Longitudinal change in foot posture in children with cerebral palsy
C Church, N Lennon, R Alton… - Journal of …, 2017 - journals.sagepub.com
Journal of Children's Orthopaedics, 2017•journals.sagepub.com
Purpose Foot deformities are common in children with cerebral palsy (CP), yet the evolution
of such deformities is not well documented. We aimed to observe and analyse changes in
foot posture during growth in children with CP. Methods We followed 51 children (16
unilateral, 35 bilateral; 37 Gross Motor Function Classification Scale (GMFCS) I/II, 14 III/IV)
aged two to 12 years in this level II, IRB-approved prospective longitudinal study. Data after
bony foot corrections were excluded. Outcome measures included coronal plane pressure …
of such deformities is not well documented. We aimed to observe and analyse changes in
foot posture during growth in children with CP. Methods We followed 51 children (16
unilateral, 35 bilateral; 37 Gross Motor Function Classification Scale (GMFCS) I/II, 14 III/IV)
aged two to 12 years in this level II, IRB-approved prospective longitudinal study. Data after
bony foot corrections were excluded. Outcome measures included coronal plane pressure …
Purpose
Foot deformities are common in children with cerebral palsy (CP), yet the evolution of such deformities is not well documented. We aimed to observe and analyse changes in foot posture during growth in children with CP.
Methods
We followed 51 children (16 unilateral, 35 bilateral; 37 Gross Motor Function Classification Scale (GMFCS) I/II, 14 III/IV) aged two to 12 years in this level II, IRB-approved prospective longitudinal study. Data after bony foot corrections were excluded. Outcome measures included coronal plane pressure index (CPPI) and pressure impulses from the heel, medial midfoot and medial forefoot. Data were LOESS smoothed and resulting models were compared for significant differences across time using a derived FANOVA method.
Results
The GMFCS I/II group had more foot valgus than typically developing (TD) children until seven years which normalised thereafter. From two to 12 years, GMFCS III/IV children had more foot valgus than TD children. Heel impulse was significantly reduced in both GMFCS groups compared with TD children, and the III/IV group had less heel contact than the I/II group.
Conclusions
Due to early variability and the tendency for resolving valgus foot posture in children with CP, conservative management of coronal plane foot deformity is suggested in early childhood, especially for children classified as GMFCS I and II.
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