Lower Limbs In Children Research Articles

Effects of acupuncture on muscle tension of lower limb in children with spastic cerebral palsy

To observe the effects of acupuncture at different acupoints in yin meridians and yang meridians on lower limb muscle tension in children with spastic cerebral palsy. Ninety children with spastic cerebral palsy aged between 2 to 6 years old were divided into a yin-meridian group, a yang-meridian group and a rehabilitation group, 30 cases in each one. The patients in the rehabilitation group were treated with routine rehabilitation treatment; the patients in the yin-meridian group were treated with routine rehabilitation treatment and acupuncture at Xuehai (SP 10), Yinlingquan (SP 9), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) along yin meridians; the patients in the yang-meridian group were treated with routine rehabilitation treatment and acupuncture at Futu (ST 32), Zusanli (ST 36), Yanglingquan (GB 34), Guangming (GB 37) and Xuanzhong (GB 39) along yang meridians. All the three groups were treated once each other day, 10 times as one course, and totally 20-day treatment was given. Before and after treatment, modified Ashworth scale (MAS), clinical spasm index (CSI) and integrated electromyography (iEMG) of surface electromyogram of gastrocnemius muscle were evaluated. Compared before treatment, the MAS and CSI in the yin-meridian group and yang-meridian group were improved after treatment (P<0.05, P<0.01); the differences before and after treatment in the rehabilitation group were not significant (both P>0.05). After treatment, the differences between the rehabilitation group and yin-meridian group, yang-meridian group were significant (P<0.05, P<0.01); the differences of MAS and CSI between the yin-meridian group and yang-meridian group were not significant (both P>0.05). Compared before the treatment, the right-side iEMG and left-side iEMG were reduced in the yin-meridian group and yang-meridian group (all P<0.05); the right-side iEMG was increased in the rehabilitation group (P<0.05). After treatment, the iEMG in the yin-meridian group and yang-meridian group were lower than that in the rehabilitation group (all P<0.05); the differences of iEMG before and after treatment in the yin-meridian group and yang-meridian group were higher than that in the rehabilitation group (all P<0.05); the differences of iEMG between the yin-meridian group and yang-meridian group were not significant (both P>0.05). Acupuncture at yin meridians and yang meridians could reduce muscle tension of lower limb and improve limb spasticity in children with spastic cerebral palsy, and the two acupuncture methods have similar clinical curative effect.

REPRODUCIBILITY OF THE BASIC X-RAY PARAMETERS OF LOWER EXTREMITY DEFORMATIONS IN CHILDREN WITH SKELETAL DYSPLASIA

Introduction: axial deformities in the lower extremities of children lead to an uneven distribution of the load in different compartments of the knee joint, which can contribute to the development of osteoarthritis. Regardless of the cause of their occurrence, the main goal of treatment is the restoration of the mechanical axis. Various calculation methods are used to determine the amount of deformity, its apex and the degree of required correction. The aim: to evaluate the reproducibility of the basic X-ray parameters characterizing the deformities of the lower extremities in the frontal plane in children with skeletal dysplasia based on the calculation of inter-rater reliability.Materials and methods: the article presents calculations of the main angulometric parameters of the knee joint (deviation of the mechanical axis — MAD, distal mechanical angle of the femur — mLDFA, proximal angle of the tibia — MPTA) in 18 patients with skeletal dysplasia (30 lower extremities) that had axial deformities of the lower extremities in the frontal plane at the level of the knee joint. The control group included the results of similar calculations of the angulometric parameters in 19 children (30 lower extremities) with valgus and varus deformities of the knee joint without skeletal dysplasia (idiopathic axial deformations, posttraumatic deformities, malformations of the lower limbs). The estimation of inter-expert reliability was made in the SPSSv. 23.Results: the analysis demonstrated that calculation of reference parameters in children without primary lesion of the growth plate has a high degree of inter-rater reliability: an intra-class correlation coefficient with a 95% confidence interval (ICC [95% CI]) when calculating the reference angles of mMPTA and mLDFA was 0.981% [0.971–0.991] and 0.993% [0.989–0.997] respectively, for MAD 0.996% [0.993–0.998]. When calculating the same parameters in children with skeletal dysplasia, the results differed. Thus, the intra-class correlation coefficient for the deviation of the mechanical axis was 0.861% [0.763–0.926] (which corresponds to the normal reproducibility of this parameter), for mMPTA — 0.586% [0.295–0.781], for mLDFA — 0.796% [0.653–0.892]. This indicates a low reproducibility and may lead to errors in the planning of correction of axial deformities of the lower limbs in children with skeletal dysplasia.Conclusion: when calculating the severity of axial deformities in the lower extremities in children with skeletal dysplasia, the most reproducible parameter is the determination of the deviation of the mechanical axis of the lower extremities as compared to the studied angulometric methods.

