Foot Morphology in Chinese School Children Varies by Sex and Age

BACKGROUND Knowledge of children's foot shape is essential for podiatric healthcare and footwear design. Differences in foot shapes relative to sex and age were demonstrated among white children; however, no study has examined the foot characteristics of Asian children according to sex and age. This study aimed to analyze the age- and sex-associated differences in foot measurements in Chinese children. MATERIAL AND METHODS We recruited 1240 boys and 1303 girls from China as participants for the present study. Foot dimensions were recorded by a video filming system, and 12 foot-shape measurements were acquired. One-way ANOVA was used to calculated the changes in measurements with age for boys and girls. Scores were analyzed as raw and normalized to foot length using the independent-samples t test. RESULTS Most measurements increased significantly at 7-8 and 8-9 years for girls and 8-9 and 10-11 years for boys. Arch height, instep length, and heel width showed greatest increases for both sexes ages 7-12 years (P<0.05). Sex differences in measurements mainly occurred at 8, 9, and 11 years. When we analyzed the normalized measurements of the same age children, instep length, heel width, ball girth, and instep girth were significantly different between boys and girls (P<0.05). CONCLUSIONS Sex- and age-associated differences were identified in the foot morphology of the Chinese school-aged children in this study. These differences should be considered when making clinical decisions about normal foot development and manufacturing shoes for Chinese school children.