Foot posture in school children from the Western Cape: Differences between footwear use, gender and race

Mathewson, Elizabeth (2016-12)

Thesis (M Sport Sc)--Stellenbosch University, 2016

Thesis

ENGLISH ABSTRACT : The feet of children are sensitive to external forces as the ligaments, muscles and bones are still in the process of maturing. The arch develops naturally within the first ten years of life. This research study reports on the factors affecting foot posture and plantar pressure parameters by describing the differences between boys and girls, age groups, and race in South-Africa, as well as the differences between South-African and German children. A cross-sectional descriptive study where quantitative data were collected was used as the primary research method for this research study. Stratified randomised samples were selected consisting of 516 South-African children and 214 German children between the ages of six to eighteen years old. Testing equipment utilised include a manufactured foot calliper, as well as an EMED-SF® pressure plate. A barefoot scale was used to quantify the footwear habits of participants. A physical activity questionnaire developed specifically for older children (PAQ-C) and for adolescence (PAQ-A), were used to evaluate the physical activity level of the participants. Within the South-African sample, no significant differences were found in foot posture between boys and girls. Younger children had significantly lower arches in terms of the dynamic arch index (DAI) (younger than ten: 1.045 (0.030), older than ten: 1.041 (0.026)) (p = 0.025), as well as increased pliability values. Children younger than ten years old presented with greatest peak pressure under the medial heel, while children older than ten years old presented with greatest peak pressure under the big toe. When comparing the DAI of white South-African children (0.171 (0.069)) (p = 0.000) to that of mixed race South-African children (0.196 (0/067)), it is clear that the mixed race children have flattened arches compared to the white children. Mixed race children presented with more pliable feet (1.050 (0.030)) compared to white children (1.040 (0.026)) (p = 0.000), as well as a decreased contact area in all regions of the foot, except for the medial midfoot, as they have greater medial midfoot contact (p < 0.05). South African children had greater peak pressure in the medial forefoot and medial midfoot, as well as the big toe and toes two to five compared to German children (p < 0.05). Maximum force, was significantly greater for South-African children in all regions of the foot compared to German children except for the medial and lateral midfoot as well as the lateral forefoot (p < 0.05). The most significant differences were observed between children of different races. Mixed race children presented with lowered arches, more pliable feet and more dispersed peak pressures. With regards to the intercontinental results, South-African children load their feet more medially with increased gripping of the toes. The increased pressure-time integral in German children puts them at an increased risk of developing foot pain.

AFRIKAANSE OPSOMMING : Die voete van kinders is sensitief teen eksterne kragte wat daarop inwerk. Die ligamente, spiere en bene in die voet is nog in die proses van ontwikkeling en nog nie ten volle volwasse nie. Die voetbrug ontwikkel spontaan binne die eerste tien jaar. Hierdie navorsingsstudie rapporteer die verskille in voetstruktuur en druk onder die voet tussen seuns en meisies, tussen verskillende ouderdomsgroepe en rasse in Suid-Afrika, sowel as verskille tussen Suid-Afrikaanse en Duitse kinders. Die studie is ‘n deursnee-studie waar kwantitatiewe data ingesamel is. ‘n Gestratifiseerde ewekansige steekproef van 516 Suid-Afrikaanse en 214 Duitse kinders tussen die ouderdom van ses en agtien jaar was gebruik. Die toerusting wat gebruik is, sluit ‘n vervaardigde meetpasser sowel as ‘n EMED-SF® druk platvorm in. ’n Kaalvoet vraelys is aan die deelnemers gegee, waar hul gewoontes van skoene dra aangedui word. ‘n Fisiese aktiwiteitsvraelys wat spesifiek vir ouer kinders (PAQ-C) en vir adolessente (PAQ-A) ontwikkel is, was gebruik om die kinders se fisiese aktiwiteitsgewoontes te bepaal. In die Suid-Afrikaanse steekproef, was geen beduidende verskille gesien in voetstruktuur tussen die seuns en die meisies nie. Kinders jonger as tien jaar oud het beduidend laer voet brûe met ‘n brug-indeks van 0.257 (0.021) en ‘n dinamiese brug-indeks van 0.188 (0.066), sowel as meer buigsaamheid (1.045 (0.030)). Kinders jonger as tien jaar oud, toon die hoogste piek druk onder die mediale hak, terwyl kinders ouer as tien jaar die hoogste piek druk onder die groottoon aandui. Wanneer die Suid-Afrikaanse wit kinders met die Suid-Afrikaanse gemende ras kinders vergelyk word, is daar bepaal dat gemende ras kinders laer voet brûe getoon het in die dinamiese brug-indeks ((0.196 (0/067))(p = 0.000) in vergelyking met wit kinders (dinamiese brug-indeks: 0.171 (0.069))). Gemengde ras kinders het meer buigsaamheid getoon (1.050 (0.030))(p = 0.000) in vergelyking met wit kinders (buigsaamheid: 1.040 (0.026)), sowel as minder piek druk in al die areas van die voet, behalwe die mediale midvoet, want hul het ‘n groter kontakoppervlak van die mediale midvoet. Wanneer die Suid-Afrikaanse kinders met die Duitse kinders vergelyk is, was dit duidelik dat die Suid-Afrikaanse kinders hoër druk onder die mediale voorvoet en mediale midvoet, sowel as die druk onder die groottoon en die tweede tot vyfde toon ondervind het (p < 0.05). Maksimum druk was beduidend hoër vir Suid-Afrikaanse kinders in alle areas van die voet behawe die laterale en mediale midvoet en die laterale voorvoet, in vergelyking met Duitse kinders (p < 0.05). Die mees beduidende verskil in die Suid-Afrikaanse steekproef was tussen die twee rasse. Kinders van gemengde ras het laer voetbrûe getoon, meer buigsaamheid en meer verspreide piek druk waardes. Met betrekking tot die interkontinentale resultate, was getoon dat Suid-Afrikaanse kinders hul voete meer mediaal belaai. Hul gebruik ook hul tone meer vir ‘n beter greep. Verhoogde druk-tyd intergaal in die Duitse kinders kan lei tot ‘n groter risiko vir die ontwikkeling van voetpyn.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/100327
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