Special aspects of the support function of lower limbs in children with the consequences of unilateral lesion of the proximal femur with acute hematogenous osteomyelitis

Background. Acute hematogenous osteomyelitis in the lesion of the proximal femur causes hypofunction or destruction of the metaepiphyseal growth zone of the femur. Theoretically, this leads to the formation of orthopedic consequences, including shortening of the lower limb.&#x0D; Aim. The study aimed to examine the plantographic characteristics of the feet in children with a lesion of the proximal femur and analyze the influence of the regularities of plantar pressure distribution in the asymmetry of the load on the lower limbs.&#x0D; Material and methods. Total 15 pediatric patients aged 6–16 years with consequences of acute hematogenous osteomyelitis of the proximal femur and shortening of the affected lower limb by 1.0–6.0 cm were examined. In addition, 15 healthy children belonging to the same age were examined for comparison. Stabilometry and plantography methods were used, and the statistical study included correlation and regression analysis.&#x0D; Results. When we conducted tests with a double-support load on the feet, in comparison to healthy children, pediatric patients exhibited a significant decrease in the value of the anterior index of the support t in both the affected and unaffected sides. The parameters of other support indices (namely, m, s, and l) of the contralateral feet in patients were within the normal range, indicating the functional consistency of the corresponding arches of the feet, providing static and dynamic limb support ability. However, the correlation and regression analysis showed that, in comparison with the norm, the foot support ability in pediatric patients is implemented due to the strengthening of the functional relationship between the inner and the medial longitudinal arches of the foot on the intact side and the inversion of the interaction of the longitudinal arches with the transverse arch on the side of the lesion.&#x0D; Conclusion. In children with consequences of acute hematogenous osteomyelitis of the proximal femur, the parameters of the plantographic characteristics indicate a change in the activity and consistency of the muscles that form all the feet arches on both the affected and intact lower limbs.

Rehabilitation improves walking kinematics in children with a knee varus: Randomized controlled trial

BackgroundPrevious studies have demonstrated increased medial stresses in knee varus alignment. Selecting a suitable treatment strategy for individuals with knee malalignment should be a priority. ObjectivesWe aimed to investigate the effects of a 16-week corrective exercise continuum (CEC) program on 3-D joint angles of the dominant and non-dominant lower limbs in children with genu varus during walking. MethodsOverall, 28 male children with genu varus (age range 9–14 years) volunteered to participate in this study. They were randomly divided into 2 equal groups (experimental and control). The participants of the experimental group received CEC for 16 weeks. 3-D gait analysis involved using a Vicon Motion System. Paired and independent sample t-tests were used for within- and between-group comparisons, respectively. ResultsFor the experimental group, comparison of pre- and post-test joint kinematics of the dominant lower limb revealed that CEC decreased the peak ankle dorsiflexion angle by 26% (P=0.020), peak foot internal rotation angle by 53% (P=0.001), peak knee internal rotation angle by 40% (P=0.011), peak hip abduction by 47% (P=0.010), and peak hip external rotation angle by 60% (P=0.001). In contrast, peak knee external rotation angle of the dominant limb was increased after the training program by 46% (P=0.044). For the non-dominant lower limb, CEC decreased the peak ankle inversion by 63% (P<0.01), peak ankle eversion by 91% (P<0.01), peak foot internal rotation by 50% (P<0.01), peak knee internal rotation by 29%; P=0.042), peak hip abduction angle by 38% (P<0.01), and peak hip external rotation angle by 60% (P<0.01). ConclusionsCEC therapy reduced excessive foot and knee internal rotations as well as excessive hip external rotation during walking in children with genu varus.

