Foot-ground interaction during upright standing in children with Down syndrome.
Kids with Down syndrome have flatter, higher-pressure feet that fall further behind typical peers each year—catch it early.
01Research in Context
What this study did
The team watched kids with Down syndrome stand still on a pressure mat. They compared foot shape and pressure to kids without Down syndrome.
Same age, same weight, same lab. Everyone stood quiet for several seconds while the mat recorded where the foot touched the ground.
What they found
Kids with Down syndrome had flatter feet and higher pressure under the mid-foot. The gap got bigger as kids got older.
Their arches looked different and the middle of the foot took more load than in typical kids.
How this fits with other research
Whitehouse et al. (2014) extended these findings. They showed the flat feet measured here led to weaker ankle push-off while walking.
Rigoldi et al. (2011) came first. They found faster side-to-side sway in Down syndrome. The new foot-shape data help explain why: a wider, flatter base gives the body more wobble.
Perry et al. (2024) looked at adults. Dance training tightened their sway almost to typical levels. Together the papers trace a line: flat feet in kids, weak push-off in teens, but practice can still help in adulthood.
Why it matters
Screen foot shape early. Note arch width and pressure spots at every visit. If the mid-foot carries too much load, consider orthotics or strength work before gait problems show up. Track change yearly; the difference grows with age.
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02At a glance
03Original abstract
This study aimed to quantitatively characterize the main foot-ground contact parameters during static upright standing and to assess foot evolution with increasing age in young individuals affected by Down syndrome (DS). To this end, 99 children with DS of mean age 9.7 (1.7) were tested using a pressure sensitive mat, and the raw data were processed to extract information about overall and rearfoot, midfoot and forefoot contact area, Arch Index (AI) and average contact pressure. The values obtained were then compared with those calculated from a sample of age- and gender-matched participants (control group, CG). Children with DS exhibited larger midfoot and reduced forefoot contact areas with respect to CG participants (+53% and -35% respectively, p<0.001), increased AI values (DS 0.31, CG 0.20, p<0.001) and increased average contact pressures in the midfoot and forefoot. The overall foot development for the two groups followed a similar trend, although in individuals with DS a curve that relates increases in midfoot contact area with age is characterized by a steeper gradient, and the forefoot contact area appeared systematically smaller regardless of age. The large prevalence of the flatfoot type in children with DS (which is known to be originated by hypotonia and ligamentous laxity) associated with the presence of higher average contact pressure in midfoot and forefoot justify the need for careful podiatric surveillance throughout childhood to reduce balance and gait impairment which are likely to affect untreated subjects when they reach adulthood.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.05.018