Association of height, foot length, and pubertal development in children aged 3-18: a cross-sectional survey in China.

Objective: This study aimed to analyze the growth patterns of height and foot length (FL) among Chinese children aged 3-18 and examine their associations with puberty development. Methods: A cross-sectional survey was conducted in September 2022 in Beijing. Data were collected through questionnaires and on-site physical examinations. The growth patterns and velocity of height and FL in different age groups were described, and their associations with puberty development were analyzed. Results: From an age perspective, the peak FL growth occurred between 9 and 11 years (boys were 11 years and girls were 9 years), while the peak height growth occurred at 11 ~ 13 years for boys and 9 ~ 11 years for girls. Additionally, boys and girls reached 99.0% of their final FL at the ages of 14 and 13, respectively, while they reached 99.0% of their final height at the ages of 16 and 15, respectively. From the perspective of Tanner stage, the age of peak FL growth in boys coincided with the age of the G2 stage, while in girls it occurred slightly earlier than the mean age of the B2 stage. The peak height growth for both boys and girls occurred between Tanner stages 2 and 3. Conclusion: Boys and girls reach their peak FL growth at 11 and 9 years old, respectively, which were both 2 years earlier than their peak height growth. The peak FL growth occurred around the onset of puberty, while the peak height growth occurred between Tanner stages 2 and 3.

Foot length - A reliable predictor of posterior tibial tendon thickness: A cadaveric study.

Background: Tibialis posterior tendon, deltoid ligament and spring ligament are the three most important structures on the medial aspect of the foot. They contribute to the stability of the foot and ankle and also to the maintenance of the arches of the foot. These structures get affected and dimensions get disrupted in various traumatic and degenerative conditions. Normal range of dimensions of these structures has not been studied in an Indian population. Our objective is to define the normal thicknesses of these structures using a cadaveric model. We also hypothesize that longer the foot, higher stresses on these structures and hence thicker they will be. We aim to assess this hypothesis as well. Methods: Dissection of the medial aspect of the foot was done on twenty cadaveric below knee specimens. Tibialis posterior tendon was identified and its thickness was measured. Deltoid and plantar calcaneonavicular ligaments were identified. Their lengths and thicknesses were measured. Length of the feet was also measured prior to dissection. Statistical analysis was done using the data obtained. Results: Mean tibialis posterior thickness was 7.0165 ± 0.387 mm. Mean deltoid thickness was 5.124 ± 0.28 mm. Its mean length was 21.328 ± 2.22 mm. Mean plantarcalcaneonavicular ligament thickness was 2.491 ± 1.120 mm. Thicknesses of the tibialis posterior tendon and plantarcalcaneonavicular ligament correlated significantly with the length of the foot. Conclusion: The thicknesses of the tibialis posterior tendon and plantar calcaneonavicular ligament are shown to be a function of and significantly proportional to the length of the foot. This helps the surgeon to estimate the thicknesses which the structures had prior to the pathology, in order to recreate the non-pathological anatomy after a tendon transfer or a reconstruction procedure. The normal thicknesses of tibialis posterior, deltoid and plantar calcaneonavicular ligaments are described for an Indian setting and deviations can be used to assess various pathologies of the foot and ankle affecting these structures.

How to measure children's feet: 3D foot scanning compared with established 2D manual or digital methods.