The influence of selected manual techniques on the relative length of lower limbs in children with postural defects – a pilot study

Introduction: One of the very important indicators used in the treatment of postural defects is the relative symmetry of the lower limbs. The selection of a safe and effective therapeutic tool is not an easy task and is particularly important in children. The authors of the experiment have decided to check the effectiveness of two manual techniques, that minimally interfere with patient's tissues. The objective of this study was to evaluate the influence of selected manual procedures: the Ackerman's second phenomenon and mobilization of the sacroiliac joint to hyperextension (Kowtun's grip) on the relative length of the lower limbs in a school-age children. Materials and methods: 70 children aged 8-12 participated in the study. All of them were diagnosed with postural abnormalities: spine defects in the sagittal plane, three-dimensional asymmetry of the torso, knee and / or foot defects and asymmetry of the length of the lower limbs. Qualification of children for a particular group with a postural defects was based on the concept of Sastre Fernandez. In each patient, the manual procedure in order to compensate the leg length, was applied once. In 28 children the applied procedure was the Ackerman's second phenomenon and in 42 it was the Kowtun's grip. The relative length of t h e l o w e r l i m b s w a s m e a s u r e d immediately before and after the manual procedure. Results: The executed experiment indicates the effectiveness of the Ackerman's second phenomenon in compensating the asymmetry of the length of the lower limbs in children with posture defects. The effect of Kovtun's mobilization is less clear. Conclusions: Manual procedure change the relative length of the lower limbs in children with postural defects. The Ackerman's second phenomenon in an effective and yet gentle and safe manual tool that can be used in children in order to compensate the relative length of the lower limbs. The effect of the Kowtun's treatment requires further research.

Radiological and clinical findings following distraction osteogenesis of the lower limb in children with or without botox injection: A preliminary report

Context: Limb lengthening correction according to Ilizarov distraction osteogenesis (DO) usually yields excellent results. While pediatric orthopedic surgeons anecdotally report that botulinum toxin A (Botox) alleviates spasm and pain during DO, no study has examined the effects of this surgery and Botox injection on muscle morphology in children. Aims: (1) To evaluate the clinical and radiological effects of lower limb lengthening in children and (2) the effects of adjunctive Botox muscle injection. Setting and Design: This was a center and randomized control trial. Methods: Seven children underwent tibial (n = 3) or femoral lengthening (n = 4) and were randomized to receive either a Botox or sterile saline solution. Quality of life and functional mobility outcomes, muscle testing, and magnetic resonance imaging examination were obtained at baseline, 12-, and 24-month postoperative. Muscle measurements were acquired on axial T1-weighted images and included: (1) total cross-sectional area (TCSA), (2) functional cross-sectional area (FCSA, fat-free area), (3) ratio of FCSA to TCSA, and (4) asymmetry between sides. Results: Physical performance improved at 12- and 24-month postoperative. Muscle strength remained functional across the three time points. A decrease in TCSA and FCSA was observed at 12-month follow-up in the operated thigh of patients undergoing femur lengthening, but muscle mass was regained at 24 months. However, TCSA and FCSA remained lower in the operated femur at 24 months. Similar findings were also observed in patients who underwent tibial lengthening. Patients in the Botox group appeared to have a slightly greater decrease in muscle mass and increase in fatty infiltration in the operated leg. Conclusions: Children undergoing DO preserved their muscle strength and improved physical performance 2-year postoperative. Our results suggest that muscle size and muscle mass remained lower in the operated leg; a finding that was slightly more prominent in children who received a Botox injection.

REGIONAL ANESTHESIA FOR CHILDREN WITH THE DISEASES OF LOWER LIMBS

The article presents an analysis of the publications devoted to the problems of anesthesia to surgical procedures at the diseases of the lower limbs in children. The article reviews the questions of anesthesia safety and the role of regional blockades in the structure of intra- and postoperative analgesia.

Use of Ganga Hospital Open Injury Severity Scoring for determination of salvage versus amputation in open type IIIB injuries of lower limbs in children—An analysis of 52 type IIIB open fractures

Introduction and aimsOpen injuries in children are rare compared to adults. In children with major open injuries, there is no specific scoring system to guide when to amputate or salvage the limb. The use of available adult scoring systems may lead to errors in management. The role of Ganga Hospital Open Injury Severity Scoring (GHOISS) for open injuries in adults is well established and its applicability for pediatric open injuries has not been studied. This study was done to analyse the usefulness of GHOISS in pediatric open injuries and to compare it with MESS(Mangled Extremity Severity Score). MethodsAll children (0–18 years) who were admitted with Open type IIIB injuries of lower limbs between January 2008 and March 2015 were included. MESS and GHOISS were calculated for all the patients. There were 50 children with 52 type IIIB Open injuries of which 39 had open tibial fractures and 13 had open femur fractures. ResultsOut of 52 type IIIB open injuries, 48 were salvaged and 4 were amputated. A MESS score of 7 and above had sensitivity of 25% for amputation while GHOISS of 17 and above was found to be more accurate for determining amputation with sensitivity of 75% and specificity of 93.75%. ConclusionGHOISS is a reliable predictor of injury severity in type IIIB open fractures in children and can be used as a guide for decision-making. The use of MESS score in children has a lower predictive value compared to GHOISS in deciding amputation versus salvage. A GHOISS of 17 or more has the highest sensitivity and specificity to predict amputation.

