The variability of plantar pressure pattern distribution in healthy children and its relation to flexible flatfoot

Introduction: There are only few papers analyzing relationships between clinical appearance of the foot, footprints and pedobarography (PBG) in healthy children. None of them covered age range wide enough to survey overall pressure pattern variability. This may be helpful in understanding phenomenon of flexible flat foot. Material and methods: The examined group consisted of 216 healthy children, 122 (57%) boys and 94 (43%) girls. Age at examination ranged from 3 to 15,9 (mean 9,8). The design of the study was cross-sectional. Clinical examination included assessment of the longitudinal arch. Footprint evaluation was based upon Clarke’s angle. Plantar pressures were recorded in standing position using PEL 38 podometric platform. Pressures were computed separately in 9 regions of the sole according to Cavanagh. Analysis of recorded values included relation to age, clinical and footprint results. Results: Pressure pattern in child’s foot underwent significant changes during development, they were the most evident in medial midfoot and central forefoot. The changeability was observed trough the whole maturation period, but intensified in children in the age 3 to 5 and 11 to 14 years. There was observed very close correlation between improvement of the longitudinal arch in clinical examination and decrease of the load in the medial midfoot and its increase in central and lateral forefoot. Conclusions: Pressure pattern recognition is more precise than footprints and physical examination. Pressure pattern varies during child’s development in the adequate way to changes of the foot shape. This variation accelerates simultaneously to growth spurs. PBG examination ,as more sensitive, discloses, that in between the groups of feet with normal and lower longitudinal arch (determined in footprints) exists a distinctive group of feet that should be considered as a variant of normal.