BACKGROUND: In infants and young children, a wide heterogeneity of foot shape is typical. Therefore, children, who are additionally influenced by rapid growth and maturation, are a very special cohort for foot measurements and the footwear industry. The importance of foot measurements for footwear fit, design, as well as clinical applications has been sufficiently described. New measurement techniques (3D foot scanning) allow the assessment of the individual foot shape. However, the validity in comparison to conventional methods remains unclear. Therefore, the purpose of this study was to compare 3D foot scanning with two established measurement methods (2D digital scanning/manual foot measurements). METHODS: Two hundred seventy seven children (125 m / 152 f; mean ± SD: 8.0 ± 1.5yrs; 130.2 ± 10.7cm; 28.0 ± 7.3kg) were included into the study. After collection of basic data (sex, age (yrs), body height (cm), body weight (kg)) geometry of the right foot was measured in static condition (stance) with three different measurement systems (fixed order): manual foot measurement, 2D foot scanning (2D desk scanner) and 3D foot scanning (hand-held 3D scanner). Main outcomes were foot length, foot width (projected; anatomical; instep), heel width and anatomical foot ball breadth. Analysis of variances for dependent samples was applied to test for differences between foot measurement methods (Post-hoc analysis: Tukey-Kramer-Test; α=0.05). RESULTS: Significant differences were found for all outcome measures comparing the three methods (p<0.0001). The span of foot length differences ranged from 3 to 6mm with 2D scans showing the smallest and 3D scans the largest deviations. Foot width measurements in comparison of 3D and 2D scans showed consistently higher values for 3D measurements with the differences ranging from 1mm to 3mm. CONCLUSIONS: The findings suggests that when comparing foot data, it is important to consider the differences caused by new measurement methods. Differences of about 0.6cm are relevant when measuring foot length, as this is the difference of a complete shoe size (Parisian point). Hence, correction factors may be required to compare the results of different measurements appropriately. The presented results may have relevance in the field of ergonomics (shoe industry) as well as clinical practice.

Identification of anthropometric surrogate measurements and their cut-off points for the detection of low birth weight and premature newborn babies using ROC Analysis.

Despite the fact that health facilities in Ethiopia are being built closer to communities in all regions, the proportion of home deliveries remains high, and there are no studies being conducted to identify low birth weight (LBW) and premature newborn babies using simple, best, alternative, and appropriate anthropometric measurement in the study area. The objective of the present study was to find the simple, best, and alternative anthropometric measurement and identified its cut-off points for detecting LBW and premature newborn babies. A health facility-based cross-sectional study was conducted in the Dire Dawa city administration, Eastern Ethiopia. The study included 385 women who gave birth in health facility. To evaluate the overall accuracy of the anthropometric measurements, a non-parametric receiver operating characteristic curve was used. Chest circumference (AUC = 0⋅95) with 29⋅4 cm and mean upper arm circumference (AUC = 0⋅93) with 7⋅9 cm proved to be the best anthropometric diagnostic measure for LBW and gestational age, respectively. Also, both anthropometric measuring tools are achieved the highest correlation (r = 0⋅62) for LBW and gestational age. Foot length had a higher sensitivity (94⋅8 %) in detecting LBW than other measurements, with a higher negative predictive value (NPV) (98⋅4 %) and a higher positive predictive value (PPV) (54⋅8 %). Chest circumference and mid-upper arm circumference were found to be better surrogate measurements for identifying LBW and premature babies in need of special care. More research is needed to identify better diagnostic interventions in situations like the study area, which has limited resources and a high proportion of home deliveries.

Tape Rule Measurement of Foot Length as Proxy for Vernier Digital Calliper in Estimating Gestational Age among Nigerian Neonates.

BACKGROUND: Estimating gestational age at birth could be challenging, particularly in settings where the expertise to use conventional methods is lacking. The use of the postnatal foot length has been proposed for this purpose. The ideal tool for measuring foot length, the Vernier Digital Calliper, is not readily available in resource-poor settings. OBJECTIVE: To determine the degree of correlation between postnatal foot length measurement using a Vernier Digital Calliper and a tape measure in the estimation of gestational age among Nigerian neonates. METHODS: Neonates aged 0 to 48 hours without lower limb deformities were studied. The Gestational age was determined using the New Ballard Scoring method. The Foot length was measured as the distance between the tip of the second toe and the heel using both the Vernier Digital Calliper (FLC) and a non-elastic, flexible tape measure (FLT). The measurements were subjected to statistical comparisons. RESULTS: A total of 260 newborn infants comprising 140 preterm and 120 term babies were studied. The foot length measurements using both the calliper and tape measure progressively increased with gestational age. FLT was consistently relatively higher than FLC across gestational ages. The relationship between the two tools was FLC = 3.05 + (0.9 x FLT) for preterm babies and FLC = 23.39 + (0.6 x FLT) for term babies. The Cronbach's Alpha correlation ranged from 0.775 to 0.958 across the gestational ages. The degree of agreement between the tools ranged from -2.03 to -1.34 with a mean difference of -1.68 (t = -9.67, p <0.001). CONCLUSION: There is a high level of intra-gestational age reliability between caliper measurements and tape measurements, the latter can be suitably used as a suitable proxy for the former in the measurement of postnatal foot length in the estimation of gestational age at birth.