Clinimetric properties of lower limb neurological impairment tests for children and young people with a neurological condition: A systematic review.

BackgroundClinicians and researchers require sound neurological tests to measure changes in neurological impairments necessary for clinical decision-making. Little evidence-based guidance exists for selecting and interpreting an appropriate, paediatric-specific lower limb neurological test aimed at the impairment level.ObjectiveTo determine the clinimetric evidence underpinning neurological impairment tests currently used in paediatric rehabilitation to evaluate muscle strength, tactile sensitivity, and deep tendon reflexes of the lower limb in children and young people with a neurological condition.MethodsThirteen databases were systematically searched in two phases, from the date of database inception to 16 February 2017. Lower limb neurological impairment tests were first identified which evaluated muscle strength, tactile sensitivity or deep tendon reflexes in children or young people under 18 years of age with a neurological condition. Papers containing clinimetric evidence of these tests were then identified. The methodological quality of each paper was critically appraised using standardised tools and clinimetric evidence synthesised for each test.ResultsThirteen papers were identified, which provided clinimetric evidence on six neurological tests. Muscle strength tests had the greatest volume of clinimetric evidence, however this evidence focused on reliability. Studies were variable in quality with inconsistent results. Clinimetric evidence for tactile sensitivity impairment tests was conflicting and difficult to extrapolate. No clinimetric evidence was found for impairment tests of deep tendon reflexes.ConclusionsLimited high-quality clinimetric evidence exists for lower limb neurological impairment tests in children and young people with a neurological condition. Results of currently used neurological tests, therefore, should be interpreted with caution. Robust clinimetric evidence on these tests is required for clinicians and researchers to effectively select and evaluate rehabilitation interventions.

Pedicled Sensate Composite Calcaneal Flap in Children With Congenital Tibial Pseudoarthrosis.

The preservation and functionality of a limb affected by a malformation (such as congenital pseudoarthrosis of the tibia) or a severely mangled lower limb in children, despite modern reconstructive techniques, remains challenging, often eventually requiring amputation to achieve a better outcome. The classical Syme and Boyd procedures are functionally better than transtibial (TT) amputation, but are not feasible for congenital tibial pseudoarthrosis. TT amputation delivers an excellent, effective, and functional stump that usually leads, after prosthetization, to a functional gait. Unfortunately, in some situations, particularly when amputation is performed conventionally, the stump is also associated with complications. Future surgical revisions are often needed, particularly in children, because of stump overgrowth. Between 2008 and 2010, three patients diagnosed with congenital pseudoarthrosis of the tibia associated with neurofibromatosis who were indicated for TT amputation with calcaneal flap after failure of all previous surgical reconstructive procedures were selected. The chosen method for osteosynthesis was an external fixator of Ilizarov. At 12 weeks of follow-up, the stump had healed in all three patients, and tibiocalcaneal fusion was achieved without complications. All patients were prosthetized and had an asymptomatic gait. After a minimum follow-up of 6 years, all three cases with the pedicled sensate composite calcaneal flap still had a strong, full weight-bearing surface and have adapted easily to the conventional prosthesis, providing a painless stump with excellent functionality. With a 0 rate of needed revisions, all 3 cases with the pedicled sensate composite calcaneal flap preserving the hind foot still have a strong, full weight-bearing surface and have easily adapted to the conventional prosthesis, providing a painless and excellent functional stump that could last a lifetime. Level IV.

Effect of supporting 3D-garment on gait postural stability in children with bilateral spastic cerebral palsy.

