Is in-toing gait physiological in children?
- Research question: This study aimed to establish reference values in 1-14 year old healthy children and to implement FPA-percentile curves for daily clinical use. Methods: 5910 healthy children performed at least 3 repetitions of barefoot walking over an instrumented walkway using a pressure measurement platform. The FPA [degrees] was extracted and analyzed by age and gender (mean +/- standard deviation; median with percentiles, MANOVA (age, gender) and Wilcoxon-Signed-Rank test for intra-individual side differences (alpha = 0.05). Results: FPA maximum was observed in 2-year-old children and diminished significant until the age of 4 to moderate out-toeing. For ages 5-14, no statistically significant differences in FPA values were present (p > 0.05). MANOVA confirmed age (p < 0.001) and gender (p < 0.001) as significant FPA influencing factors, without combined effect (p > 0.05). In every age group, right feet showed significantly greater out-toeing (p < 0.05). Significance: Percentile values indicate a wide FPA range in children. FPAResearch question: This study aimed to establish reference values in 1-14 year old healthy children and to implement FPA-percentile curves for daily clinical use. Methods: 5910 healthy children performed at least 3 repetitions of barefoot walking over an instrumented walkway using a pressure measurement platform. The FPA [degrees] was extracted and analyzed by age and gender (mean +/- standard deviation; median with percentiles, MANOVA (age, gender) and Wilcoxon-Signed-Rank test for intra-individual side differences (alpha = 0.05). Results: FPA maximum was observed in 2-year-old children and diminished significant until the age of 4 to moderate out-toeing. For ages 5-14, no statistically significant differences in FPA values were present (p > 0.05). MANOVA confirmed age (p < 0.001) and gender (p < 0.001) as significant FPA influencing factors, without combined effect (p > 0.05). In every age group, right feet showed significantly greater out-toeing (p < 0.05). Significance: Percentile values indicate a wide FPA range in children. FPA development in young children shows a spontaneous shift towards moderate external rotation (age 2-4), whereby in-toeing <= 1-5 degrees can be present, but can return to normal. Bilateral in-toeing after the age of four and unilateral in-toeing after the age of seven should be monitored.…
Author details: | Ronald VerchORCiDGND, Anja HirschmüllerORCiDGND, Juliane Müller, Heiner BaurORCiDGND, Frank MayerORCiDGND, Steffen Müller |
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DOI: | https://doi.org/10.1016/j.gaitpost.2018.08.019 |
ISSN: | 0966-6362 |
ISSN: | 1879-2219 |
Pubmed ID: | https://pubmed.ncbi.nlm.nih.gov/30170136 |
Title of parent work (English): | Gait & posture |
Subtitle (English): | Results of a large cohort study in 5910 healthy (pre-) school children |
Publisher: | Elsevier |
Place of publishing: | Clare |
Publication type: | Article |
Language: | English |
Year of first publication: | 2018 |
Publication year: | 2018 |
Release date: | 2021/09/22 |
Tag: | Children; Foot progression angle; Gait; In-toeing; Out-toeing |
Volume: | 66 |
Number of pages: | 6 |
First page: | 70 |
Last Page: | 75 |
Funding institution: | Federation of the German Footwear Industry (HDS, Offenbach, Germany); Ricosta Schuhfabriken GmbH (Donaueschingen, Germany); University of Potsdam (Potsdam, Germany) |
Organizational units: | Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Sport- und Gesundheitswissenschaften |
DDC classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |