Article

The purpose of this study was to examine foot function during walking in
symptomatic (SFF) and asymptomatic (ASFF) flexible flatfeet. Thirty-five
paediatric and juvenile patients with idiopathic flexible flatfeet were recruited
from an orthopaedic outpatient department (14 SFF and 21 ASFF). Eleven
age-matched participants with typically developing feet served as controls (TDF).
To study foot function, 3D multi-segment foot kinematics and ankle joint kinetics
were captured during barefoot gait analysis. Overall, alterations in foot
kinematics in flatfeet were pronounced but differences between SFF and ASFF were
not observed. Largest discriminatory effects between flatfeet and TDF were
noticed in reduced hindfoot dorsiflexion as well as in increased forefoot
supination and abduction. Upon clinical examination, restrictions in passive
dorsiflexion in ASFF and SFF were significant. During gait, the hindfoot in
flatfeet (both ASFF and SFF) was more everted, but less flexible. In sagittal
plane, limited hindfoot dorsiflexion of ASFF and SFF was compensated for by
increased forefoot mobility and a hypermobile hallux. Concerning ankle kinetics,
SFF lacked positive joint energy for propulsion while ASFF needed to absorb more
negative ankle joint energy during loading response. This may risk fatigue and
overuse syndrome of anterior shank muscles in ASFF. Hence, despite a lack of
symptoms flatfoot deformity in ASFF affected function. Yet, contrary to what was
expected, SFF did not show greater deviations in 3D foot kinematics than ASFF.
Symptoms may rather depend on tissue wear and subjective pain thresholds.
CI - Copyright (c) 2013. Published by Elsevier B.V.

Langue : ANGLAIS