Longitudinal study of foot pressures during real-world walking as infants develop from new to confident walkers

Price, C ORCID: https://orcid.org/0000-0002-5633-1250, Montagnani, E, Martinez Santos, A ORCID: https://orcid.org/0000-0003-1808-5914, Nester, CJ ORCID: https://orcid.org/0000-0003-1688-320X and Morrison, S 2022, 'Longitudinal study of foot pressures during real-world walking as infants develop from new to confident walkers' , Gait & Posture, 92 , pp. 351-358.

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Background: Onset of walking in infants leads to regular cyclic loading of the plantar foot surface for the first time. This is a critical period for evolving motor skills and foot structure and function. Plantar pressure literature typically studies gait only once walking is established and under conditions that artificially constrain the walking direction and bouts compared to how infants move in the real-world. We therefore do not know how the foot is loaded when self-directed walking is first achieved and whether it changes as walking is practiced. Research Question: How do pressures on the plantar foot in real-world walking change from new to confident walking? Methods: Fifty-seven infants participated in a twosite longitudinal study. Bespoke child-friendly spaces incorporated large pressure platforms and video. Data was collected at two milestones: new (403 days) and confident (481 days) walking. Steps were defined as walking straight or turning medially/laterally. Pressure variables were calculated for eight-foot regions and compared between milestones. Results: Confident walking resulted in more steps (median: 18 v 35) and almost twice as many turning steps. During straight-line steps, confident walking increased peak pressures in the medial heel (median: 99.3 v 106.7kPa, p<.05) and lateral forefoot (median: 53.9 v 65.3kPa, p<.001) and reduced medial toe pressure (median: 98.1 v 80.0kPa, p<.05). Relative medial midfoot contact area reduced (median: 12.4 v 11.2%, p<.05) as absolute foot contact increased. A faster transition across stance and a reduced relative contact time in the forefoot were recorded in confident walking. Significance: Pressures change rapidly as walking is initiated with significant differences in foot loading evident within an average 77 days. Importantly, these changes differ in straight and turning walking. Continued reliance on assessment of straight-line walking during early stages of ambulation likely fails to characterise 26% of steps experienced by infant feet.

Item Type: Article
Schools: Schools > School of Health and Society > Centre for Health Sciences Research
Journal or Publication Title: Gait & Posture
Publisher: Elsevier
ISSN: 0966-6362
Related URLs:
Funders: Dr. William M Scholl Unit of Podiatric Development Fund
Depositing User: C Price
Date Deposited: 07 Dec 2021 09:21
Last Modified: 06 Dec 2022 02:30
URI: https://usir.salford.ac.uk/id/eprint/62495

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