Made available in DSpace on 2016-12-06T17:07:12Z (GMT). No. of bitstreams: 1 Dissertacao Juliana Kretzer 2007.pdf: 2790715 bytes, checksum: 66d50d2d2bcbb684e27f9ef3d9a900a4 (MD5) Previous issue date: 2007-06-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The presence of flat foot during infancy is very frequent and is considered a physiological normal condition. However, it needs to be clarified, since it is the most frequent in pediatric orthopaedics consultations. Therefore, this study has the main goal to evaluate the behavior of clinical and biomechanical characteristics of children with and without flexible flat foot. At the same time a profilatical and therapeutic program should be proposed to estimulate formation of a neutral arch. Subjects were 26 children, both genders, with mean age of 4 years and 8 months. They were divided in two groups: 17 children with idiopatyc flat feet and 9 children with normal feet. The research was a descriptive, exploratory and experimental one. Data collection were at the gym area of a state school were the kids belong. Regarding the clinical aspects, all subjects were considered hypermobile and there was a high correlation between the presence of flat foot and the postural condition in valgus ankle. The anthropometrical variable height of the navicular bone was considered lower in flated foot children s group. The plantar pressure distribution was measured during walking and running conditions. It was verified that children with flat foot had larger plantar arch index values as well as a larger contact area of the midfoot and a smaller contact area at lateral midfoot and lateral forefoot. Looking at the peak pressure values, these were lower at the lateral forefoot and higher at the hallux and second toe. The flat foot group showed also higher relative load values for the medial midfoot, hallux and second toe and lower values for the lateral forefoot. Children with flat foot were divided in an experimental and a control group. After 18 weeks of application of a profilatical and therapeutic program this children showed the evolution in their clinical foot classification due also to the concomitant physical and motor development, regarding their age and the fact that they have feet that are considered physiological flat feet. In relation to the plantar pressure distribution most of them showed a development showing values closed to the children s normal feet values for this age group. The effects of the profilatical and therapeutic program although not always clearly represented in the biomechanical parameters went further than the pure quantitative statistics appreciation. It is to highlight the importance of the program s proposal as well as the development of intervention studies that contribute for a similar opportunity in the area of human movement science. / A presença de um pé plano durante a primeira infância é extremamente freqüente e considerada como uma condição fisiológica normal, entretanto, necessita de esclarecimentos, pois é o maior causador de consultas em ortopedia pediátrica. Desta forma, esta pesquisa teve como objetivo principal avaliar o comportamento de características clínicas e biomecânicas dos pés de crianças com pés planos flexíveis e compará-las com crianças com pés normais. Além de verificar os efeitos da aplicação de um programa terapêutico profilático que estimulasse a formação de um arco neutro. Os sujeitos pesquisados totalizaram 26 crianças, de ambos os sexos, com média de idade igual a 4 anos e 8 meses, separados em um grupo com pés planos idiopáticos, composto por 17 crianças, e outro grupo com pés normais, composto por 9 crianças. A pesquisa caracterizou-se como do tipo descritiva exploratória e experimental, e as coletas de dados foram desenvolvidas nas dependências físicas do Ginásio de uma Escola Estadual, onde os sujeitos estudavam. Quantos aos aspectos clínicos, todos os sujeitos foram considerados hipermóveis e encontrou-se uma correlação significante entre a presença dos pés planos e a postura em valgo dos tornozelos. A variável antropométrica, altura do navicular foi considerada menor no grupo de crianças com pés planos. A distribuição de pressão plantar, mensurada através do Sistema Emed, foi avaliada durante o movimento da caminhada e da corrida. Verificou-se que as crianças com pés planos apresentavam o índice do arco plantar maiores, assim como uma maior área de contato da região do mediopé medial e na menor região do mediopé lateral e antepé lateral. Quanto aos picos de pressão, estes foram menores sob o antepé lateral e maiores sob o hálux e 2º dedo. O grupo com pés planos apresentou também maiores cargas relativas sob mediopé medial, hálux, e 2º dedo e menores cargas sob o antepé lateral. Dividiram-se as crianças com pés planos em um grupo experimental e outro controle. Após 18 semanas de aplicação do programa ambos, evoluíram quanto à classificação clínica dos pés, em virtude do concomitante desenvolvimento físico e motor ocorrido, tendo em vista ainda a faixa etária e o fato de possuírem pés planos considerados fisiológicos. Em relação as variáveis da distribuição de pressão plantar, a maioria delas evoluiu aproximando-se dos valores encontrados nas crianças com pés normais. Os efeitos da aplicação do programa terapêutico profilático, nos sujeitos com pés planos do grupo experimental, apesar de não serem representados claramente em todas as variáveis biomecânicas, vão além da estatística meramente quantitativa. Ressalta-se a importância da proposta do programa, bem como o desenvolvimento de estudos intervencionistas que proporcionem uma oportunidade similar.

