RELATIONSHIP OF FOOT POSTURE AND BODY COMPOSITION MEASURES IN CHILDREN WITH DEVELOPMENTAL COORDINATION DISORDER

T.T.T. Yam¹, S.S.M. Fong², W.W.N. Tsang³

¹Hong Kong Metropolitan University, Department of Physiotherapy, Hong Kong`, Hong Kong, ²The Education University of Hong Kong, Department of Health and Physical Education, Hong Kong, Hong Kong, ³Hong Kong Metropolitan University, Department of Physiotherapy, Hong Kong, Hong Kong

Background: Children with developmental coordination disorder (DCD) is a neurodevelopmental condition displaying a great variability of balance and motor deficits. Children with DCD are more likely to be overweight or obese. This is postulated to increase the chances of developing flat foot as a compensatory mechanism to counter excessive body weight. It has been suggested that the development of flat foot is associated with the amount of muscle mass and body composition measures.

Purpose: This study aimed to
i) compare the foot posture and body composition measures between children with and without DCD; and
ii) investigate the relationship between foot posture and fat percentage in children with DCD.

Methods: This was a cross-sectional study with fifty-nine children with DCD (mean age = 8.07) and sixty-two typically developing children (mean age = 7.97). All children received a foot structure assessment with the Foot Posture Index 6 (FPI-6). Children also underwent a whole-body dual-energy X-ray absorptiometry (DXA) with body composition measures including lower limb fat mass and lean mass, total fat percentage and fat mass index.

Results: Children with DCD had a significantly high FPI-6 total scores when compared to typically developing children (Left: 1.12; 95% CI: 0.172, 2.061; Right: 1.15; 95% CI: 0.218, 2.079). FPI-6 sub-scores also revealed significant differences between children with and without DCD for the talar head and forefoot position. The DXA outcome measures revealed that children with DCD had a significantly higher total fat mass, total fat percentage and fat mass index than typically developing children (1247.48g, 1.82% and 0.56kg/m² respectively). Additionally, a significant relationship was revealed between FPI-6 right total score and total fat percentage (r = -0.281, p = 0.031). Total fat percentage was a significant predictor of FPI-6 right total score (t = -2.213).

Conclusions: Children with DCD exhibited more pronated foot posture when compared to typically developing children. This is accompanied by higher body composition measures including total fat mass and total fat percentage. Moreover, a higher total fat percentage was revealed to be associated with a more pronated foot posture.

Implications: Childhood obesity is a worldwide problem where a higher body weight influences the force distribution of the midfoot. This study provides insight into the relationship between adipose tissue content and the foot’s structure in children with and without DCD. Thus, it may be worthwhile to reassess the emphasis of intervention. High body weight is speculated to influence motor performances and weight-related flattening of the medial longitudinal arch. Striking a balance between motor skills training and promoting a healthy lifestyle to prevent overweight and obesity in children with DCD is crucial. Further research is warranted to explore the extent of influence body composition measures have on motor performance in children with DCD.

Funding acknowledgements: No funding was provided for this study

Keywords:
Developmental coordination disorder
Flat foot
Body composition measures

Topics:
Paediatrics
Primary health care
Musculoskeletal

Did this work require ethics approval? Yes

Institution: The University of Hong Kong

Committee: Human Research Ethics Committee

Ethics number: EA1512037