Children with cerebral palsy show dysfunctional postural control which interferes with their functional performance and daily-life activities. The aim of the study was to identify the effect of a 3D supporting garment on trunk postural control and interjoint coordination during gait in children with bilateral cerebral palsy. We analyzed tridimensional trunk motion, trunk-thigh and interjoint coordination in 15 4-10 year-old children with bilateral spastic cerebral palsy (GMFCS I or II) and 16 4-10 year-old typically developing children while walking with or without a supporting garment. We found significantly changes in the coordination between trunk and lower limbs in children with cerebral palsy. Step velocity and cadence both increased significantly in children with cerebral palsy but in controls, the cadence remained unaltered. Interjoint coordination between hip-knee and knee-ankle was altered during the stance phase only in the subgroup of children with cerebral palsy without any limitations in ankle joint passive range of motion. 3D supporting garments improve trunk-thigh and lower limb interjoint coordination in walking in children with bilateral cerebral palsy.

Reconstruction des traumatismes complexes des membres inférieurs chez l’enfant

Lower limb multi-tissular injuries are rare in children but require elaborate surgical care considering the child's growth potential, donor-site morbidity and the psychological consequences for the child and his family. This review outlines the various coverage options, from simple to more complex, developing their principles and their results. Technical features of wound repair of the lower limb in children will be detailed. An efficient and ambitious care can give excellent functional outcomes in children, even when extended, multi-tissue lesions members are involved.

Heterogeneity of muscle sizes in the lower limbs of children with cerebral palsy.

Cerebral palsy (CP) is associated with reduced muscle volumes, but previous studies have reported deficits in only a small number of muscles. The extent of volume deficits across lower limb muscles is not known. This study presents an imaging-based assessment of muscle volume and length deficits in 35 lower limb muscles. We imaged and segmented 35 muscles in 10 subjects with CP and 8 typically developing (TD) controls using MRI. Muscle volumes were normalized, and Z-scores were computed using TD data. Volume Z-scores and percent deficits in volume, length, and cross-sectional area are reported. Muscle volumes are 20% lower, on average, for subjects with CP. Volume deficits differ significantly between muscles (12%-43%) and display significant heterogeneity across subjects. Distal muscles, especially the soleus, are commonly and severely small. Heterogeneity across muscles and across subjects reinforces the subject specificity of CP and the need for individualized treatment planning. Muscle Nerve 53: 933-945, 2016.

Effects of strength training program on hip extensors and knee extensors strength of lower limb in children with spastic diplegic cerebral palsy.

[Purpose] The purpose of this study was to determine whether strength training programs for hip extensors and knee extensors improve gross motor function of children with cerebral palsy in Myanmar. [Subjects and Methods] Forty children (25 boys and 15 girls, mean age: 6.07 ± 2.74 years) from National Rehabilitation Hospital, Yangon, Myanmar, who had been diagnosed with spastic diplegic cerebral palsy, Gross Motor Classification System I and II participated in a 6-week strength training program (45 minutes per day, 3 days per week) on hip and knee extensors. Assessment was made, before and after intervention, of the amount of training weight in pounds, as well as Gross Motor Function Measure (GMFM) dimensions D (standing) and E (walking, running, jumping). [Results] All scores had increased significantly after the strength-training program. [Conclusion] A simple method of strength-training program for hip and knee extensors might lead to improved muscle strength and gross motor function in children with spastic diplegic cerebral palsy.

Osmičkové dlahy - nové možnosti v managementu řešení osových a délkových diskrepancí dolních končetin u dětí. Naše první zkušenosti

Osmičkové dlahy - nové možnosti v managementu řešení osových a délkových diskrepancí dolních končetin u dětí. Naše první zkušenosti

Efecto inmediato del vendaje neuromuscular aplicado en tronco para disminuir la espasticidad en extremidades superiores e inferiores en niños con parálisis cerebral nivel V conforme al sistema de clasificación de la función motora gruesa

ObjectiveTo evaluate the immediate effect of the application of neuromuscular bandage on trunk to reduce spasticity in upper and lower limbs in children with cerebral palsy GMFS V. DesignWe performed a prospective comparative study, clinical testing approach, quasi-experimental with measures pre test-post test, where 21 patients with cerebral palsy GMFS V were studied. Spasticity was assessed with the modified Ashworth scale for upper and lower limbs, bilateral adductor tone scale hips and goniometric measurements of the angles of flexion, extension and hip abduction, knee flexion and extension, dorsiflexion and plantar flexion ankles, flexion, extension and shoulder abduction, elbow flexion and extension, all of the above made by the specialist physician in pediatric rehabilitation. For statistical analysis nonparametric Wilcoxon test was used for paired samples, after verification of the distribution of the data using SPSS version 17.0, considering a P value ≤.05 as statistically significant. ResultsThe obtained reduction in spasticity in all four limbs, decreased muscle tone hip adductors and increased ranges of flexion, extension and abduction of the hips and shoulders, bending, knee extension and ankle was statistically significant, P<.05 and clinically relevant in an application session of neuromuscular bandage. ConclusionsThe neuromuscular bandage applied on the trunk is an effective method to reduce spasticity.

