Related Experiment Video
Updated: Mar 25, 2026
Evaluating the Function of the Foot Core System in the Elderly
Published on: March 11, 2022
Medial Longitudinal Arch Development of Children Aged 7 to 9 Years: Longitudinal Investigation
1J.W.K. Tong, PhD, Allied Health Specialties, KK Women's and Children's Hospital, Singapore and Physical Education and Sports Science Academic Group, Nanyang Technological University, Singapore.
Background:
It is unclear at what age the medial longitudinal arch (MLA) of the foot becomes stable in children. The influence of footwear on MLA development also is unknown.
Objective:
The purpose of this study was to examine the MLA development of children using a longitudinal approach. The relationship between wearing different types of footwear and MLA development also was explored longitudinally.
Design:
This was a longitudinal cohort observational study.
Methods:
The MLA of 111 healthy children (mean age=6.9 years, SD=0.3) was evaluated using 3 parameters (arch index [AI], midfoot peak pressure [PP], and maximum force [MF]) extracted from dynamic foot loading measurements at baseline (t0), 10-month follow-up (t1), and 22-month follow-up (t2). Information on footwear usage was surveyed. Linear mixed modeling was used to test for differences in MLA over time.
Results:
The MLA of the children remained stable over time (AI: t0/t1/t2=0.25 [95% confidence interval (CI)=0.24, 0.26]/0.25 [95% CI=0.24, 0.26]/0.25 [95% CI=0.24, 0.26]; P=.95). When the children's sex was considered, the AI of boys decreased (higher arch) with age (0.26 [95% CI=0.24, 0.27]/0.25 [95% CI=0.24, 0.27]/0.25 [95% CI=0.23, 0.27]; P=.02). Boys also displayed a flatter MLA than girls at age 6.9 years (AI: mean difference=0.02 [95% CI=0.01, 0.04]; P=.02). At baseline, children who wore closed-toe shoes displayed the lowest MLA overall (AI: closed-toe shoes/sandals/slippers=0.26 [95% CI=0.24, 0.28]/0.24 [95% CI=0.23, 0.25]/0.25 [95% CI=0.24, 0.26]; P<.01). Children who used slippers at toddlers' age experienced a higher PP (flatter arch) in later childhood than those who wore sandals (mean difference=31.60 kPa [95% CI=1.44, 61.75]; post hoc P=.04).
Limitations:
Information on the type of footwear worn was self-reported and, therefore, may be subjected to recall bias.
Conclusions:
The MLA of children remained stable from 7 to 9 years of age. The child's sex and the type of footwear worn during childhood may influence MLA development.
Related Concept Videos
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:07Development of the Limb Synovial Joints
The mesenchymal stem cells differentiate into chondrocytes that form the hyaline cartilage, and later the cartilaginous model of the bone. This model further transforms into a bone. This process is known as endochondral ossification.
During development, the limbs...
01:10Ankle Joint
01:10Bones of the Lower Limb: Tibia and Fibula
01:24Bone Formation by Endochondral Ossification