CONTEXTE: L'estimation de l'âge gestationnel à la naissance peut s'avérer difficile, en particulier dans les contextes où l'expertise nécessaire à l'utilisation des méthodes conventionnelles fait défaut. La longueur du pied postnatal a été proposée à cette fin. L'outil idéal pour mesurer la longueur du pied, le pied à coulisse numérique de Vernier, n'est pas facilement disponible dans les régions à faibles ressources. OBJECTIF: Déterminer la corrélation entre deux méthodes de mesure de la longueur du pied postnatal dans l'estimation de l'âge gestationnel chez les nouveau-nés nigérians. MÉTHODES: Des nouveau-nés âgés de 0 à 48 heures sans déformation des membres inférieurs ont été étudiés. L'âge gestationnel a été déterminé à l'aide de la méthode New Ballard Scoring. La longueur du pied a été mesurée comme la distance entre l'extrémité du deuxième orteil et le talon à l'aide d'un pied à coulisse numérique de Vernier (FLC) et d'un mètre ruban souple non élastique (FLT). RÉSULTATS: Au total, 260 nouveau-nés, dont 140 prématurés et 120 nés à terme, ont été étudiés. Les mesures de la longueur du pied à l'aide du pied à coulisse et du mètre ruban augmentent progressivement avec l'âge gestationnel. La FLT était toujours relativement plus élevée que la FLC, quel que soit l'âge gestationnel. La relation entre les deux outils était la suivante : FLC = 3,05 + (0,9 x FLT) pour les prématurés et FLC = 23,39 + (0,6 x FLT) pour les enfants nés à terme. La corrélation alpha de Cronbach allait de 0,775 à 0,958 selon l'âge gestationnel. CONCLUSION: Le mètre ruban est un substitut adéquat au pied à coulisse pour la mesure de la longueur du pied postnatal. Mots clés: Âge gestationnel estimé; Pied à coulisse numérique; Longueur du pied; Prématurité.

A new method to estimate children's weight accurately in emergency settings using foot length and mid-upper arm circumference.

BACKGROUND: In emergency settings, medication dosages are primarily determined based on the child's weight; however, the healthcare personnel sometimes may have to make the first intervention without knowing the patient's weight, which may result in an underdose or overdose of the medication. We aimed to find a reliable method to estimate children's bodyweight, including the obese and malnourished. METHODS: We conducted the study with children between the ages of 3 and 17 years. We measured the children's bodyweight, right foot length, and mid-upper arm circumference in centimeters during their examination. We created a concise formula through regression analysis to estimate the patients' weight based on the right foot length and mid-upper arm circumference. Finally, we compared this formula to other conventional formulae. RESULTS: The study included 741 patients whose average age was 8.4±3.9 (3-17) years. A high correlation was found between the patients' foot length, arm circumference, and bodyweight (R: 0.866, p<0.001 and R: 0.910, p<0.001, respectively). A single formula was created by regression analysis based on foot length and the mid-upper arm circumference without including sex and age in the calculation to make a more straightforward and faster calculation in emergency cases. CONCLUSION: The formula created may be advantageous for reliably and easily estimating the weight of children aged 3-17 of any sex and body habitus in emergency settings without special equipment. This newly developed formula may enable a low-cost optimal level of weight estimation without the need for special equipment.

Correlation analysis between body mass index and foot length in Chinese adolescents: a regional study.

