Assessing pediatric foot deformities by pedobarography

Abstract

The majority of children's feet are considered as normal at birth but still may develop certain characteristics where a distinction between normal shape and foot deformity appears necessary, not only for addressing parents' concerns for their child's health and well-being but also to decide whether an intervention - be it conservative or surgical - is warranted. Therefore the natural development of children's feet should be monitored not only with visual and/or radiographical assessment but preferably also with functional assessment. There are several methods to assess foot function under dynamic loading conditions, one regularly applied method being pedobarography, i.e., the measurement of the plantar pressure distribution during gait. This method can be and has been used from infancy all the way to adolescence as it provides a detailed description and analysis of the local load distribution under the plantar aspect of the foot. The spatial resolution of the sensor area should be sufficient to identify the main loading areas even in the smaller feet of children, and the temporal resolution should be fast enough to provide sufficient detail for the various phases of the ground contact in dynamic loading situations. With a range of parameters, the local loading characteristics can be described for various regions of the foot. This allows for a detailed assessment of the individual's foot loading characteristics and for comparisons across the life-span. The present contribution aims to provide insights into the application of pedobarography as an assessment tool for normal children's feet as well as for pediatric foot deformities such as clubfeet, idiopathic flatfeet, and CMT feet, supported by demonstrations with appropriate examples.