IMPACT OF FOOT STRUCTURAL ABNORMALITY OR FOOT DEFORMITY ON STATIC AND DYNAMIC BALANCE IN ATHLETES WITH INTELLECTUAL DISABILITY (ID)

D. Bainbridge¹, T. Kovačič², J. Hanley³, D. Jenkins⁴

¹University of Montana, College of Health Professions & Biomedical Sciences, Missoula MT, United States, ²University of Ljubljana, Faculty of Health Science, Special Olympics Slovenia, Ljubljana, Slovenia, ³Special Olympics International, Research Division, Washington DC, United States, ⁴Midwestern University, Arizona College of Podiatric Medicine, Glendale, AZ, United States

Background: The foot and ankle are the distal end of the lower bio-kinematic chain. Research supports the negative impact of foot deformities and structural abnormalities on balance. People with ID such as Down syndrome have foot abnormalities that might impact balance.

Purpose: This project examined the impact of foot deformities and structural abnormalities on balance in adults with ID. Influence of age, gender and game status were also assessed.

Methods: Data from 10.983 Special Olympics Healthy Athletes® screenings from 2007-2019 were analyzed; screenings included World Games (WG) and local events from global regions. Data on deformities and abnormalities from Fit Feet podiatric screening were compared to static (single leg stance eyes open [SLS eo] and closed {SLS ec} and dynamic (functional reach {FRT}) balance tests on FUNfitness physical therapy screening. Pass for balance tests was: SLS eo < 20 seconds; SLS ec <10 seconds; FRT < 20 cm. All statistics are Pearson Chi-Square, using a threshold of p < 0.05.

Results: Foot deformity did not correlate with balance when compared to no foot deformities (48.1 vs 45.5%). However, WG athletes were less likely to have balance problems from deformity than non-WG athletes (36.3 vs 47.4%). Number of deformities increased with age (28.6% at 20-29 years to 51.6% at 60+ years). Foot structural abnormalities demonstrated a different pattern. Those with any foot abnormality had more balance problems than those without (52.2 vs 45.2%); age, gender, and game status had no association. When evaluated independently, athletes with pes planus had more balance problems than those without (52.2 vs 45.9%); gender and game status had little influence (52 vs. 50%). Tibial varum significantly impacted balance (59.4 vs 48.7%). Age and gender had no added impact, but game status did (3.2% non-WG vs 1.2% WG athletes). When calcaneal position was evaluated, those with abnormal calcaneal position were more likely to have balance problems than those without (53 vs 42.6%). Gender slightly influenced balance in those with calcaneal malposition (41.3% females vs 39.6% males), but game status had a stronger impact (31.8% WG athletes vs. 41.1% non-WG athletes). When assessing calcaneal valgus versus varus, the presence of valgus did not impact balance, nor did age or gender. However, game status was an influence; WG athletes with valgus had more balance problems (47.2%) than non-WG athletes (29%). Varus had minimal impact on balance (47.7%) while those without varus had greater balance problems (52.2%). The presence of varus increased with age (8.8% in 20-29 years to 11.5% in 50-59 years). While gender had no influence, game status had a strong impact; WG athletes had higher rates of calcaneal varus compared to non-WG athletes (20.1 vs 9.4%).

Conclusions: Foot deformities had less impact on balance than foot abnormalities in all athletes. Pes planus. tibial varum, and calcaneal position had greatest impact on balance. Age and game status influenced the impact of foot abnormalities on balance.

Implications: Physiotherapists should include evaluation of foot deformities and structural abnormalities as a component of balance assessment. Findings can be mitigated by the physiotherapist or podiatric referral.

Funding acknowledgements: Work supported by Award Number NU27DD000021, funded by the Centers for Disease Control and Prevention and the Golisano Foundation.

Keywords:
Feet
Balance
Intellectual disability

Topics:
Intellectual disability
Musculoskeletal
Sport & sports injuries

Did this work require ethics approval? No

Reason: Special Olympics approved and provided the data for this research analysis. All participants have been de-identified prior to the research analysis.
Further, all participants or their legal guardians signed a consent for use of data for programmatic and research purposes prior to their participation in any Healthy Athletes event. Finally, this project only involved data analysis, so further consent is not indicated.