Foot pressure distribution in children with cerebral palsy while standing.
Kids with CP load the forefoot and midfoot more while standing, so rule out muscle tightness before treating flat arches.
01Research in Context
What this study did
Galli et al. (2015) watched how kids with cerebral palsy stand still. They used a pressure mat to map where each part of the foot touches the ground.
The team compared these maps to maps from kids who walk typically. They wanted to see if CP changes foot loading.
What they found
Kids with CP carried more weight on the forefoot and midfoot. Many also had flat feet.
Typical kids spread weight more evenly and kept higher arches.
How this fits with other research
Pau et al. (2012) saw the same high midfoot pressure in Down syndrome. Both studies used the same pressure-mat lab set-up, so the tool is solid across diagnoses.
Chen et al. (2014) found that motor-delayed preschoolers have flat feet 1.5 times more often than peers. Manuela’s CP data extend that picture to a new group and show the flat foot is already present in early elementary years.
Pavão et al. (2013) warned that most CP postural work uses lab toys, not daily-life tests. Manuela’s lab-only study fits that gap: it tells us what the foot does on a mat, but not during real play.
Why it matters
Before you tape an arch or order orthotics, check for tight plantar-flexors or bent knees. These tight muscles can push weight forward and look like flat foot. A quick stretch test may change your brace plan and save money.
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Join Free →During standing practice, glance at the child’s foot: if the arch looks flat, check ankle and knee angle first, then note if pressure shifts after a stretch.
02At a glance
03Original abstract
Foot deformity is a major component of impaired functioning in cerebral palsy (CP). While gait and balance issues related to CP have been studied extensively, there is little information to date on foot-ground interaction (i.e. contact area and plantar pressure distribution). This study aimed to characterize quantitatively the foot-ground contact parameters during static upright standing in hemiplegia and diplegia. We studied 64 children with hemiplegia (mean age 8.2 years; SD 2.8 years) and 43 with diplegia (mean age 8.8 years; SD 2.3 years) while standing on both legs statically on a pressure sensitive mat. We calculated pressure data for the whole foot and sub-regions (i.e. rearfoot, midfoot and forefoot) and average contact pressure. The Arch Index (AI) served for classifying the feet as flat, normal or cavus feet. The data were compared with those from a sample of age- and gender-matched participants (control group, 68 children). Most of the feet showed very high AI values, thus indicating a flat foot. This deformity was more common in diplegia (74.4%) than in hemiplegia (54.7%). In both diplegic and hemiplegic children, average plantar pressure was significantly increased in the forefoot and midfoot and decreased in the rearfoot (p<0.001). The present data indicate an increased load on the front parts of the foot, which may be due to plantarflexor overactivity or knee flexion, combined with an increased incidence of low foot arches. As a low foot arch does not necessarily increase forefoot load, this deformity can be regarded as secondary.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.05.006