Article

Flat feet in children are common, and at times symptomatic, but the relationship
between function and symptoms or impairment is still unclear. We undertook a
prospective, observational study comparing children with paediatric flexible flat
foot (PFF) and children with neutral feet (NF) using three dimensional gait
analysis (3DGA). It was hypothesised that children with PFF would demonstrate
differences in both spatio-temporal parameters of gait and foot and ankle
kinematics compared to the NF group and that these differences would correlate
with impaired quality of life (QoL). The kinematic differences were expected to
be most marked in hindfoot coronal plane motion and forefoot sagittal and
transverse plane motion. Eighty-three children between the ages of 8 and 15 were
recruited in this study: Forty-two were classified as having PFF and forty-one as
NF. Each child underwent 3DGA and completed the Oxford Ankle Foot Questionnaire
for Children (OxAFQ_C). Reduced OxAFQ_C physical domain scores in the PFF
children were associated with slower walking speed (p=0.014) and reduced
normalised stride length (p=0.008). PFF children also demonstrated significantly
increased hindfoot eversion and forefoot supination during gait. Significant
differences between groups were not observed for other foot and ankle joint
motions. Increased maximum hindfoot eversion and increased forefoot supination
correlated strongly with lower QoL scores in PFF children. These data further our
understanding of the functional characteristics that lead to impaired QoL in PFF
children. These findings will help guide the surveillance and management of
children with this ubiquitous condition.
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