This study aims to analyse the relationship between body mass index and foot length in Chinese adolescents and to provide theoretical guidance for preventing a flat foot in Chinese adolescents. This study recruited 1477 students aged 14-23 years. The participants' height, weight, and body mass index were measured, as well as baseline data, including age, gender and foot length. Differences in foot length (bilateral) and flat foot distribution were statistically significant except for the normal foot and high arch foot distribution based on different body mass index groups. Linear correlation analysis demonstrated that body height, weight and body mass index were positively correlated with bilateral foot length regardless of gender. Body mass index acted as a risk factor for flat foot (bilateral) through disordered multi-classification logistic regression analysis. Body mass index was positively correlated with left and right foot length regardless of gender and acted as a risk factor for a flat foot in Chinese adolescents. Practitioner summary: Significant differences exist in the anthropometric data of various races and ethnic groups. The study was investigated in the form of a cross-sectional study. BMI was positively correlated with bilateral foot length and acted as a risk factor for a flat foot in Chinese adolescents.

Postnatal foot length in the estimation of gestational age in relation to intrauterine growth pattern among Nigerian neonates

Objectives: To determine the relationship between postnatal foot lengths and estimated gestational age (EGA) in relation to intrauterine growth patterns determined at birth among Nigerian neonates. Design: Hospital-based, cross-sectional. Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Participants: 260 neonates with EGA 30- 42 weeks within 48 hours of life. Interventions: Postnatal foot lengths (FL) were measured with Vernier digital calliper in millimetres. The intra-uterine growth pattern was determined using the Lubchenco chart. Pearson correlation and regression analysis tests were performed. Main outcome measures: Postnatal foot length in relation to Intra-Uterine Growth Pattern. Results: The mean postnatal FL had a strong positive correlation with the EGA from 30 through 42 weeks (r = 0.855, p < 0.001). The overall mean foot length for preterm neonates was 65.44 (6.92) mm, while that of term neonates was 77.92 (4.24) mm. The linear regression equation was generated as: EGA = 9.43 + (0.37 × FL), p < 0.001. The EGA as measured by FL had the highest positive correlation with Small for Gestational Age (SGA) intra-uterine-growth pattern, followed by Appropriate for Gestational Age (AGA) and least by Large for Gestational Age (LGA) respectively (r = 0.936> 0.861 > 0.666). Conclusion: The postnatal foot length correlated well with estimated gestational age, and the correlation was best among SGA infants

Postnatal foot length in the estimation of gestational age in relation to intrauterine growth pattern among Nigerian neonates.

Objectives: To determine the relationship between postnatal foot lengths and estimated gestational age (EGA) in relation to intrauterine growth patterns determined at birth among Nigerian neonates. Design: Hospital-based, cross-sectional. Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Participants: 260 neonates with EGA 30- 42 weeks within 48 hours of life. Interventions: Postnatal foot lengths (FL) were measured with Vernier digital calliper in millimetres. The intra-uterine growth pattern was determined using the Lubchenco chart. Pearson correlation and regression analysis tests were performed. Main outcome measures: Postnatal foot length in relation to Intra-Uterine Growth Pattern. Results: The mean postnatal FL had a strong positive correlation with the EGA from 30 through 42 weeks (r = 0.855, p < 0.001). The overall mean foot length for preterm neonates was 65.44 (6.92) mm, while that of term neonates was 77.92 (4.24) mm. The linear regression equation was generated as: EGA = 9.43 + (0.37 × FL), p < 0.001. The EGA as measured by FL had the highest positive correlation with Small for Gestational Age (SGA) intra-uterine-growth pattern, followed by Appropriate for Gestational Age (AGA) and least by Large for Gestational Age (LGA) respectively (r = 0.936> 0.861 > 0.666). Conclusion: The postnatal foot length correlated well with estimated gestational age, and the correlation was best among SGA infants. Funding: None declared.

Comprehensive Understanding of Foot Development in Children Using Capacitive Textile Sensors.

