Ali KELEŞ, Mehmet Tuğrul YILMAZ, Sevim AKDOĞAN, Meryem Esma DÜZ, Huriye Nur KANTAR, Duygu AKIN SAYGIN, Neslihan ALTUNTAŞ YILMAZ

3-10 YAŞINDAKİ ÇOCUKLARDA MEDİAL LONGİTUDUNAL ARKIN GELİŞİMİ

Amaç: Çocuklarda medial arkın gelişiminin takip edilmesi ve gelişim yetersizliği durumunda erken dönemde tespiti oldukça önemlidir. Bu çalışmanın amacı çocuklarda MLA gelişiminin ayak plantar temas alanı oranının ve basıncının yaş ile değişiminin araştırılarak belirlenmesidir. Gereç ve Yöntem: Çalışmamıza ayak taban basınç ölçüm cihazında değerlendirmesi yapılan randomizasyon yöntemi ile aileleri tarafından onamları alınmış 51 (16 kız, 35 erkek) sağlıklı çocuk (3-10 yaş) dahil edildi. Değerlendirme için ayağın ön kısmının medial ve laterali, orta kısmının medial ve laterali ve arka kısmının medial ve lateral olarak altıya ayrıldı. Çalışmamızda ayağın belirlenen bölgelerinin temas yüzeylerinin tüm ayak taban alanına göre oranı ve birim yüzeye düşen taban basınçları istatistiksel olarak yaşa göre değerlendirildi. Elde edilen veriler SPSS 11.0 paket programında tanımlayıcı istatistikler ve yüzdelik analizler ile incelendi. Bulgular: Yapılan istatistiksel analiz sonucunda sağ ve sol ayak bölgelerinin plantar basınç ve temas alan oran değerleri arasında istatistiksel olarak anlamlı fark bulunmadı (p>0,05). Plantar basınç değerinin yaşa göre analizinde ise sadece orta ayağın medialinde 3,4 ve 5 yaşlarının 9 ve 10. yaşlarla anlamlı fark çıkmamıştır (p>0,05). Plantar temas alan oranlarında ise; ayağın ön kısmının mediali ve ayağın arka kısmının lateralinde8 yaş üstünde anlamlı artış varken, ayağın orta kısmının medialinde anlamlı azalış dikkat çekmiştir (p<0,05). Sonuç: Elde ettiğimiz sonuçlara MLA gelişiminde 8 yaşın önemli olduğu ve arkın gelişmesiyle ayak temasının ayağın ön kısmının medialinden, ayağın arka kısmının lateraline aktarıldığı belirlenmiştir.

Anahtar Kelimeler:

çocuk, medial longitudinal ark, taban temas alan oranı, taban basıncı

Development of Medial Longitudunal Arc in Children Aged 3-10 Years

Purpose: It is very important to follow the development of the medial arch in children and to detect it in the early period in case of developmental deficiency. The aim of this study is to determine the development of medial arch in children by investigating the change in plantar contact area ratio and pressure with age. Materials and Methods: 51 (16 girls, 35 boys) healthy children (3-10 years old) whose consent was obtained by their families with the randomization method evaluated on the foot sole pressure measuring device were included in our study. For evaluation, medial and lateral of the anterior part of the foot, medial and lateral of the middle part, and medial and lateral of the posterior part of the foot were divided into six. In our study, the ratio of the contact surfaces of the determined areas of the foot to the entire foot sole area and the sole pressure per unit surface were statistically evaluated according to age. The obtained data were analyzed with descriptive statistics and percentage analyzes in the SPSS 11 package program. Results: As a result of the statistical analysis, no statistically significant difference was found between the plantar pressure and contact area ratio values of the right and left foot regions (p>0.05). In the analysis of the plantar pressure value according to age, there was no significant difference between the 9th and 10th ages of 3,4 and 5 years of age only in the medial of the midfoot (p>0.05). In plantar contact area ratios; While there was a significant increase in the medial part of the anterior part of the foot and the lateral part of the posterior part of the foot above the age of 8, there was a significant decrease in the medial part of the middle part of the foot (p<0.05). Conclusion: According to the results we obtained, it was determined that 8 years of age is important in the development of MLA and with the development of the arch, foot contact is transferred from the medial of the anterior part of the foot to the lateral part of the posterior part of the foot.

