Fizyolojik Pes Planus Görülen Çocuklarda Sağlıkla İlgili Yaşam Kalitesi ile Alt Ekstremite Biyomekaniksel Özellikleri Arasındaki İlişkinin İncelenmesi – Pilot Çalışma

Year 2021, Volume: 11 Issue: 2, 176 - 182, 07.05.2021

Şulenur Yıldız , Sedef Şahin , Nilgün Bek

https://doi.org/10.33631/duzcesbed.800903

Abstract

Amaç:Bu pilot çalışmanın amacı, fizyolojik pes planus görülen çocukların, sağlıkla ilgili yaşam kaliteleri ile alt ekstremitenin biyomekaniksel karakteristikleri arasında ilişkinin araştırılmasıydı.
Gereç ve Yöntemler:Bu çalışma kapsamında, yaşları ortalama 8,47±2,94 yıl olan, 8 kız ve 8 erkek olmak üzere 16 fizyolojik pes planusu olan çocuğun 32 alt ekstremitesi incelendi. Olguların alt ekstremitelerine ait biyomekaniksel özelliklerinin ortaya konabilmesi amacıyla, metatarsal esneklik (ME), ağırlıklı topuk-bacak açısı (TBA-WB), navikular düşme testi (NDT), Ayak Postür İndeksi (FPI), ayak bileği plantar fleksor kas kısalığı, popliteal açı (PA) ve Beighton Skoru (BS) değerlendirildi. Sağlıkla ilgili yaşam kalitesinin değerlendirmesinde, Çocuklar için Yaşam Kalitesi Ölçeği ÇİYKÖ-Çocuk Formu kullanıldı. Çalışma kapsamında ayrıca, ebeveynlerin çocuklarının sağlıkla ilgili yaşam kalitelerine bakış açısını değerlendiren ÇİYKÖ-Ebeveyn Formu uygulandı.
Bulgular:Olguların ÇİYKÖ-Çocuk formunun fiziksel, sosyal, emosyonel, okul, psikososyal sağlık özet skoru ve toplam skorlar ile ME, TBA-WB, FPI, plantar fleksor kas kısalığı, PA ve BS verileri arasında anlamlı ilişki bulunmadı (p>0,05). ÇİYKÖ-Ebeveyn formuna göre ise, fiziksel skor ile sağ alt ekstremite PA (r= 0,535; p= 0,048), sosyal skoru ile sol PA (r= 0,537; p= 0,048) ve ÇİYKÖ toplam skoru ile sol PA verileri arasında pozitif ve anlamlı ilişki bulundu (r= 0,702; p= 0,005).
Sonuç:Fizyolojik pes planus görülen çocukların, sağlıkla ilgili yaşam kaliteleri ile alt ekstremitenin biyomekaniksel karakteristikleri arasındaki ilişkiyi araştırdığımız pilot çalışmamızın sonuçlarına göre, çalışma içinde değerlendirilen parametreler açısından klinik öneme sahip herhangi bir ilişkiyi işaret etmemiştir. Daha fazla sayıda ve farklı şiddetlerdeki patolojilere göre gruplanmış olgu sayısının dahil edildiği, görülen patolojilerin bireyin yaşam kalitesine etkisini kendi algısı ve ebeveyn algının karşılaştırıldığı çalışmalara gereksinim duyulmaktadır.

Keywords

Biyomekani, çocuk, pes planus, yaşam kalitesi

The Relationship Between Health-Related Quality Of Life And Lower Extremity Biomechanical Features In Children With Physiological Pes Planus – A Pilot Study

Abstract

Aim: The aim of this study was to investigate the relationship between the health related quality of life and biomechanical characteristics of the lower extremity in children with physiological pes planus.Materials and methods:In this study, 32 lower extremities of 16 children with physiological pes planus (8 girls and 8 boys) with an average age of 8.47 ± 2.94 years were examined. Metatarsal flexibility (ME), weighted heel-leg angle (TBA-WB), navicular drop test (NDT), Foot Posture Index (FPI), ankle plantar flexor muscle shortness, popliteal angle (PA) and Beighton Score (BS) were used to evaluate the anthropometric properties of the lower extremities.The Pediatric Quality of Life Inventory (PedsQL)-Child Form was used to evaluate health-related quality of life.The PedsQL-Parent Form, which evaluates the parents' perspective on their children's health-related quality of life, was also applied.Results:There was no significant relationship between the physical, social, emotional, school, psychosocial health summary score and total scores of the PedsQL-Child form of the cases and the data of ME, TBA-WB, FPI, plantar flexor muscle shortness, PA, and BS (p>0.05).According to the PedsQL-Parent form, there was a positive and significant relationship between physical score and right lower extremity PA(r=0.535; p=0.048), social score and left PA (r=0.537; p=0.048), and PedsQL total score and left PA(r=0.702; p=0.005).Conclusion:The results of our study, the relationship between the health-related quality of life and the biomechanical characteristics of the lower extremity in children with physiological pes planus did not indicate any clinical significance in terms of evaluated parameters.There is a need for studies with a larger number of cases grouped according to pathologies of different severity and the effects of pathologies seen on the individual’s quality of life, and comparison of child’s own and parental perception.