Knowledge of foot growth can provide information on the occurrence of children's growth spurts and an indication of the time to buy new shoes. Podiatrists still do not have enough evidence as to whether footwear influences the structural development of the feet and associated locomotor behaviours. Parents are only willing to buy an inexpensive brand, because children's shoes are deemed expendable due to their rapid foot growth. Consumers are not fully aware of footwear literacy; thus, views of consumers on children's shoes are left unchallenged. This study aims to embed knitted smart textile sensors in children's shoes to sense the growth and development of a child's feet-specifically foot length. Two prototype configurations were evaluated on 30 children, who each inserted their feet for ten seconds inside the instrumented shoes. Capacitance readings were related to the proximity of their toes to the sensor and validated against foot length and shoe size. A linear regression model of capacitance readings and foot length was developed. This regression model was found to be statistically significant (p-value = 0.01, standard error = 0.08). Results of this study indicate that knitted textile sensors can be implemented inside shoes to get a comprehensive understanding of foot development in children.

The foot drawing method: reliability of measuring foot length and outward rotation in children with clubfoot.

BACKGROUND: The Ponseti method is the gold standard for clubfoot treatment. However, relapse and residual gait deviations are common, and follow-up until 7 years of age is recommended. We evaluated the reliability of the foot drawing method, a new instrument for the follow-up of clubfoot. The method uses drawings of the foot in the neutral position and external rotation to measure foot length and outward rotation. METHODS: Nineteen children aged 2.5-7 years who were treated with the Ponseti method for congenital clubfoot were included. Two raters made the drawings twice (D1 and D2). Each rater measured foot length, foot rotation, and foot-tibial rotation independently (D1). Later, the raters repeated the measurements (D2). Interrater reliability was assessed using the D1 from each rater. Intrarater reliability was assessed using the measurements from each rater's D1 and D2. Bland-Altman plots were used to visualize the limits of agreement (LoA). The mean, 95% confidence interval, and one standard deviation of the differences in all measurements were calculated. RESULTS: The mean differences between and within raters were: foot length < 1 mm, foot rotation < 1°, and foot-tibia rotation < 2°, which indicated no systematic differences. The LoA for foot length were: 4.5 mm and 5.9 mm between raters for D1, - 4.8 mm and 5.9 mm for rater 1 (D1-D2), and - 5.1 mm and 5 mm for rater 2 (D1-D2). The LoA for foot rotation: were - 12° and 10.6° between raters (D1), - 8.4° and 6.6° for rater 1 (D1-D2), and - 14° and 14.1° for rater 2 (D1-D2). The LoA for foot-tibia rotation were: - 17.8° and 14.3° between raters (D1), - 12° and 12.2° for rater 1 (D1-D2), and - 12.7° and 13.6° for rater 2 (D1- D2). CONCLUSIONS: The absence of systematic differences between and within raters, and LoA observed indicate that the foot drawing method is applicable in clinical practice and research. However, the results of the foot and foot-tibia rotation analyses imply that caution is needed when interpreting changes in foot rotation in feet with higher degrees of rotation.

Estimation of Kidney Size From Foot Length in Newborns: A Cross-Sectional Study.

Background Kidney size determination and sonographic follow-up are important in clinical diagnosis and treatment in children. Various anthropometric measurements are correlated with gestational age and birth weight and are used to identify high-risk babies in need of early interventions. Although foot length has emerged as a simple and reliable anthropometric measurement, it is not correlated with kidney size, except in the fetal period. This study was undertaken to find a correlation between foot length and kidney dimensions and estimate kidney size by finding regression equations in newborns. Methods We conducted a cross-sectional study and 216 newborns were enrolled at a tertiary care hospital. Foot length was measured by digital Vernier calipers and kidney dimensions were measured by ultrasonography. The Pearson correlation coefficient and simple linear regression tests were used to determine the relationship between foot length and kidney dimensions. Results Foot lengths and kidney dimensions were comparable in males and females as well as on the right and left sides, except for kidney length, which was found to be longer in males. Both right and left foot lengths showed highly significant (p<0.001) but small, positive correlations with corresponding side kidney length, breadth, and area, with R-values ranging from 0.2874 to 0.3668. However, the correlation between birth weight and foot length was significant, positive, and moderate (r=0.6962 and 0.6923 for right and left foot lengths, respectively). The regression equation for estimation of kidney size from foot length was obtained but the variance explained was small (e.g. R2=0.1325 for right kidney length). Out of 216 babies in our study, 10 babies had a renal anomaly. Conclusions We found a significant but small, positive correlation between foot length and kidney dimensions. Only 13.25% of the variance in kidney length was associated with foot length. Birth weight also had a significant and positive but small correlation with kidney dimensions. However, the correlation of birth weight with foot length was moderate, and a 57.14% variance in foot length was associated with birth weight. Multivariate regression analysis with more anthropometric parameters and gestational age may help in finding a better estimation of kidney size.

