Abstract
Human body segments interact harmoniously and efficiently so that homeostasis is maintained in any circumstances. Even the slightest modification of the support surface can have repercussions on postural control strategies and consequently can lead to a change in the alignment of the whole body. Flat foot is the most common condition of the lower limb. It is clinically manifested on multiple anatomical planes: flattening of the medial longitudinal arch (sagittal plane), valgus of the calcaneus (frontal plane) and abduction of the anterior foot (transverse plane). In any case, the influence of structural modifications of the flat foot on one’s posture, especially in children, still remains an insufficiently researched topic. The purpose of this study was to assess the effects that structural modifications of a flat foot have on the pelvis and spine in the sagittal plane, in children aged 7-9. Thus, the following hypothesis was formulated: the structural modifications of flat feet can modify the sagittal alignment of the pelvis and spine in children aged 7-9. The flat feet were assessed using the Foot Posture Index-6 (FPT-6) while the sagittal alignment of the pelvis and spine was measured using the GPS-400 computerised postural analysis system. Statistical analysis of the data did not indicate any significant correlations between the FPI-6 score and pelvic tilt angle or between the FPI-6 score and differences between the sensors and the lumbar and dorsal spinous processes.
Highlights
The following hypothesis was formulated: the structural modifications of flat feet can modify the sagittal alignment of the pelvis and spine in children aged 7-9
The purpose of this study was to assess the effects that structural modifications of a flat foot have on the pelvis and spine in the sagittal plane, in children aged 7-9
Flat feet and sagittal alignment of the spine Based on the anatomical link between foot, leg, pelvis and spine, the professional literature suggests the following: the functionality of the feet may be perturbed in the case of flat feet; bilateral pronation of the subtalar joint can lead to biomechanical adjustments manifested by an internal rotation of the tibia, an internal rotation of the femur and a forward motion of the pelvis (Ghasemi et al, 2016); the pelvis, as a link between the lower and upper body, could cause the spine to modify its alignment in order to restore postural balance (Legaye et al, 1998)
Summary
The plantar surface, which is rich in somatic-sensory afferentations, provides information that allows the adjustment of postural responses (Alexe, 2013). Cordun (2009) believes that the asymmetrical distribution of plantar pressure causes a change in the architecture of the foot This could be the starting point for upper-muscle chain imbalances that alter postural alignment. Several authors tried to define flat foot by including two consistent features: the collapse of the medial longitudinal arch and the valgus heel position. It can occur in one foot (unilateral) or in both feet (bilateral). A collapse of the posterior face of the navicular can be observed radiologically, which creates an expansion of the articular space with the talus (Peeters et al, 2013) These changes trigger the collapse of the medial longitudinal arch (Dare & Dodwell, 2014)
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