) (younger than ten: 1.045 (0.030), older than ten: 1.041 (0.026)) (p = 0.025), as well as increased pliability values. Children younger than ten years old presented with greatest peak pressure under the medial heel, while children older than ten years old presented with greatest peak pressure under the big toe. When comparing the DAI of white South-African children (0.171 (0.069)) (p = 0.000) to that of mixed race South-African children (0.196 (0/067)), it is clear that the mixed race children have flattened arches compared to the white children. Mixed race children presented with more pliable feet (1.050 (0.030)) compared to white children (1.040 (0.026)) (p = 0.000), as well as a decreased contact area in all regions of the foot, except for the medial midfoot, as they have greater medial midfoot contact (p < 0.05).South African children had greater peak pressure in the medial forefoot and medial midfoot, as well as the big toe and toes two to five compared to German children (p < 0.05). Maximum force, was significantly greater for South-African children in all regions of the foot compared to German children except for the medial and lateral midfoot as well as the lateral forefoot (p < 0.05).The most significant differences were observed between children of different races. Mixed race children presented with lowered arches, more pliable feet and more dispersed peak pressures. With regards to the intercontinental results, South-African children load their feet more medially with increased gripping of the toes. The increased pressure-time integral in German children puts them at an increased risk of developing foot pain.

[发布机构] Stellenbosch University