Estimated Gestational Age From Infant's Foot Length in Japanese.

Aim In developed countries including Japan, gestational age (GA) is predicted by the last menstrual period (LMP) and/or fetal ultrasound. In some developing countries, GA is predicted by infant's foot length (FL). Pregnant women who did not have pregnancy check-up is not infrequent in Japan, therefore there are sometimes opportunities to estimate the GA from infants after the delivery. The aim of this study is to determine the estimated GA formula from infant's FL in Japanese. Methods This study was a prospective cohort study. Infants between May 2021 and August 2021 at Iizuka Hospital and Tagawa Hospital or transferred from other hospitals within 24 hours of birth were collected. GA was determined using LMP and/or fetal ultrasound. The infant's FL was measured with a digital caliper within 24 hours of birth. The relationship between FL and GA was analyzed by simple regression analysis to determine the coefficient of determination (R2). The infant's FL of males and females, infant's FL of preterm and term, and infant's FL of low birth weight and appropriate weight infants were performed by the t-test as independent samples. A statistically significant difference was p < 0.05. Statistical analysis was performed using JMP Pro 16 (SAS Institute Japan Co., Ltd., Minato-ku, Tokyo). Results Ninety of the 135 infants were enrolled. The average GA was 38.2 ± 1.8 weeks, the average infant's FL was 7.230 ± 0.411 centimeter (cm), and the range of the infant's FL was 5.385 to 8.089 cm. The estimated GA formula, GA = 18.49 + 0.27 x infant's FL (R2 = 0.39), was determined. Conclusions We determined the estimated GA formula from the infant's FL. There are some limitations and care should be taken in the use.

Estimation of Stature from foot length in male indigenous population of Assam Region.

Human stature is one of the biological profiles that can and should be used in the identification of humans from different parts of the human skeleton. Estimation of stature from feet dimensions may play an important role in the identification process of a human. Further, it is also possible to establish a relationship between the feet dimensions and stature of a person. This study is focused on the measurements of feet dimension in indigenous population groups found in the North-East Indian Region (Assam). Measurements of the length of the foot and body height were carried out with the help of Vernier Calipers and standard measuring tape. This paper emphasizes the study of a total the number of 200 male bodies aged between 18 to 65. Linear correlation and regression equation were used to determine the correlation between the foot and body height and using Pearson's coefficient (ρ < 0.001) for the correlation between foot length and stature.

Foot Length for Gestational Age Assessment and Identification of High-Risk Infants: A Hospital-Based Cross-Sectional Study.

The knowledge of the gestational age of the newborn is essential for management. In the absence of a dating scan, the postnatal assessment scores have drawbacks of being difficult to learn and administer in the community. The measurement of the foot length is easy, reproducible and offers an objective assessment. The objective of this study was to determine the correlation of postnatal (<48 h) foot length measurement (with calipers) with gestational age as determined by antenatal dating ultrasound, create a predictive model for the same and propose foot length measurement cutoffs for <37 and <34 weeks of gestation. Secondary objectives were to assess the correlation between foot length as measured with calipers and that measured with a ruler and a paper footprint. This was a hospital-based cross-sectional study. Among the 520 babies assessed, the correlation of foot length with gestational age was 0.89. Operational cutoffs for the categories of <37 and <34 weeks at a sensitivity of 95% were <70 and <65 mm, respectively. The Pearson's correlation between foot length as measured by caliper and ruler was 0.95 and between caliper and paper footprint was 0.87. This study correlating foot length and gestational age has the potential to help neonatal care providers make informed management decisions, particularly in resource-limited settings.

Development of foot length in children with congenital clubfoot up to 7 years of age: a prospective follow-up study.

