EJournalClub

The Overweight Child and Flat Feet

 Issue  No. 14       
With obesity on the rise, many clinicians and researchers speculate about the musculoskeletal complications associated with obesity, especially in children. Most clinicians have observed the flat feet displayed by young obese and overweight children. Today, we will review a study by Mickle et al. that evaluated whether young overweight children's feet are flat or just fat.
 
Sincerely,
 
Cherri Choate, DPM
Larry Huppin, DPM
Alona Kashanian, DPM
Paul R. Scherer, DPM
 
 
E-Journal Review
The Feet of Overweight and Obese Young Children
Significance of the Article
Significance for Orthotic Therapy
Reference
Orthotic Recommendations for Pediatric Flatfoot
The Feet of Overweight and Obese Young Children
Mickle et al. evaluated 38 children between three and five years old (19 overweight or obese and 19 of normal weight) to determine whether flat feet in obese/overweight children are due to the presence of a thicker midfoot plantar fat pad or due to a lowering of the longitudinal arch. Midfoot fat pad thickness was measured via ultrasound. External foot structure and arch height were assessed through 10 anthropometric measurements and footprint analysis. 
 
The midfoot fat pad thickness was not significantly different between the two groups, but the overweight/obese children had significantly lower plantar arches when compared to the non-overweight children.
Significance of the Article 
Childhood obesity is at an all-time high. The structural changes observed in this study "may adversely affect the functional capacity of the medial longitudinal arch [and] might be exacerbated if excess weight bearing continues throughout childhood and into adulthood." In other words, the feet of obese/overweight children may be undergoing structural changes that could impact their foot function for a lifetime.
Significance for Orthotic Therapy 
For decades the pediatric flatfoot has been difficult to evaluate.  Overweight or obese children exhibiting flat feet may benefit from early orthotic intervention, along with lifestyle and dietary changes. Fitting this particular patient group with prefabricated or custom orthoses may prevent future problems. This may be a good article to share with your pediatric colleagues.
Reference 
Mickle KJ, Steele JR, Munro BJ: The feet of overweight and obese young children: Are they flat or fat? Obesity, 14(11):1949-1953, 2006.
Orthotic Recommendations for Pediatric Flatfoot
ProLab uses evidence-based research in the design of all orthoses, including our Pathology Specific Orthoses for pediatric flatfoot and our Kiddythotics prefabs. 
 
For additional information on pediatric flatfoot, read Dr. Scherer's articles The Obesity Epidemic in Children is Causing Flatfeet and Treatment of Pediatric Flexible Flatfoot with Functional Orthoses.
 
Questions or comments about our E-Journals? Go to the Open Forum section of our blog or join one of the blog discussions about pediatric flatfoot.
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