Author: Bc. Kateřina Kellerová Title: Foot Arch in Childhood Problem definition: The most often diagnosis related to the foot arch in childhood is definitely flexible flat foot also called pes planovalgus. Because of that this thesis will be mostly oriented on this diagnosis. There are many articles about flexible flat foot and many studies were oriented on this problem. The informations about etiology, influencing factors or therapy are sometimes discordant in different articles. But almost all of them contain one same statement which says that the prevalence of this diagnosis is decreasing as the foot arch is changing during the child's growth. It means in older children there is not flexible flat foot so often as in the younger ones. But there is no detailed description of the dynamics of these changes of the foot arch in childhood. Aim of this thesis: The aim of this thesis is to find out the development of the foot arch in children of pre-school age. In other words to run the survey to find out the changes of the foot arch in children of pre-school age which occurs in six months. Method: The survey contains anamnesis questionnare for parents and also these examinations: footprints, examination of joint laxity, mobility of hip joint, position of knee, patellae and heel, Jack's test, posibility...

Background Pes planus is one of the most common diagnoses in the pediatric field; flexible flat foot being the most prevalent. This developmental type of flatfoot is a normal finding in young children, seen to resolve spontaneously with growth and development and also remain asymptomatic. Despite this, there is still a large incidence of flat feet in adolescence and many cases of adult flatfeet are frequently presented as residual pediatric flatfeet. The factors that influence the prevalence of flatfeet during a child's development have also the capacity to altering its course and gaining insight on what they are and their influence aids in diagnosing, treating and preventing flat feet. Purpose The aim of this literature review was to enhance knowledge on the persistence of the flat feet condition in the pediatric population by determining the development of flat feet in children with an outline of its affect on posture and gait and identifying contributing factors that affect the incidence and progression of the deformity. Methodology An electronic database search was conducted to obtain articles from relevant journals (from early 2012 to mid 2013). Only full text English articles were obtained, with a few exceptions. Further information was collected from online textbooks and the reference lists of the...

In summary of findings we first address problems of correct and poor posture. We present methods how to easily detect function disorders of locomotive system, their basic characteristics, and how to compensate such disorders, or how to prevent them completely. The research focuses on determination of the most common function disorders in children of young school age. Total of 384 children from 1st and 2nd grades of all elementary schools in Strakonice participated in the survey. The following methods were chosen evalutation of posture according to Jaroš and Lomíček, which disclosed that the most common function disorders apply to lower limbs. Testing according to Matthias showed that 33 % of children suffer from poor posture. The research includes a questionaire, which helped us to find out that poor posture occurs less frequently in children who pursue physical activities.

