Would foot arch development in children characterize a body maturation process? A prospective longitudinal study

Area of Science:

• Pediatrics
• Orthopedics
• Biomechanical Engineering

Background:

• Flatfoot (Pes Planus) is common in children, causing parental concern due to the lack of predictive tests for arch development.
• This study addresses the need for a diagnostic criterion to understand flatfoot progression in pediatric populations.

Purpose of the Study:

• To analyze changes in the footprint index (Chippaux-Smirak index - CSI) during pediatric foot arch development.
• To identify predictive factors for developing a foot arch in children.
• To investigate if foot arch development is linked to overall body growth and maturation.

Main Methods:

• A prospective longitudinal study involving 572 children assessed at ages 6.7 and 8.2 years.
• Utilized the bimodal distribution of the Chippaux-Smirak index (CSI) to define flatfoot (CSI <0.58) and non-flatfoot (CSI >0.61).
• Compared anthropometric parameters and physical fitness between children who developed arches and those who remained flatfooted.

Main Results:

• Among 263 children initially diagnosed with flatfeet, 70 showed significant CSI changes (0.72 to 0.46) over 1.5 years, indicating arch development.
• Children developing arches had lower initial CSI, improved one-leg balance in boys, and less height increase in girls compared to persistent flatfoot cases.
• Sex and weight were similar between groups, suggesting other factors influence arch development.

Conclusions:

• The study highlights a specific maturational pattern in CSI changes, suggesting a developmental stage influences foot arch formation.
• The transition from flatfoot to non-flatfoot correlates with improved ankle motor control, evidenced by better one-leg balance.
• Foot arch development in children is associated with maturation and improved motor control, not solely body growth.