Keywords:

child, medial longitudunal arch, base contact area ratio, base pressure,

PDF

___

Hillstrom HJ, Song C, Kraszewski AP, et al. Foot type biomechanics part 1: structure and function of the asymptomatic foot. Gait & posture 2013;37(3): 445-451.
Bertsch C, Unger H, Winkelmann W,et al. Evaluation of early walking patterns from plantar pressure distribution measurements. First year results of 42 children. Gait & posture 2004;19(3): 235-242.
Halabchi F, Mazaheri R, Mirshahi M, Abbasian L. Pediatric flexible flatfoot; clinical aspects and algorithmic approach. Iranian journal of pediatrics 2013;23(3): 247.
Mosca VS. The cavus foot. Journal of Pediatric Orthopaedics 2001; 21(4): 423-424.
Sacco IC, Onodera AN, Bosch K, Rosenbaum D. Comparisons of foot anthropometry and plantar arch indices between German and Brazilian children. BMC pediatrics 2015;15(1): 1-6.
Delgado-Abellán L, Aguado X, Jiménez-Ormeño E, Mecerreyes L, Alegre LM. Foot morphology in Spanish school children according to sex and age. Ergonomics 2014; 57(5): 787-797.
Bosch K, Gerss J, Rosenbaum D. Development of healthy children's feet—nine-year results of a longitudinal investigation of plantar loading patterns. Gait & posture 2010;32(4): 564-571.
Hennig EM, Staats A, Rosenbaum D. Plantar pressure distribution patterns of young school children in comparison to adults. Foot & ankle international 1994;15(1): 35-40.
Müller S, Carlsohn A, Müller J, Baur H, Mayer F.Static and dynamic foot characteristics in children aged 1–13 years: a cross-sectional study. Gait & posture 2012;35(3): 389-394.
Hotfiel T, Carl HD, Wendler F, Jendrissek A, Heiß R, Swoboda B. Plantar pressures increase with raising body weight: A standardised approach with paired sample using neutral shoes. Journal of back and musculoskeletal rehabilitation 2017;30(3): 583-589.
Lasse H, Pape JP, Kostakev M, Peterlein C.Pedobarographic changes during first month after subtalar extra-articular screw arthroereisis (SESA) operation of juvenile flexible flatfoot. Arch Orthop Trauma Surg 2020;140(3): 313-320.
Williams DS, IS McClay, J Hamill et al. Lower extremity kinematic and kinetic differences in runners with high and low arches. Journal of applied biomechanics 2001; 17(2): 153-163.
Melai T, IJzerman H, Schaper NC et al. Calculation of plantar pressure time integral, an alternative approach. Gait & posture 2011;34(3): 379-383.
Bek N. Çocukluklarda Ayak Gelişimini ve Deformite Oluşumunu Etkileyen Faktörler. Ankara Sağlık Hizmetleri Dergisi 2010; 9(1): 25-30.
Tuna H. Pedobarographic Evaluation in Foot Disorders. Turk J Phys Med Rehab 2005;51: 51-54.
Ortega FB, Artero EG, Ruiz JR et al. Physical fitness levels among European adolescents: the HELENA study. British journal of sports medicine 2011;45(1): 20-29.
Kasović M, Štefan L, Zvonár M. Foot characteristics during walking in 6-14- year-old children. Scıentıfıc Reports 2020;11(10 (1)).
Kellis E. Plantar pressure distribution during barefoot standing, walking and landing in preschool boys. Gait & posture; 2001. 14(2): 92-97.
Mickle KJ, Cliff DP, Munro BJ, Okely AD, Steele JR. Relationship between plantar pressures, physical activity and sedentariness among preschool children. Journal of Science and Medicine in Sport 2011;14(1): 36-41.
Riddiford-Harland DL, Steele JR, Cliff DP et al. Lower activity levels are related to higher plantar pressures in overweight children. Medicine and science in sports and exercise 2015; 47(2): 357-362.
Kothari A, Bhuva S, Stebbins J, Zavatsky AB, Theologis T. An investigation into the aetiology of flexible flat feet: the role of subtalar joint morphology. The bone & joint journal 2016; 98(4): 564-568.
Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M. Prevalence of flat foot in preschool-aged children. Pediatrics 2006; 118(2): 634-639.
Sivaslı E, Bozkurt Aİ, Özçırpıcı B, Şahinöz S, Coşkun Y. Gaziantep yöresinde 7-15 yaşındaki çocuklarda vücut kitle indeksi referans değerleri. Çocuk sağlığı ve hastalıkları dergisi 2006; 49: 30-35.