Dynamic plantar pressure patterns in children with CP related foot deformities

Research Objectives: To classify foot deformities in children with cerebral palsy (CP) using foot pressure analysis

Design: Retrospective study

Setting: Center for Motion Analysis, University Hospital

Participants: 18 children (8 female, 10 male; mean age 12.9 yrs) with CP for a total of 36 feet. Children were excluded if they were nonambulatory, had GMFCS 4-5, or received surgery or botulinum toxin within the previous 6 months.

Interventions: N/A

Main Outcome Measures: Main Outcome Measures: A total of 15 pressure parameters on 8 foot regions were assessed using the EMED NT-4 pressure platform system, especially including foot contact area, maximal force, peak pressure, pressure-time integral (PTI), geometry, and center of pressure (COP) trajectories.

Results: CP children with unique patterns of foot pressure were divided into forefoot only pathology (n=3, Type 1), forefoot/midfoot pathology (n=2, Type 2) and forefoot/midfoot/hindfoot pathology (n=31, Type 3). Type 3 consisted of 4 subgroups in terms of abnormal pressure patterns corresponding to inversion/eversion, neutral, and /or varus/valgus on the forefoot, midfoot and hindfoot, respectively. Overall 8 pressure matrix related to foot deformities were significant differences among 4 subgroups in type 3 (P < 0.05, mixed-effects ANOVA). Among the parameters tested (P < 0.05), instant of max force in medial forefoot predicted forefoot pathology, contact area and max force in midfoot predicted midfoot pathology and average velocity of COP in heel predicted hindfoot pathology.

Conclusions: Foot pressure analysis was able to characterize 4 unique patterns of foot deformities in children with CP, which may shed light of tone reduction intervention or different orthotic managements.

Author(s) Disclosures: None