Influence of a Foot Insole for a Down Syndrome Patient with a Flat Foot: A Case Study

Abstract

Background and Objectives: Patients with Down syndrome have many orthopedic problems including flat foot. Insertion of an insole for a flat foot provides support to the medial longitudinal arch; thus, insole therapy is often used to treat a flat foot. However, the influence of an insole insertion on the knee joint kinematics for a patient with Down syndrome is unknown. This study aimed to elucidate the influence of an insole for a flat foot on the knee kinematics during gait for a patient with Down syndrome. Materials and Methods: The subject was a 22-year-old male with Down syndrome who had a flat foot. The knee joint angle during the gait was measured using a 3D motion capture system that consisted of eight infrared cameras. Results: The gait analysis demonstrated a reduction in the knee flexion angle during double knee action. The knee valgus and tibial internal rotation angles also decreased during the loading response phase while wearing shoes that contained the insole. Conclusions: As the angle of the knee joint decreased during the gait, it was considered that the stability of the knee joint improved by inserting the insole. In particular, there was a large difference in the tibial internal rotation angle when the insole was inserted. It is thus hypothesized that the insole contributes to the rotational stability of the knee joint. This study suggests that knee stability may improve and that gait becomes more stable when a Down syndrome patient with a flat foot wears an insole.

Abnormal Biomechanical Conditions of the Foot in Child with Down Syndrome During Standing: A Finite Element Study

“…The radiographic studies about the foot structure in DS children with pes planus showed large talo first-metatarsal angle, low navicular height and calcaneal inclination angle in their feet revealing abnormal alignment of the talonavicular and calcaneocuboid joint [5,6].…”

“…The radiographic studies about the foot structure in DS children with pes planus showed large talo first-metatarsal angle, low navicular height and calcaneal inclination angle in their feet revealing abnormal alignment of the talonavicular and calcaneocuboid joint [5,6]. Some studies pointed out that the ligament laxity and hypotonia caused by genetic issue are the main reasons for DS children's pes planus which induce abnormal alignment of foot [1,7,8].…”

Influence of Foot Morphology on the Center of Pressure Pattern in Patients with Down Syndrome

“…Since flat feet can significantly alter several aspects of the gait pattern of individuals with DS [9], the use of quantitative, computerized gait analysis represents a very useful tool to elucidate the mechanisms with which features related to this genetic condition differentiate the gait of people with DS from unaffected individuals. For example, it has been observed that the flat-footed condition affects the generated power of the ankle, leading to muscle fatigue and an energetically more expensive gait compared with those of individual with DS with a normal arch or healthy subjects [9,10]. However, it is noteworthy that little information is available regarding the trajectory of the Center of Pressure (COP, the point of application of the ground reaction force (GRF)) during the gait of individuals with DS.…”

The Effect of Combination of Core Stability Training and Lower Extremity Strength Training on Static Standing Balance Ability in a Child with Down Syndrome

“…This makes children with Down syndrome more susceptible to flat foot which is a plantar ankle condition that does not have an arch. The arch of the plantar ankle works to help support body weight and reduce the load on the plantar ankle (Endo et al, 2020). If the flat foot condition is left unattended, it can cause postural disorders in children when standing or walking (Arumugam et al, 2016).…”