BACKGROUND: Clubfeet are typically shorter than normal feet. This study aimed first to describe the development of foot length in a consecutive series of children with congenital clubfoot and second to relate foot length to development of relapse and motion quality. METHODS: Foot length was measured every 6 months in 72 consecutive children with congenital clubfoot (29 bilateral) aged from 2 to 7 years. The initial treatment was nonsurgical followed by standardized orthotic treatment. Foot length growth rate was calculated every half year. In children with unilateral clubfeet, the difference in foot length between the clubfoot and the contralateral foot was calculated. Motion quality was evaluated by the Clubfoot Assessment Protocol (CAP). Student's t test, the Mann-Whitney U test and Spearman's correlation were used for group comparisons. Bonferroni correction was used when multiple comparisons were performed. RESULTS: Clubfeet were smaller (P < 0.001) than reference feet at all ages but had a similar growth rate up to age 7. Unilateral clubfeet with greater difference in size compared with the contralateral foot at the first measurement, relapsed more frequently (P = 0.016) and correlated with poorer motion quality (r = 0.4; P = 0.011). CONCLUSIONS: As previously reported, clubfeet were smaller than reference feet at all ages. The growth rate, however, was similar between clubfeet and reference feet. Children with unilateral clubfeet and greater foot length difference at 2 years of age had a higher tendency to relapse and poorer motion quality at 7 years of age, indicating that foot length could be used as a prognostic tool.

A Comparison of the Accuracy of Various Methods of Postnatal Gestational Age Estimation; Including Ballard Score, Foot Length, Vascularity of the Anterior Lens, Last Menstrual Period and Also a Clinician's Non-Structured Assessment.

INTRODUCTION: Gestational age is a strong determinant of neonatal mortality and morbidity. Early obstetric ultrasound is the clinical reference standard, but is not widely available in many developing countries. METHODS: A prospectively designed diagnostic accuracy study in a tertiary referral hospital in a developing country. Early ultrasound (<20 weeks) was the clinical reference standard. Methods evaluated included anthropometric measurements (including foot length), vascularity of the anterior lens, the New Ballard Score and last menstrual period. Clinicians' non-structured global impression 'End of Bed' Assessment was also evaluated. RESULTS: 106 babies were included in the study. Median age at birth was 34 weeks (interquartile range 29-36). Ballard Score and 'End of Bed' Assessment had a mean bias of -0.14 and 0.06 weeks respectively but wide 95% limits of agreement. The physical component of the Ballard score, the total Ballard score and Foot length's ability to discriminate between term and preterm infants gave an area under the receiver operating characteristics curve of 0.97, 0.96 and 0.95, respectively. DISCUSSION: Although 'End of Bed' Assessment and Ballard score had small mean biases, the wide confidence intervals render the methods irrelevant in clinical practice. Foot length was particularly poor in Small for Gestational Age infants. None of the methods studied were superior to a non-structured clinician's informal 'End of Bed' Assessment. CONCLUSION: None of the methods studied met the a priori definition of clinical usefulness. Improving access to early ultrasound remains a priority. Instead of focusing on chronological accuracy, future research should compare the ability of early ultrasound and Ballard score to predict morbidity and mortality. Lay summary. BACKGROUND: Gestational age describes the time interval between conception and the delivery of the baby. Babies born before 37 weeks of gestation (preterm) or after 42 weeks of gestation (post-dates) have an increased risk of death and specific illnesses. The best way to estimate the gestational age is to perform an ultrasound scan on the mother before 20 weeks. However, this is not widely available in many developing countries. Methods to estimate gestational age after birth include calculating the time from the last period, various measurements of the child (such as weight, foot length or head circumference) physical and neurological markers of maturity and examination of the blood vessels on the lens in the eye. METHODS: In this study, we assessed how accurate these methods were when compared with the best available method; early ultrasound. We also analyzed the clinicians own personal feeling of what the most likely gestation was, based on an informal 'end of bed' assessment. If a method was to be deemed clinically useful it was agreed that it would have to confidently identify the gestation to within 1 week of the true gestation. RESULTS: None of the methods studied could confidently predict the gestational age of individual babies within 1 week. Ballard scoring and the clinician's informal 'End of Bed' Assessment were the most accurate and also had the smallest inter-operator variability when the results of two separate researchers were compared. Foot length performed particularly badly with babies who were small for their gestational age. CONCLUSION: None of the methods studied confidently predicted gestational age within a week, so have little use in clinical practice. Access to early ultrasound should be improved. Further research into the relationship between maturity markers such as the Ballard score and the rates of death and specific premature related illnesses is warranted.

