Inter-Segmental Foot Motions in Children and Adolescents Using a Three-Dimensional Multi-Segment Foot Model

Abstract

Category: Basic Sciences/Biologics Introduction/Purpose: In the last two decades, several multi-segmental foot models (MFMs) have been introduced for the in vivo analysis of dynamic foot kinematics. However, the literature has not yet sufficiently described normal gait patterns in normal children and adolescents. Normal range of gait pattern should be established before applying gait analysis clinically in order to assess and treat pathological gait patterns. The purpose of this study is to suggest normal foot kinematics of clinically normal children and adolescents using three dimensional multi-segment foot model (3D MFM). Using this data, we will be able to distinguish between normal and abnormal gait more precisely in pediatric population and to evaluate gait improvement by certain treatment methods. Methods: One-hundred fifteen children and adolescents without anatomical or functional abnormalities of foot were involved. Fifty-seven individuals were boys and 58 were girls. The mean age was 11.4 years (range: 7-17). We divided the pediatric subjects into two groups; age between 7 to 10 years (Prepuberty) when the foot is still growing and age of 11 or older (Puberty) when the gait pattern is thought to be similar with that of adults. The Difference of gait kinematics of the two groups was analyzed. Using 12 sets of 3D optical motion capture cameras, gait motion data were collected while the subjects were walking. In 5 separate experiments, gait analysis was performed for 3 different kinds of stride. Foot segment kinematics were measured and analyzed by Foot 3D Multi-Segment Software program (Motion Analysis Co., Santa Rosa. CA). We performed student’s t-test to analysis the difference between the groups. Results: The basic demographic data showed that there was no significant difference in proportion of stance phase among groups. There are some significant difference of foot motion between prepuberty and puberty (Figure 1). Both boys and girls in puberty showed approximately 4.5 degrees greater big toe motion in sagittal plane than in prepuberty. Mostly, increase of dorsiflexion angle was evident. Hallux valgus angles did not show significant difference in boys, but girls showed marked increase in puberty. In forefoot motion analysis, there were significant difference in sagittal, coronal and transverse plane between prepuberty and puberty girl, but did not show significant difference in boys. Sagittal plane of hindfoot motions increased in both boys and girls in puberty and coronal plane hindfoot motion showed increased pronation in puberty. Conclusion: The results suggest that sagittal motion of the great toe mainly involves plantar flexion and increase in hallux valgus angle is evidently greater in females than in males throughout growth development. Increase in sagittal plane motion and valgus angle of the big toe rapidly increased in puberty, while increase in sagittal motion of forefoot and hindfoot were gradual. In summary, authors identified children’s normal gait pattern and especially, difference between boys and girls and changes according to age groups in this study.