The effect of wearing shoes on the outcome of selected balance measures in children with typical development and with mild motor dysfunction

Stowell, Michelle (2020-03)

Thesis (MScPhysio)--Stellenbosch University, 2020.

Thesis

ENGLISH ABSTRACT : Balance is a critical motor skill essential for the development of functional performance. It is complex in nature as it involves many systems, namely the motor system, sensory system and central nervous system. As the human is bipedal, meaning we walk on two legs, the feet are an important factor as they form the base of support from which we balance. Wearing shoes affect development of feet and may affect balance. Current outcome measures for balance in children are indifferent as to wearing shoes or not. The primary aim of this study was to determine whether wearing shoes affects the scores of selected paediatric balance and motor function measures, namely the Paediatric Balance Scale (PBS) and the Bruininks-Oseretsky Test of Motor Proficiency (BOT-MP), and to determine whether this effect is greater in children with balance impairments compared to their age matched peers with typical development (TD). A descriptive, cross-sectional study design was used to determine the effect of wearing shoes on balance. Children four to ten years were recruited from five purposively selected schools in Johannesburg, South Africa. Children were included if they had been referred to physiotherapy or occupational therapy for balance, postural or gross motor concerns. These children were allocated to the mild motor dysfunction group. They were then matched for age and gender with their peers who had never been referred for physiotherapy or occupational therapy. All children were tested with shoes on and barefoot, using the BOT-MP and the PBS. The test scores were compared between groups and between outcome measures. Children had significantly better balance when wearing shoes compared to being barefoot when tested with the BOT-MP. This was found for both the typically developing group (p< 0.0001) and the group with mild motor dysfunction (p< 0.001). No significant difference was found when testing with the PBS within or between the groups. There was also a weak relationship between age and gender with older children having better balance and girls having better balance than boys of the same age. Based on this study, the effect of shoes was detectable in the BOT-MP however, not when using the PBS. This study concluded that wearing shoes may improve balance and practitioners should control for this when assessing balance in the clinical setting. This study also found that girls scored slightly better when matched to their male peers of the same age. This study also suggests that recommendations on which shoes should be worn to assist children who have poor balance should be developed as there are currently no clear guidelines for this.

AFRIKAANSE OPSOMMING : Balans is ‘n kritiese motoriese vaardigheid noodsaaklik vir die ontwikkeling van funksionele beweging. Dit is kompleks van aard en afhanklik van menige sisteme, naamlik die motoriese sisteem, sensoriese sisteem en die sentrale senuweestelsel. Die mens staan en loop op twee bene (bipedaal) en die voete speel ‘n kritiese rol met betrekking tot ondersteuning en balans. Skoene affekteer die ontwikkeling van die voete en dus dan ook die balans. Die huidige uitkomsmetings om balans te toets in kinders is onverskillig met betrekking tot die dra van skoene, aldan nie. Die primêre doel van die studie was om vas te stel of skoene dra die uitkoms van geselekteerde pediatriese balans- en motoriese vaardighede metings, naamlik die “Paediatric Balance Scale” (PBS) en die “Bruininks-Oseretsky Test of Motor Proficiency” (BOT-MP), sal beinvloed en om te bepaal of the effek groter is in kinders met balans probleme invergelyking met hulle ouderdom portuurgroep met tipiese/ normale ontwikkeling. `n Beskrywende deursnitstudie ontwerp is gebruik om die effek van skoene op kinders se balans te bepaal. Kinders tussen die ouderdom van vier tot tien jaar is gewerf van vyf doelgerig geselekteerde skole in Johannesburg, Suid-Afrika. Kinders was ingesluit as hul vir fisioterapie of arbeidsterapie verwys is, spesifiek vir balans, postuur of grof motoriese vaardigheidsproblem. Hierdie kinders het die minimaal motoriese disfunksie groep gevorm. Daarna is hulle gepaar met kinders van dieselfde ouderdom en geslag. Laasgenoemde is kinders wat nie voorheen verwys is vir fisioterapie of arbeidsterapie nie. Alle kinders is getoets op die BOT-MP en die PBS, met en sonder skoene. Die twee uitkomsmetings se balanstoetstellings is met mekaar vergelyk asook tussen die twee groepe kinders. Kinders het beduidend beter balans getoon op die BOT-MP met skoene aan invergelyking met toe hulle kaalvoet was. Die beduidende resultate is in beide groepe, naamlik die kinders met tipiese ontwikkeling (p< 0.0001) en kinders met minimale motoriese disfunksie (p< 0.001) gevind. Met die PBS is daar geen noemenswaardige verskil binne of tussen die groepe nie. Daar was `n swak korrelasie tussen ouderdom en geslag. Ouer kinders het beter balans as jonger kinders en dogters het beter balans as seuns in dieselfde ouderdomsgroep. Op grond van hierdie studie was die effek van skoene dra waarneembaar met die BOT-MP uitkomsmeting maar nie met die PBS nie. Hierdie studie het tot die gevolgtrekking gekom dat, skoene dra balans kan verbeter en dat terapeute dit in ag moet neem en daarvoor kontroleer wanneer hulle balans in kinders toets. Hierdie studie het ook gevind dat dogters beter balans het as seuns van dieselfde ouderdom. Hierdie studie stel ook voor dat riglyne ontwikkel word vir die voorskryf van skoen vir kinders met swak balans aangesien daar huidiglik geen duidelike riglyne is nie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/108277
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