A Cross-Sectional Study of Foot Growth and Its Correlation with Anthropometric Parameters in a Representative Cohort of Schoolchildren from Southern Spain

Abstract

Background: The relationship between growth of the foot and other anthropometric parameters during body development until puberty has been scarcely studied. Some studies propose that growth of the foot in length may be an early index of puberty. The objective of this cross-sectional study was to analyze the relationship between the growth of the foot in length and width with other anthropometric parameters, in prepubertal and early pubertal schoolchildren (Tanner stage II). Methods: Using an instrument that was designed and calibrated for this purpose, maximum foot length, width and height were obtained in 1005 schoolchildren. Results: The findings indicate that the age of onset of pubertal foot growth spur was 7–8 years in girls, and 8–9 years in boys. Growth in foot length stabilized in both sexes after 12 years of age. In boys, a strong correlation was found between height and foot length (r = 0.884; p < 0.047), and between body mass index (BMI) and forefoot width at 12 years of age (r = 0.935; p < 0.020). A strong correlation was found between height and forefoot width at 6 years in girls (r = 0.719; p < 0.001), as well as between BMI and metatarsal width in 10 years-old girls (r = 0.812; p <0.001). Conclusions: The average increase in foot length and width that precedes the onset of Tanner’s stage II in both girls and boys can be considered as a useful biological indicator of the onset of puberty.

Relationship of the Use of Short Footwear with the Development of Hallux Valgus in a Sample of Andalusian Schoolchildren

“…These data are not consistent with other studies carried out in schoolchildren in our country where it was observed that girls from 8 to 9 years old had a significantly worse footwear fit in length than boys [6]. Recent observational studies carried out in schoolchildren in southern Spain have shown that the age of onset pubertal foot growth was 7-8 years in girls and 8-9 years in boys and that, in the age range between 7 and 11 years, an adequate footwear fit in length is essential [3,5].…”

“…In general, an increase in HVA with age was also observed in both sexes, especially in girls in the age group between 11 and 14 years. We believe that this circumstance may be influenced in part by the increase in foot length and width that precedes the onset of Tanner's stage II in both sexes and that matches with the peak of longitudinal growth of the foot taking place prior to the peak of growth in height [2,3].…”

“…Once the gauge was extracted from the shoe, length and width were calculated using a retractable measuring tape. All the measuring instruments were designed and evaluated by the Andalusian Centre of Metrology and have been used in previous studies [3,5].…”

“…The influence of footwear on the appearance of foot deformities seems to have a notable impact at an early age since the maturation of the bone structure of children's feet has not yet finished. Recent studies carried out on schoolchildren show that between 4 and 12 years of age, there is an important progressive growth especially in length in the feet of children [2,3]. These rapid changes may be conditioned by extrinsic factors, such as footwear, or intrinsic factors, such as gender, foot morphology or body mass index, among others, which in combination can influence the morphological and functional development of the adult foot [3,4].…”

“…Recent studies carried out on schoolchildren show that between 4 and 12 years of age, there is an important progressive growth especially in length in the feet of children [2,3]. These rapid changes may be conditioned by extrinsic factors, such as footwear, or intrinsic factors, such as gender, foot morphology or body mass index, among others, which in combination can influence the morphological and functional development of the adult foot [3,4]. Based on the observations made in different studies on the high rate of ill-fitting footwear in schoolchildren, several investigations highlight the importance of making frequent changes in footwear, especially before Tanner's stage in boys and premenarchal girls to prevent the risk of developing deformities in the feet early on [3][4][5][6][7][8][9].…”