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Background: Variance in the morphological characteristics and frequency of pathology in the paediatric foot are thought to exist between ethnic groups. Differences in characteristics have primarily been studied from a footwear perspective with limited research describing the effects of ethnicity on dynamic foot loading. The aim of this study was to investigate the influence of ethnicity on loading characteristics of the paediatric foot. Methods: Dynamic plantar pressures were measured in 93 children aged 7-11 years (mean age 9.4 +1.6 years) using the MatScan® 3150 pressure platform. Participants were recruited from local schools in East London and stratified into four ethnic groups (white, mixed, black and asian). Mean peak plantar pressure at six different segments across the plantar foot was calculated from three walking trials using the midgait protocol. Multiple linear regression was used to test for ethnic effects, whilst controlling for gender and body mass. Results: Significant differences for mean pressure at the lateral heel (p = ˂ 0.05) and the medial heel (p = ˂ 0.05) were identified. These were principally driven by differences between the mixed ethnic group for loading at the medial heel (p = ˂ 0.05), which showed significantly lower mean peak pressure than the white ethnic group. Significantly lower peak pressures were also identified at the lateral heel for both the mixed (p = ˂ 0.05) and black (p = ˂ 0.05) ethnic groups. Conclusion: Significant differences in peak plantar pressure across the heel were identified in an ethnically diverse sample of children aged 7-11 years from East London. These findings suggest that differences in foot loading characteristics exist between the groups and may be explained by variances in foot position during gait. It is anticipated that this research will increase understanding of typical foot development in different ethnic groups.

Background Plantar pressure assessment can provide information pertaining to the dynamic loading of the foot, as well as information specific to each region in contact with the ground. There have been few studies which have considered the reliability of plantar pressure data and therefore the purpose of this study was to investigate the reliability of assessing plantar pressure variables in a group of typically developing children, during barefoot level walking. Methods Forty-five participants, aged 7 to 11 years, were recruited from local primary and secondary schools in East London. Data from three walking trials were collected at both an initial and re-test session, taken one week apart, to determine both the within- and between-session reliability of selected plantar pressure variables. The variables of peak pressure, peak force, pressure-time and force-time integrals were extracted for analysis in the following seven regions of the foot; lateral heel, medial heel, midfoot, 1st metatarsophalangeal joint, 2nd-5th metatarsophalangeal joint, hallux and the lesser toes. Reliability of the data were explored using Intra Class Correlation Coefficients (ICC 3,1 and 3,2) and variability with Coefficients of Variation (CoV's). Results The measurements demonstrated moderate to good levels of within-session reliability across all segments of the foot (0.69-0.93), except the lesser toes, which demonstrated poor reliability (0.17-0.50). CoV's across the three repeated trials ranged from 10.12-19.84% for each of the measured variables across all regions of the foot, except the lesser toes which demonstrated the greatest variability within trials (27.15-56.08%). The between-session results demonstrated good levels of reliability across all foot segments (0.79-0.99) except the lesser toes; with moderate levels of reliability reported at this region of the foot (0.58-0.68). The CoV's between-sessions demonstrated that the midfoot (16.41-36.23%) and lesser toe region (29.64-56.61) demonstrated the greatest levels of variability across all the measured variables. Conclusions These findings indicate that using the reported protocols, reliable plantar pressure data can be collected in children, aged 7 to 11 years in all regions of the foot except the lesser toes which consistently reported poor-to-moderate levels of reliability and increased variability.

Background Childhood obesity is thought to predispose to structural foot changes and altered foot function. Little is currently understood about whether similar changes occur in overweight children. The aim of this study was determine foot loading characteristics in obese, overweight and normal weight children aged 7 to 11 years during level walking. Methods Dynamic plantar pressures were measured in 22 obese, 22 overweight and 56 normal weight children recruited from local primary and secondary schools in East London. Peak pressure, peak force, normalised peak force, pressure–time and force-time integrals were analysed at six regions of the plantar foot: lateral heel, medial heel, midfoot, 1st metatarsophalangeal joint, 2nd-5th metatarsophalangeal joint and hallux. A one-way ANOVA was used to test for significant differences in variables across the groups. Where differences existed Tukey post-hoc tests were used to ascertain the location of the difference. Results Children who were obese and overweight demonstrated significantly (pp Conclusion Findings from this study indicated that overweight children, as young as seven, displayed differences in foot loading during walking, when compared with normal weight children. These findings were consistent with loading patterns of children who were obese and suggest that early assessment and intervention may be required in overweight children to mitigate against the development of musculoskeletal complications associated with excessive body mass.