HAKAN TUNA, Mustafa YILDIZ, COŞKUN ÇELTİK, Siranuş KOKİNO

Ergenlik dönemindeki çocuklarda statik ve dinamik ayak basınç değerleri

Amaç: Türk toplumunda ergenlik dönemi yaş grubunun statik ve dinamik pedobarografik normal verilerinin belirlenmesi ve bu değerler ile demografik veriler arasındaki ilişkilerin araştırılması amaçlandı. Çalışma planı: Çalışmaya, AOFAS'nin (American Orthopaedic Foot and Ankle Society) ayak bileği ve ayak klinik değerlendirme sistemiyle sağlıklı ayağa sahip oldukları belirlenen 50 gönüllü (25 kız, 25 erkek, ört. yaş 14; dağılım 13-15) alındı. Tüm olguların statik ve dinamik ayak basınçları Mini-Emed pedobarografi cihazı kullanılarak ölçüldü. Sonuçlar: Statik ölçümlerde kızlarda sağ ayağın ön-orta ve parmak kısımlarının, erkeklerde ise sol ayağın orta kısmının pedobarografik değerleri belirgin olarak diğer cinsten yüksekti (p

Anahtar Kelimeler:

Cinsiyet faktörleri, Vücut ağırlığı, Yürüyüş şekli, Ergen, Ayak, Podiatri

Static and dynamic pressure measurements in adolescents

Objectives: This study was designed to determine normal values of pedobarography during standing and walking in adolescents in our country and to investigate correlations between demographic data and pedobarographic values. Methods: Fifty volunteers (25 girls, 25 boys; mean age 14 years; range 13 to 15 years) who were found to have healthy foot according to the AOFAS (American Orthopaedic Foot and Ankle Society) clinical rating system for the ankle and foot were enrolled into the study. Plantar pressures were measured during standing and walking tasks with the use of the Mini-Emed pedobarographic device. Results: Static measurements showed significantly higher pedobarographic values for right medial forefoot and toes in girls, and for left midfoot in boys (p<0.05). Overall, no signif-icant differences existed between static pressure values for the right and left feet. The mean right medial foot pressure was higher than that of the contralateral foot in girls. There were no significant differences between the right and left feet in boys. Dynamic measurements showed a significantly larger contact area of the right foot in boys, and a significantly higher maximum plantar pressure of the left medial forefoot in girls (p<0.05). The strength of the correlation of body weight and body mass index was high with maximum plantar pressures (r=0.87 and r=0.83), and moderate with contact area of the foot (r=0.63 and r=0.59) in static measurements. Body weight (r=0.64) and body mass index (r=0.54) were moderately correlated with contact area of the foot in dynamic measurements. Conclusion: Appreciation of normal plantar pressure values in adolescents is important in monitoring the development stages of foot, in the assessment of foot disorders, and in making proper footwear modifications in compliance with age.

Keywords:

Sex Factors, Body Weight, Gait, Adolescent, Foot, Podiatry,

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1.Cavanagh PR, Ulbrecht JS, Zanine W, Welling RL, Leschinsky D, van Schie C. A method for the investigation of the effects of outsole modifications in therapeutic footwear. Foot Ankle Int 1996;17:706-8.
2. Orlin MN, McPoil TG. Plantar pressure assessment. Phys Ther 2000;80:399-409.
3. Aharonson Z, Voloshin A, Steinbach TV, Brull MA, Farine I. Normal foot-ground pressure pattern in children. Clin Orthop 1980;(150):220-3.
4. Hennig EM, Rosenbaum D. Pressure distribution patterns under the feet of children in comparison with adults. Foot Ankle 1991;11:306-11.
5. Hennig EM, Staats A, Rosenbaum D. Plantar pressure distribution patterns of young school children in comparison to adults. Foot Ankle Int 1994;15:35-40.
6. Bennett PJ, Duplock LR. Pressure distribution beneath the human foot. J Am Podiatr Med Assoc 1993;83:674-8.
7.Kellis E. Plantar pressure distribution during barefoot standing, walking and landing in preschool boys. Gait Posture 2001;14:92-7.
8. Craxford AD, Minns RJ, Park C. Plantar pressures and gait parameters: a study of foot shape and limb rotations in children. J Pediatr Orthop 1984;4:477-81.
9. Kamegaya M, Shinohara Y. Gait disorders and leg deformities in children. J Orthop Sci 2002;7:154-9.
10. Cailliet R. Foot and ankle pain. 3rd ed. Philadelphia: FA Davis; 1997.
11. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 1994; 15:349-53.
12. Operating Manual Mini-Emed System. Munich: Novel; 1991.
13. Özaras N, Yalçın S. Normal yürüme. In: Özaras N, editör. Yürüme analizi. 1. baskı.İstanbul: Avrupa Tıp Kitapçılık; 2001. s. 1-23.
14. Malouin F, Richards CL. Preparatory adjustments during gait initiation in 4-6-year-old children. Gait Posture 2000;11: 239-53.
15. Davitt JS, MacWilliams BA, Armstrong PF. Plantar pressure and radiographic changes after distal calcaneal lengthening in children and adolescents. J Pediatr Orthop 2001;21:70-5.
16. Kapandji IA. The physiology of the joints. 2nd ed. Edinburg: Churchill Livingstone; 1970.
17. Kanatli U, Yetkin H, Bolukbasi S. Evaluation of the transverse metatarsal arch of the foot with gait analysis. Arch Orthop Trauma Surg 2003;123:148-50.
18. Femery V, Moretto P, Renaut H, Thevenon A, Lensel G. Measurement of plantar pressure distribution in hemiplegic children: changes to adaptative gait patterns in accordance with deficiency. Clin Biomech 2002;17:406-13.
19. Günel U, Korkusuz F. Ayak ve ayak bileğinin biyomekaniği. In: Ege R, editör. Ayak ve ayak bileği sorunları. 2. baskı. Ankara: Türk Hava Kurumu Basımevi; 1999. s. 47-68.
20. Rozema A, Ulbrecht JS, Pammer SE, Cavanagh PR. In-shoe plantar pressures during activities of daily living: implications for therapeutic footwear design. Foot Ankle Int 1996;17:352-9.