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Reliability of pediobarographs for paediatric foot deformity

  • Original Clinical Article
  • Published:
Journal of Children's Orthopaedics

Abstract

Purpose

Dynamic pediobarograph measures foot–floor contact pressure during walking and provides a quantitative functional assessment. The goal of this study was to assess the reliability of pediobarograph measurements in normal children and in those with cerebral palsy (CP).

Materials and methods

During the first investigation, five non-disabled children and four with CP had three pediobarograph measurements taken of each foot, repeated five times. The pediobarographs were analysed by dividing the foot into five segments; the heel, the lateral midfoot, the medial midfoot, the lateral forefoot and the medial forefoot. A measure of valgus/varus foot posture was defined as the relative medial–lateral difference of combined mid- and forefoot impulse, named valgus/varus index. During the second investigation, 50 children (100 feet) with spastic diplegic CP were studied to calculate the standard error of measurements (SEM), to investigate the number of pediobarograph measurements necessary to obtain accurate results. The third investigation was an inter- and intraobserver study performed on one normal subject’s repeated measurements.

Results

In the first investigation, the group with CP had a significantly increased variability in the medial midfoot (P = 0.013). The variability of the valgus/varus index had a standard deviation of 13%, demonstrating that this measure is relatively stable. The SEM and 95% confidence interval from the second experiment showed that, even if the accuracy increased with the number of measurements, the greatest gain seemed to be contributed by increasing the number of measurements from 3 to 6. The inter- and intraobserver study showed good to mostly excellent agreement.

Conclusion

Pediobarograph measurements can be used to monitor and quantitatively assess the progressive changes of foot deformity over time. Pediobarograph is a reliable measurement that shows little variability between measurements at the same occasion and between measurements on different days. Three to six measurements seems practical and adequate to obtain. The technical aspect of measuring shows good repeatability and agreement between observers.

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References

  1. Bowen TR, Miller F, Castagno P, Richards J, Lipton G (1998) A method of dynamic foot-pressure measurement for the evaluation of pediatric orthopaedic foot deformities. J Pediatr Orthop 18:789–793

    CAS  Google Scholar 

  2. Chang CH, Miller F, Schuyler J (2002) Dynamic pedobarograph in evaluation of varus and valgus foot deformities. J Pediatr Orthop 22:813–818

    Google Scholar 

  3. Craxford AD, Minns RJ, Park C (1984) Plantar pressures and gait parameters: a study of foot shape and limb rotations in children. J Pediatr Orthop 4:477–481

    Article  CAS  Google Scholar 

  4. Liu XC, Thometz JG, Tassone C, Barker B, Lyon R (2005) Dynamic plantar pressure measurement for the normal subject: free-mapping model for the analysis of pediatric foot deformities. J Pediatr Orthop 25:103–106

    Google Scholar 

  5. Thometz JG, Liu XC, Tassone JC, Klein S (2005) Correlation of foot radiographs with foot function as analyzed by plantar pressure distribution. J Pediatr Orthop 25:249–252

    Article  Google Scholar 

  6. Armstrong DG, Lavery LA (1998) Plantar pressures are higher in diabetic patients following partial foot amputation. Ostomy Wound Manage 44:30–32, 34, 36 passim

    CAS  Google Scholar 

  7. Armstrong DG, Peters EJ, Athanasiou KA, Lavery LA (1998) Is there a critical level of plantar foot pressure to identify patients at risk for neuropathic foot ulceration? J Foot Ankle Surg 37:303–307

    Article  CAS  Google Scholar 

  8. Holmes GB Jr, Timmerman L (1990) A quantitative assessment of the effect of metatarsal pads on plantar pressures. Foot Ankle 11:141–145

    Article  Google Scholar 

  9. Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J, Boulton AJ (2003) Predictive value of foot pressure assessment as part of a population-based diabetes disease management program. Diabetes Care 26:1069–1073

    Article  Google Scholar 

  10. Minns RJ, Craxford AD (1984) Pressure under the forefoot in rheumatoid arthritis. A comparison of static and dynamic methods of assessment. Clin Orthop Relat Res Jul-Aug(187):235–242

  11. Singh N, Armstrong DG, Lipsky BA (2005) Preventing foot ulcers in patients with diabetes. JAMA 293:217–228

    Article  CAS  Google Scholar 

  12. Andreacchio A, Orellana CA, Miller F, Bowen TR (2000) Lateral column lengthening as treatment for planovalgus foot deformity in ambulatory children with spastic cerebral palsy. J Pediatr Orthop 20:501–505

    CAS  Google Scholar 

  13. Chang CH, Albarracin JP, Lipton GE, Miller F (2002) Long-term follow-up of surgery for equinovarus foot deformity in children with cerebral palsy. J Pediatr Orthop 22:792–799

    Google Scholar 

  14. Huber H, Dutoit M (2004) Dynamic foot-pressure measurement in the assessment of operatively treated clubfeet. J Bone Joint Surg Am 86-A:1203–1210

    Google Scholar 

  15. Metaxiotis D, Accles W, Pappas A, Doederlein L (2000) Dynamic pedobarography (DPB) in operative management of cavovarus foot deformity. Foot Ankle Int 21:935–947

    CAS  Google Scholar 

  16. Ahroni JH, Boyko EJ, Forsberg R (1998) Reliability of F-scan in-shoe measurements of plantar pressure. Foot Ankle Int 19:668–673

    Article  CAS  Google Scholar 

  17. Hennig EM, Staats A, Rosenbaum D (1994) Plantar pressure distribution patterns of young school children in comparison to adults. Foot Ankle Int 15:35–40

    Article  CAS  Google Scholar 

  18. Holmes GB Jr, Timmerman L, Willits NH (1991) Practical considerations for the use of the pedobarograph. Foot Ankle 12:105–108

    Article  Google Scholar 

  19. Mueller MJ, Strube MJ (1996) Generalizability of in-shoe peak pressure measures using the F-scan system. Clin Biomech (Bristol, Avon) 11:159–164

    Article  Google Scholar 

  20. Walker M, Fan HJ (1998) Relationship between foot pressure pattern and foot type. Foot Ankle Int 19:379–383

    Article  CAS  Google Scholar 

  21. McGraw K (1996) Psychological methods, pp 30–46

  22. Fleiss JL (1986) Confidence intervals vs significance tests: quantitative interpretation. Am J Public Health 76:587–588

    Article  CAS  Google Scholar 

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Conflict of interest

The authors received no grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organisation with which the authors are affiliated or associated.

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Authors and Affiliations

  1. Orthopedic Department, Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Jacques Riad & Freeman Miller

  2. Ädelstensvägen 3B, 541 42, Skövde, Sweden

    Jacques Riad

  3. Gait Laboratory, Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Scott Coleman & John Henley

Authors
  1. Jacques Riad
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  2. Scott Coleman
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  3. John Henley
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  4. Freeman Miller
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Corresponding author

Correspondence to Jacques Riad.

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All patients and subjects gave their consent to participate in the study.

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Cite this article

Riad, J., Coleman, S., Henley, J. et al. Reliability of pediobarographs for paediatric foot deformity. J Child Orthop 1, 307–312 (2007). https://doi.org/10.1007/s11832-007-0053-1

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  • DOI: https://doi.org/10.1007/s11832-007-0053-1

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