The causes of musculoskeletal disorders, at present affecting a considerable pro-portion of the adult population and leading to poor posture, are to be looked for as early as in childhood. In recent decades an enormous increase in poor posture in the children of younger and older school-age has occurred, which is in most cases the result of a bad lifestyle. The lack of physical activity, an inappropriate school regime, unsuitable school furniture or heavy backpacks the children carry on their backs every day are the in-fluencing factors. Another aspect that can lead to poor posture in children is a relatively high number of children with flat feet. An inappropriate lifestyle and one-sidedness of modern life also leads to obesity and thus the restriction of movement in children. In my thesis I focused on poor posture in pupils of selected primary schools in the district of Příbram. The monitored group was children aged 8-15 years, attending 3-9 primary school grades. The purpose of my diploma thesis was to assess the prevalence of poor posture in primary school pupils in relation to their lifestyle and physical activity, to survey the risk factors leading to poor posture in these children, and to map the connection of poor posture in primary school children with prevalence of flat feet in children. In relation to the purpose I stated three hypotheses, assuming that children with a wrong lifestyle and an insufficient physical activity are more prone to poor posture, that the children influenced by more risk factors suffer more often from musculoskeletal disorders and poor posture and also that the children with flat feet are more predisposed to poor posture. To conduct the research, I chose the methodology of quantitative descriptive study through questionnaires. The research was carried out in two schools differently specialized, one of the schools is focused on mathematics and computer science and implements the program the Health Promoting School (Primary School Jiráskovy sady in Příbram), the second is focused on sports, particularly volleyball (Primary School Pod Svatou Horou Příbram). A total of 340 children from both schools were addressed by identical question-naires. The questionnaire was anonymous and the questions were directed primarily at these children lifestyle assessment. The questionnaire contained 37 questions in total, focused primarily on the principles of healthy lifestyle, physical activity, leisure activi-ties, school furniture, the school work regime and the prevalence of poor posture and flat feet. The return rate of the completed questionnaires was 85,3%, which means 290 questionnaires from the two schools. Based on the results from the completed questionnaires, I compared the two groups of examined pupils in terms of their compliance with the principles of healthy lifestyle, the prevalence of poor posture and the prevalence of flat feet.

Nowadays there is no unified method of prevention and correction of flat feet both in children in general, as well as in young athletes. The study was focused on development and justification of rehabilitation program of flat feet in young athletes of various specializations. Based on analyzed data, we formulated actuality of the above mentioned problem, studied anatomy of foot and described pathogenesis of foot deformation. 22 young athletes aged 5-6 years were recruited for the study. Questionnaire, planthography and analysis for vertical jumps with the use of force plate were applied. We developed rehabilitation program for young athletes with flat feet with the use of rough surfaces. Effectiveness of the proposed rehabilitation was confirmed during the experimental study. Guidelines and recommendations for trainers and physical therapists were developed for inclusion of this program into training process. / На сегодняшний день одной из важных проблем является отсутствие единой методики по профилактике и коррекции плоскостопия как среди детей, так и юных спортсменов. Цель исследования – разработать и обосновать программу реабилитации плоскостопия у юных спортсменов различной спортивной специализации. На основе проанализированных данных научной литературы была сформулирована актуальность проблемы, изучена анатомия стопы, описаны причины и механизм возникновения деформации. Исследование проводилось среди 22 спортсменов различной специализации в возрасте 5-6 лет с помощью опроса, плантографии и тензоплатформы. В результате исследования была разработана программа реабилитации при плоскостопии у юных спортсменов с использованием неровных поверхностей, проведен эксперимент. По результатам работы была выявлена эффективность программы реабилитации при плоскостопии. Были разработаны методические рекомендации для тренеров и специалистов в данной области по включению предлагаемой программы реабилитации в учебно-тренировочный процесс.

Title: The effect of flat feet on the stability of the ankle joint of floorball players. Objectives: The main aim of this thesis is to determine whether a flat feet has any effects on the floorball players' ankle joint stability. Furthermore, the thesis focuses on the chronic ankle instability, other leg pathologies and on the options of therapeutic interventions. Eventually, the thesis provides summary and output data for physiotherapist, sport couches and the examined players. Methods: First a literature study was conducted to establish a theoretical framework. Based on the feature/aspect examination of longitudinal foot arching and an initial questionnaire 10 particular subjects aged 22 to 29 were selected, all of them form the TJ Tatran Střešovice team. The subjects were divided in 2 groups - with longitudinal flat feet and without longitudinal flat feet pathology. The examined subjects were scored with negative points according to occurrence of any pathologies. Both groups were also benchmarked in the Star Excursion Balance Test that determined feet dynamic stability index. Results: The examination proved that flat feet affects the stability of the ankle joint as the subjects of the group without longitudinal flat feet scored results that were 31% better than results of the subjects with...