Relationship between flat foot condition and gait pattern alterations in children with Down syndrome.
Flat feet rob kids with Down syndrome of ankle push-off power—screen early and support the arch.
01Research in Context
What this study did
Whitehouse et al. (2014) watched kids with Down syndrome walk on a lab walkway. They split the group into those with flat feet and those with typical arches. Motion cameras and force plates captured each step so the team could measure ankle power at push-off.
The goal was to see if flat feet change the way the ankle works during walking.
What they found
Kids with Down syndrome and flat feet produced much less ankle power at the end of each step. Their plantar-flexor moment and power were significantly lower than those of DS kids with typical arches.
Less ankle power means a weaker push-off and a less efficient gait.
How this fits with other research
Pau et al. (2012) had already shown that children with DS have flatter, higher-pressure feet. Whitehouse et al. (2014) now link that flat structure to poor ankle function while walking. The two papers form a clear cause-and-effect chain.
Rigoldi et al. (2011) tracked DS gait across the lifespan and saw stiff, frontal-plane strategies emerge after childhood. The new ankle-power loss reported in 2014 gives one reason why that stiff pattern appears.
Diemer et al. (2023) later found slow, unstable step negotiation in adults with DS. The reduced ankle power seen in kids may be the starting point that grows into the adult stair-climbing problems.
Why it matters
If you work with children with Down syndrome, check the arch. A quick footprint or pressure mat can flag flat feet. Once identified, refer for orthotics or targeted calf-strength drills to restore ankle push-off. Better push-off today can mean safer stairs and faster walking tomorrow.
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02At a glance
03Original abstract
BACKGROUND: In patients with Down syndrome (DS) one of the most common abnormalities is flat foot which can interfere significantly with normal daily activities, such as gait. The aim of this study was to quantitatively assess the relationship between the flat foot and the gait alterations in DS children. METHOD: Twenty-nine patients with DS and 15 non-affected subjects were assessed using 3D Gait Analysis, using an optoelectronic system, force platforms and video recording. The degree of flat foot was assessed using the arch index and kinematic and kinetic parameters were identified and calculated from 3D Gait Analysis for each study participant. RESULTS: Data showed that ankle plantarflexion moment and ankle power during terminal stance were significant to differentiate the patients with and without flat feet: their peak values were significantly lower for the patients with flat foot. In addition, the research for correlation demonstrated that the higher the arch index value, the lower the peak of ankle moment and of the generated ankle power during terminal stance and the minimum of absorbed ankle power. CONCLUSIONS: Children with flat foot displayed a less functional gait pattern in terms of ankle kinetics than children without flat foot, suggesting that the presence of flat foot may lead to a weaker efficient walking. Then, the increasing flat foot tended to result in lower push-off ability, leading to a less functional walking.
Journal of intellectual disability research : JIDR, 2014 · doi:10.1111/jir.12007