Above-the-knee replantation in a child: a case report with a 24-year follow-up.

Replantation of an amputated limb is generally contraindicated in crushing and traction injuries. Injury to muscle tissue and skin also creates difficulties in coverage, and bony fractures may shorten limb length which can impede lower extremity function. Numerous cases have been reported on the successful replantation of the lower limb in children; however, review of previous English literature has documented only very few replantation at the thigh level, and those with severe crushing injury resulted in subsequent amputation. We report a case of successful thigh-level replantation in a 3-year-old child who sustained a crushing–traction type of injury with a follow-up of 24 years. After the replantation, early and late complications developed but these were successfully managed. On her last visit, the patient had pain-free ambulation without assistance, had intact protective sensation distal to the injury, and was very satisfied with the outcome. Replantation of the lower limb in children with crushing or avulsion type of injuries is still a worthwhile procedure. However, both the patient and the family should be aware that multiple surgeries may be needed to accommodate to long-term complications such as joint stiffness, scar contractures, and limb length discrepancies.

Accuracy of needle placement by electrical stimulation guidance in botulinum toxin type a injections in the lower limbs of children with hypertonia

Accuracy of needle placement by electrical stimulation guidance in botulinum toxin type a injections in the lower limbs of children with hypertonia

The use of intramedullary telescopic fixateur for osteosynthesis of long bones of the lower limbs in children with osteogenesis imperfecta

Osteogenesis imperfecta (OI) is a heterogeneous pathology which is accompanied by the development of multiple fractures and deformi­ties of the long bones of the extremities. Objective: to present out­comes of surgical treatment in patients with OI using intramedullary telescopic fixateur (ITF). Methods: 9 patients with bone deformities of the extremities due to OI were operated (4 boys, 5 girls aged 1,5–11 years). Correction was performed with using of percuta­neous semi-open osteoclasia on top of deformity. Bone fragments were fixed by means of ITF developed by authors which provides bone elongation during growth. After surgery we used an orthosis for external fixation. Rehabilitation envisaged work out active and passive movements in joints of the operated extremity, exercises for increasing of muscle strength, and hydrokynesiotherapy. Control checkups (clinical and radiological examination, determination of active movements in joints and muscle strength of the lower limbs) were performed every 3–4 months. Outcomes were assessed by FAQ Ambulation Scale. In all patients there were found consolidation of fragments in the area of osteotomy, preservation of achieved axial correction of parameters in lower extremities, increasing of active movements in hip and knee joints. Bearing-kinematic function of the lower extremities grew on 5 classes, and in two cases — on 7 ones. Improvement of functional class according to FAQ Ambula­tion Scale was found in 4 patients. In 6 patients which were not able to walk before surgery an ability for vertical standing and walking appeared. Conclusion: The proposed ITF provides restoration of anatomical axis of a limb, function of walk and bearing capacity in lower extremities, early start of the rehabilitation period, reduction of the percentage of complications, and also reduces the need for repeated surgeries, prevents the progression of deformation and a nascence of secondary fractures of long bones.

Foot arch condition in comparison with the muscular balance of lower limbs in children at school age of 6–14 years

Introduction. Foot arch condition plays an important role in correct setting of lower limbs joints, proper muscles tone and well-being [1]. More and more frequently foot arch deviations affect population of school age children [2, 3]. It is based on anatomic knowledge that abnormal foot arch is strongly connected with the disturbed muscle tone of lower limb. The aim of the presented study is to evaluate the relation between the foot arch condition and muscular balance of the lower limbs.Material and methods. Children were assessed using the Clarke’s angle and indicatory muscles length tests including: quadratus lumborum muscle, hamstring muscle, thigh adductors, piriformis muscle.Results. Abnormal foot arch was showed by 70% of subject children. The greatest number of muscles length abnormality was observed in quadratus lumborum muscles. There was a statistically significant correlation between right hamstring muscle contraction and abnormal foot arch (p = 0.011). Conclusions. Foot arch alternations increasingly more often appear in the greater number of school–age children. The assessment and therapy of abnormal foot arch should include the examination of muscular balance of the lower limbs.