Keywords

Biomechanics, child, pes planus, quality of life

References

• 1. Bresnahan PJ, Juanto MA. Pediatric Flatfeet—A Disease Entity That Demands Greater Attention and Treatment. Frontiers in Pediatrics 2020; 8; 19.
• 2. El O, Akcali O, Kosay C, Kaner B, Aslan Y, Sagol E, et al. Flexible flatfoot and related factors in primary school children: a report of a screening study. Rheumatology International. 2006; 26: 1050–3.
• 3. Carr JB, Yang S, Lather LA. Pediatric pes planus: a state-of-the-art review. Pediatrics. 2016; 137(3): e20151230.
• 4. Şenaran H. Çocuklarda Pes Planus Tanımı, Doğal Seyri ve Tedavi Seçenekleri. Türk Ortopedi ve Travmatoloji Birliği Derneği Dergisi. 2006;5:2.
• 5. Houghton KM. Review for the generalist: evaluation of pediatric foot and ankle pain. Pediatric Rheumatology. 2008;6 : 6.
• 6. Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M. Prevalence of flat foot in preschool-aged children. Pediatrics. 2006; 118: 634-9.
• 7. Bordin D, De Giorgi G, Mazzocco G, Rigon F. Flat and cavus foot, indexes of obesity and overweight in a population of primary-school children. Minerva Pediatrica. 2001; 53: 7-13.
• 8. Staheli LT, Chew DE, Corbett M. The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults. The Journal of Bone and Joint Surgery. 1987; 69: 426-8.
• 9. Chen KC, Yeh CJ, Tung LC, Yang JF, Yang SF, Wang CH. Relevant factors influencing flatfoot in preschool aged children. European Journal of Pediatrics. 2011; 170: 931-6.
• 10. Onodera AN, Sacco IC, Morioka EH, Souza PS, de Sá MR, Amadio AC. What is the best method for child longitudinal plantar arch assessment and when does arch maturation occur? Foot. 2008; 18: 142–9.
• 11. Kothari A, Stebbins J, Zavatsky AB, Theologis T. Health-related quality of life in children with flexible flatfeet: a cross-sectional study. Journal of Children’s Orthopaedics. 2014; 8: 489-96.
• 12. López López D, de Los Angeles Bouza Prego M, Constenla AR, Canosa JLS, Casasnovas BA, et al. The impact of foot arch height on quality of life in 6-12 year olds. Colombia Medica (Cali). 2014; 45: 168-72.
• 13. Acak M, Bayer R. Pes planus olan pes planus olan Inönü üniversitesi öğrencilerinin fiziksel uygunluk düzeyi, yaşam kalitesi ve benlik saygılarının değerlendirilmesi. Beden Eğitimi ve Spor Bilimleri Dergisi. 2019;21.
• 14. López-López D, Vilar-Fernandez JM, Barros-Garcia G, Losa-Iglesias ME, Palomo-Lopez P, Becerro-de-Bengoa Vallejo R, et al. Foot arch height and quality of life in adults: a strobe observational study. International Journal of Environmental Research and Public Health. 2018; 15: 1555.
• 15. Keith R, Ashford RL, Evans A. Non‐surgical interventions for paediatric pes planus. Cochrane Database of Systematic Reviews. 2010; 7: CD006311.
• 16. Van Melick N, Meddeler BM, Hoogeboom TJ, Nijhuis-van der Sanden MWG, van Cingel REH. How to determine leg dominance: The agreement between self-reported and observed performance in healthy adults. Plos One. 2017; 12:e0189876.
• 17. Otman SA. Tedavi hareketlerinde temel değerlendirme prensipleri. 7.Baskı, Ankara: Hipokrat kitabevi; 2015.
• 18. Kim JA, Lim OB, Yi CH. Difference in static and dynamic stability between flexible flatfeet and neutral feet. Gait Posture. 2015; 41: 546-50.
• 19. Sobel E, Levitz S, Caselli M, Brentnall Z, Tran MQ. Natural history of the rearfoot angle: preliminary values in 150 children. Foot & Ankle International. 1999; 20: 119-25.
• 20. Katz K, Rosenthal A, Yosipovitch Z. Normal ranges of popliteal angle in children. Journal of Pediatric Orthopedics. 1992; 12: 229-31.
• 21. Nakale NT, Strydom A, Saragas NP, Ferrao PNJF. Association between plantar fasciitis and isolated gastrocnemius tightness. Foot & Ankle International. 2018; 39: 271-7.
• 22. Redmond AC, Crane YZ, Menz HB. Normative values for the Foot Posture Index. Journal of Foot and Ankle Research. 2008; 1: 6.
• 23. Williams DS, McClay IS. Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity. Physical Therapy. 2000; 80: 864-71.
• 24. Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Annals of Rheumatic Diseases. 1973; 32: 413–7.
• 25. Varni JW, Seid M, Kurtin PS. PedsQL™ 4.0: Reliability and validity of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales in healthy and patient populations. Medical Care. 2001; 39: 800-12.
• 26. Kabak VY, Yakut Y, Çetin M, Düger T. Reliability and Validity of the Turkish Version of the PedsQL 3.0 Cancer Module for 2-to 7-Year-Old and the PedsQL 4.0 Generic Core Scales for 5-to 7-Year-Old: The Hacettepe University Experience. Turkish Journal of Hematology. 2016; 33: 236.
• 27. DiGiovanni CW, Langer P. The role of isolated gastrocnemius and combined Achilles contractures in the flatfoot. Foot and Ankle Clinics. 2007; 12: 363-79.
• 28. Raymond WL, Xie KK. Association between Achilles tightness and lower extremity injury in children. HSS Journal. 2016; 12: 245-9.
• 29. Kim HW, Weinstein SL. Flatfoot in children: Differential diagnosis and management. Current Orthopaedics. 2000; 14: 441-7.
• 30. Hsieh RL, Peng HL, Lee WC. Short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children: A randomized controlled trial. Medicine. 2018; 97: e10655.
• 31. Chen YC, Lou SZ, Huang CY, Su FC. Effects of foot orthoses on gait patterns of flat feet patients. Clinical Biomechanics (Bristol, Avon). 2010; 25: 265–70.