The contralateral foot in children with unilateral clubfoot: a study of pressures and forces involved in gait.
The unaffected contralateral side of patients with unilateral clubfeet has sometimes been taken as control in foot pressure measurement studies. However, it has never been shown that the pressure pattern under the contralateral foot is similar to a normal foot. Sixteen patients with unilateral clubfoot and 110 normal subjects took part in this study. All participants were aged from 4 to 8 years. Studies comprised clinical examination and foot pressure measurements in barefoot walking. Evaluations of the measurements were completed by the calculation of forces acting under 10 anatomical foot areas normalized to ground reaction force at foot-flat and push-off. Significant differences in peak pressure were observed between the control group and the contralateral foot of patients under the heel and the metatarsals 1 to 4. Significant differences in the forces at foot-flat and push-off are seen especially in the midfoot. Both sides of the patients with unilateral clubfeet exert significantly less ground reaction force than normal subjects. Different pressure and force distributions of clubfoot children on their contralateral side compared with the normal feet of the control group may indicate differences in the general control pattern generated by the central nervous system. Differences can still be observed after normalization of the forces. We therefore conclude that when foot pressure measurements are made with clubfeet, it might be advisable to use a collective of normal feet, instead of the contralateral foot, for comparison.
Favre
Philippe
P
Laboratory for Orthopaedic Research, Department of Orthopaedics, Balgrist, University of Zurich, Zurich, Switzerland. pfavre@research.balgrist.ch
Exner
Gerhard U
GU
Drerup
Burkhard
B
Schmid
Denise
D
Wetz
Hans H
HH
Jacob
Hilaire A C
HA
D001696:Biomechanical Phenomena; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000503:physiopathology*; D005260:Female; D005528:Foot / Q000502:physiology*; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D011312:Pressure