dc.description.abstract |
Title: Foot arch characteristics and lower limb overuse injuries in habitually barefoot and
shod Kenyan adolescents.
Background: The barefoot habitus typical of early human lifestyles may cause intrinsic foot
structural adaptations which could protect lower limbs from impact related overuse injuries.
Objective : This study sought to assess foot arch height and flexibility, intrinsic foot muscle
strength and prevalence of the common lower limb overuse injuries in habitually barefoot, rural
school going adolescents; in comparison to an age, weight and sex matched group from a shod
population.
Methodology: This was a cross-sectional study conducted in both rural Nandi for the habitually
barefoot and a modern setting for the shod group. 38 habitually barefoot (HB) and 38 age, gender
and weight matched habitually shod adolescents (HS) were investigated for foot arch
characteristics, intrinsic foot muscle strength and lower limb overuse injury prevalence. Arch height
at 50% of foot length was measured seated and standing by an arch height index measurement
system, and relative arch deformability computed. Intrinsic foot muscle strength was measured
using a commercially available foot strength electronic dynamometer. Physical activity was
quantified using uni-axial accelerometry. Injury incidence was interrogated via a structured
questionnaire and physical examination.
Results: The foot arch was higher and more flexible in the HB compared to HS. (Arch height
6.7{5.6, 8.1} vs. 6.2{4.6, 7.2} p= 0.01; Relative arch deformability 0.76{0.58, 1.063} vs.
0.64{0.41, 0.79} p= 0.012, respectively). The HB had stronger intrinsic foot muscles (IFM) than
the HS (IFM strength 4.7kgs {3.10, 6.13} vs. 3.30kgs {2.18, 4.35} p= 0.03). There was a higher
lower limb overuse injury incidence rate in the HS (28.8% vs. 2.6%, chi-square 9.896, p<0.02).
There was no statistically significant correlation between gender, physical activity levels and the
measured foot arch characteristics.
Conclusions and recommendations: In comparison to shod adolescents, the habitually barefoot
were found to have a higher, more flexible medial longitudinal foot arch and stronger foot intrinsic
musculature. They also recorded a lower incidence of lower limb overuse injuries. Further
prospective studies are recommended to relate the morphological foot differences found between
HB and HS, and overuse injuries in all active age groups. |
en_US |