title: A kinematic description of dynamic midfoot break in children using a multi-segment foot model.
abstract: Midfoot break (MFB) is a foot deformity that occurs most commonly in children with cerebral palsy (CP), but may also affect children with other developmental disorders. Dynamic MFB develops because the muscles that cross the ankle joint are hypertonic, resulting in a breakdown and dysfunction of the bones within the foot. In turn, this creates excessive motion at the midfoot. With the resulting inefficient lever arm, the foot is then unable to push off the ground effectively, resulting in an inadequate and painful gait pattern. Currently, there is no standard quantitative method for detecting early stages of MFB, which would allow early intervention before further breakdown occurs. The first step in developing an objective tool for early MFB diagnosis is to examine the difference in dynamic function between a foot with MFB and a typical foot. Therefore, the main purpose of this study was to compare the differences in foot motion between children with MFB and children with typical feet (Controls) using a multi-segment kinematic foot model. We found that children with MFB had a significant decrease in peak ankle dorsiflexion compared to Controls (1.3 ± 6.4° versus 8.6 ± 3.4°) and a significant increase in peak midfoot dorsiflexion compared to Controls (15.2 ± 4.9° versus 6.4 ± 1.9°). This study may help clinicians track the progression of MFB and help standardize treatment recommendations for children with this type of foot deformity.
authors.affiliation: Shriners Gait Lab, Sunny Hill Health Centre for Children, 3644 Slocan Street, Vancouver, BC V5M 3E8, Canada. jmaurer@cw.bc.ca
authors.forename: Jessica D
authors.initials: JD
authors.lastname: Maurer
authors.forename: Valerie
authors.initials: V
authors.lastname: Ward
authors.forename: Tanja A
authors.initials: TA
authors.lastname: Mayson
authors.forename: Karen R
authors.initials: KR
authors.lastname: Davies
authors.forename: Christine M
authors.initials: CM
authors.lastname: Alvarez
authors.forename: Richard D
authors.initials: RD
authors.lastname: Beauchamp
authors.forename: Alec H
authors.initials: AH
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000843:Ankle Joint / Q000502:physiology / Q000503:physiopathology; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005530:Foot Deformities / Q000209:etiology / Q000503:physiopathology*; D005684:Gait / Q000502:physiology; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans