Assessing Clubfoot and Cerebral Palsy by Pedobarography

Reference work entry

Abstract

The use of pedobarography to assess foot deformity in children with cerebral palsy or clubfoot is becoming increasingly prevalent. Given the unique challenges posed by these populations, it is critical that a standardized protocol is used when collecting pressure data. A number of factors need to be considered when developing such a protocol, including the physical setup of the system, as well as the process for acquiring the data. Currently, pedobarography is used in four broad areas for children with foot deformity, including assessing the efficacy of specific interventions, classification of feet into specific categories, correlation of findings with other measurement modalities, and characterization of different groups of patients. In order to reliably use pressure data to aid treatment planning, further research is required to link pressure findings to specific clinical and functional limitations in children with foot deformity. In addition, the predictive value of pedobarography in terms of treatment outcomes is yet to be established. It is recommended that future work focus on these key areas.

Keywords

Cerebral palsy Clubfoot Pedobarography Plantar pressure Foot deformity Children 

References

  1. Abousamra O et al (2015) The effect of plantar flexor lengthening on foot pressure in children with cerebral palsy. Gait Posture 42:S15CrossRefGoogle Scholar
  2. Bennett D et al (2007) Use of a dynamic foot pressure index to monitor the effects of treatment for equinus gait in children with cerebral palsy. J Pediatr Orthop 27:288–294CrossRefGoogle Scholar
  3. Bensahel H et al (1987) Surgery in residual clubfoot: one-stage medioposterior release. J Pediatr Orthop 7:145–148CrossRefGoogle Scholar
  4. Bus SA, Valk GD (2008) The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review. Diabetes Metab Res Rev 24:162–180CrossRefGoogle Scholar
  5. Chang HC, Miller F, Schuyler J (2002) Dynamic pedobarograph in evaluation of varus and valgus foot deformities. J Pediatr Orthop 22:813–818Google Scholar
  6. Cooper A et al (2014) The contralateral foot in children with unilateral clubfoot, is the unaffected side normal? Gait Posture 40:375–380CrossRefGoogle Scholar
  7. El-Shamy SM et al (2013) Effect of neuromuscular electrical stimulation on foot pressure distribution in congenital clubfoot. J Am Sci 699(6):178–183, Available at: http://www.jofamericanscience.orgGoogle Scholar
  8. Favre P et al (2007) The contralateral foot in children with unilateral clubfoot a study of pressures and forces involved in gait. J Pediatr Orthop 27:54–59CrossRefGoogle Scholar
  9. Femery V et al (2002) Measurement of plantar pressure distribution in hemiplegic children: changes to adaptive gait patterns in accordance with deficiency. Clin Biomech 17:406–413CrossRefGoogle Scholar
  10. Hee TH, Hin L, Lee GS (2001) Gait and pedobarographic patterns of surgically treated clubfeet. J Foot Ankle Surg 40(5):287–294CrossRefGoogle Scholar
  11. Henn FR et al (2008) Subtalar release in clubfeet: a retrospective study of 10-year outcomes. Foot Ankle Int 29(4):390–395CrossRefGoogle Scholar
  12. Herd F, Macnicol M, Abboud RJ (2004) The need for biomechanical evaluation in the assessment of clubfoot. Foot 14:72–76CrossRefGoogle Scholar
  13. Herd F et al (2008) Foot pressure in clubfoot-the development of an objective assessment tool. Foot 18:99–105CrossRefGoogle Scholar
  14. Holt JB et al (2015) Long-term results of tibialis anterior tendon transfer for relapsed idiopathic clubfoot treated with the ponseti method a follow-up of thirty-seven to fifty-five years. J Bone Joint Surg (Am) 97:47–55CrossRefGoogle Scholar
  15. Huber H, Dutoit M (2004) Dynamic foot-pressure measurement in the assessment of operatively treated clubfeet. J Bone Joint Surg (Am) 86-A(6):1203–1210CrossRefGoogle Scholar
  16. Jeans KA, Karol LA (2010) Plantar pressures following ponseti and French physiotherapy methods for clubfoot. J Pediatr Orthop 30:82–89CrossRefGoogle Scholar
  17. Jeans KA et al (2014) Plantar pressures following anterior tibialis tendon transfers in children with clubfoot from the texas scottish rite hospital for children. J Pediatr Orthop 34:552–558CrossRefGoogle Scholar
  18. Kadhim M, Miller F (2014) Crouch gait changes after planovalgus foot deformity correction in ambulatory children with cerebral palsy. Gait Posture 39:793–798CrossRefGoogle Scholar
  19. Kadhim M, Holmes L, Church C et al (2012a) Pes planovalgus deformity surgical correction in ambulatory children with cerebral palsy. J Child Orthop 6:217–227CrossRefGoogle Scholar
  20. Kadhim M, Holmes L, Miller F (2012b) Correlation of radiographic and pedobarograph measurements in planovalgus foot deformity. Gait Posture 36:177–181CrossRefGoogle Scholar
  21. Kothari A et al (2014) Health-related quality of life in children with flexible flatfeet: a cross-sectional study. J Child Orthop 8(6):489–496CrossRefGoogle Scholar
  22. Kothari A et al (2015) Gait & posture the relationship between quality of life and foot function in children with flexible flatfeet. Gait Posture 41(3):786–790, Available at:  https://doi.org/10.1016/j.gaitpost.2015.02.012
  23. Liu X et al (1999) Dynamic plantar pressure in the treated clubfoot: an orthopaedic engineering 460 study. In: First joint BMES/EMBS conference, IEEE Xplore. Engineering in Medicine and Biology - Proceedings of t meeting of Biomedical Engineering Society, p 527.  https://doi.org/10.2209/IEMBS.1999.802605.
  24. MacWilliams BA, Armstrong PF (2000) Clinical applications of plantar pressure measurement in pediatric orthopedics. In: Pediatric gait, 2000. A new millennium in clinical care and motion analysis technology. Chicago, pp 143–150.  https://doi.org/10.1109/PG.2000.858886
  25. Oto M et al (2011) Correlation between selective pedobarographic and radiographic measures in the assessment of surgically treated CTEV patients. Joint Dis Relat Res 22(3):145–148Google Scholar
  26. Park ES et al (2006) Dynamic foot pressure measurements for assessing foot deformity in persons with spastic cerebral palsy. Arch Phys Med Rehabil 87:703–708CrossRefGoogle Scholar
  27. Park KB et al (2008) Changes in dynamic foot pressure after surgical treatment of valgus deformity of the hindfoot in cerebral palsy. J Bone Joint Surg (Am) 90:1712–1721CrossRefGoogle Scholar
  28. Ramanathan AK et al (2009) A new scoring system for the evaluation of clubfoot: the IMAR-Clubfoot scale. Foot 19:156–160CrossRefGoogle Scholar
  29. Riad J et al (2007) Reliability of pediobarographs for paediatric foot deformity. J Child Orthop 1:307–312CrossRefGoogle Scholar
  30. Riad J, Henley J, Miller F (2009) Does footprint and foot progression matter for ankle power generation in spastic hemiplegic cerebral palsy? Acta Orthop Traumatol Turc 43(2):128–134CrossRefGoogle Scholar
  31. Salazar-Torres JJ et al (2014) Plantar pressures in children with congenital talipes equino varus-A comparison between surgical management and the Ponseti technique. Gait Posture 39:321–327CrossRefGoogle Scholar
  32. Sinclair MF et al (2009) Pedobarographic analysis following ponseti treatment for congenital clubfoot. Clin Orthop Relat Res 467:1223–1230CrossRefGoogle Scholar
  33. Son SM, Park IS, Yoo JS (2015) Short-term effect of botulinum toxin a injection on spastic equinovarus foot in cerebral palsy patients: a study using the foot pressure measurement system. Ann Rehabil Med 39(1):1–9CrossRefGoogle Scholar
  34. Stebbins J, Giacomozzi C (2012) Clinical relevance of anatomy-based plantar pressure analysis in clubfoot. In: Proceedings of expert scientific meeting. http://novel.de/novelcontent/images/files/ESM-2012_proceedings-abstracts.pdf.
  35. Stebbins JA et al (2005) Assessment of sub-division of plantar pressure measurement in children. Gait Posture 22:372–376CrossRefGoogle Scholar
  36. Stebbins J et al (2006) Repeatability of a model for measuring multi-segment foot kinematics in children. Gait Posture 23:401–410MathSciNetCrossRefGoogle Scholar
  37. Stebbins J, Way L, Giacomozzi C (2014) Integrating pressure and motion capture to assess deviations from normal in the clubfoot population. Gait and Posture 42 (Suppl 3):S28–S29Google Scholar
  38. Thometz JG et al (2005) Correlation of foot radiographs with foot function as analyzed by plantar pressure distribution. J Pediatr Orthop 25(2):249–252Google Scholar
  39. Van Der Leeden M et al (2006) Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristics. Rheumatology 45:465–469CrossRefGoogle Scholar
  40. Van Der Leeden M et al (2016) Reproducibility of plantar pressure measurements in patients with chronic arthritis: a comparison of one-step, two-step, and three-step protocols and an estimate of the number of measurements required. Foot Ankle Int 25(10):739–744CrossRefGoogle Scholar
  41. Wearing SC et al (1999) Technical note a comparison of gait initiation and termination methods for obtaining plantar foot pressures. Gait Posture 10:255–263CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Oxford Gait Laboratory, Oxford University Hospitals NHS Foundation TrustOxfordUK
  2. 2.Nuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, University of OxfordOxfordUK

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