Relationship Between Foot Length and Gestational Age in Pakistan.

Preterm births have a high risk of mortality. Therefore, knowledge of the gestational age (GA) at birth is crucial to guide the appropriate management of a newborn. Common methods for estimating GA such as the last menstrual period, ultrasonography, and post-natal Ballard scoring have some limitations. This study aimed to determine the relationship between foot length and GA to develop and validate an equation for predicting GA of Pakistani newborns. We conducted a prospective study in a large obstetric hospital in Pakistan. Data for this analysis were extracted from the hospital files of eligible women by trained study midwives. Midwives were also trained in performing the Ballard examination and taking foot length using a disposable measuring tape within an hour of the birth. The GA was calculated using an android-based GA calculator. Simple and multiple linear regression were used to construct predicting equations for GA. Both the foot length and GA were available for 1542 cases. The median GA was 34.5 (IQR 4.7) weeks and the median foot length was 7 cm (IQR 1.4). There was a positive linear relationship between foot length and GA (r 2 81.7%, P-value < .001). Stratified analysis showed an r 2 of 81.7% for males and 81.6% for females. The r 2 for stillbirths was 84.1% and, 82.3% for live births. The r 2 for macerated stillbirths was 88.6% and 90.6% for fresh stillbirths. In resource poor settings, the use of foot length can estimate GA in both live births and stillbirths and can easily identify preterm infants.

Body height and its estimation utilizing foot length measurements in Montenegrin adolescents: a national survey.

INTRODUCTION: Background: the purpose of this research was to determine a regression equation for the estimation of stature based on foot length measurements. Methods: this research was carried out in 1,001 subjects (504 male and 497 female) from the population of Montenegrin adolescents. The stature and foot length measurements were taken according to the ISAK protocol, and the data were analyzed statistically. A linear regression analysis determined the prediction of foot length for the criterion variable of body height at a significance level of p < 0.05. These relations are presented in the form of a scatter diagram. We obtained the coefficient of determination, multiple correlation coefficients, a partial correlation coefficient, the regression, a t-test and a standardized beta coefficient. Results: the results of this research study confirmed that foot length reliably predicts stature in Montenegrin adolescents of both genders, and revealed a very useful finding for physical anthropologists and experts from related fields. Conclusions: it was confirmed that there is a correlation between foot length and body height (males: 41.9 %, females: 44.3 %). Therefore, foot length has proven to be a reliable predictor on the basis of which actual body height can be estimated. Keywords.

Effects of toe length, foot arch length and toe joint axis on walking biomechanics.

Toe joint articulation has been shown to affect gait mechanics, as evidenced by walking simulations, biped robots, and foot prostheses. However, it is not known how parameters such as toe length, foot arch length (i.e., heel-to-toe-joint length) or toe joint axis angle affect human walking. We utilized a previously developed adjustable ankle-toe prosthesis to systematically examine these three foot parameters. We tested ten able-bodied persons walking on a force instrumented-treadmill while wearing a pair of adjustable prostheses attached bilaterally below simulator boots (which fixated their biological ankles). We collected motion and ground reaction force data to compute lower-limb kinematics and kinetics as well as COM power and work. We observed that increasing the foot arch length by 60 mm (35%) increased COM Push-off work by ~5 J, due to increased energy storage and return by the ankle spring. Increasing the toe length by 40 mm (80%) and changing the toe joint axis by ±9° from a neutral angle resulted in negligible effects on COM mechanics and lower limb kinetics. This study provides further insights regarding toe joint function; knowledge which may benefit the design/integration of toe joints into prostheses, exoskeletons and legged robots.