Longitudinal study of foot pressures during real-world walking as infants develop from new to confident walkers |
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| Institution: | 1. School of Health and Society, University of Salford, Frederick Road Campus, Salford, UK;2. School of Health Sciences, University of Brighton, Darley Road Campus, Eastbourne, UK;1. School of Podiatry, Marseille, France;2. School of Health Sciences, Brian Blatchford Building, University of Salford, Salford M6 6PU, England, United Kingdom;3. LBA, IFSTTAR, Aix-Marseille University, Marseille, France;4. MD DS-ACI UMR MD2, Aix-Marseille University, Marseille, France;1. Shanghai University of Sport, School of Physical Education and Sport Training, Shanghai, China;2. Suzhou Early Childhood Education College, Suzhou, Jiangsu Province, China;3. Huangqiao Central Kindergarten, Suzhou, Jiangsu Province, China;4. Department of Physical Education, Sanda University, Shanghai, China;5. Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai, China;1. University Bonn, Institute of Finance and Statistics, Adenauerallee 24-26, 53113 Bonn, Germany;2. Hausdorff Center for Mathematics, Bonn, Germany;1. Department of Kinesiology, Utah State University, Logan, UT, United States;2. School of Kinesiology, University of Michigan, Ann Arbor, MI, United States;3. Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, United States;4. School of Kinesiology, Western University, London, Ontario, Canada |
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| Abstract: | BackgroundOnset of walking in infants leads to regular cyclic loading of the plantar foot surface for the first time. This is a critical period for evolving motor skills and foot structure and function. Plantar pressure literature typically studies gait only once walking is established and under conditions that artificially constrain the walking direction and bouts compared to how infants move in the real-world. We therefore do not know how the foot is loaded when self-directed walking is first achieved and whether it changes as walking is practiced.Research questionHow do pressures on the plantar foot in real-world walking change from new to confident walking?MethodsFifty-seven infants participated in a two-site longitudinal study. Bespoke child-friendly spaces incorporated large pressure platforms and video. Data was collected at two milestones: new (403 days) and confident (481 days) walking. Steps were defined as walking straight or turning medially/laterally. Pressure variables were calculated for eight-foot regions and compared between milestones.ResultsConfident walking resulted in more steps (median: 18 v 35) and almost twice as many turning steps. During straight-line steps, confident walking increased peak pressures in the medial heel (median: 99.3 v 106.7kPa, p < .05) and lateral forefoot (median: 53.9 v 65.3kPa, p < .001) and reduced medial toe pressure (median: 98.1 v 80.0kPa, p < .05). Relative medial midfoot contact area reduced (median: 12.4 v 11.2%, p < .05) as absolute foot contact increased. A faster transition across stance and a reduced relative contact time in the forefoot were recorded in confident walking.SignificancePressures change rapidly as walking is initiated with significant differences in foot loading evident within an average 77 days. Importantly, these changes differ in straight and turning walking. Continued reliance on assessment of straight-line walking during early stages of ambulation likely fails to characterise 26% of steps experienced by infant feet. |
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| Keywords: | Gait Independent Walking Foot plantar pressure Paediatrics |
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