目的 调查北京市通州区托幼机构学龄前儿童足底压力分布特点,评估学龄前儿童扁平足、高弓足检出率,为预防扁平足提供临床依据。方法 于2024年对北京市通州区8所托幼机构1 935例4~6岁学龄前儿童进行足底筛查,比较不同足型儿童性别、家族史、年龄、地区、体质量指数(BMI)、每日课外活动时长的差异,采用多元logistic回归方法分析足型的影响因素。结果 扁平足检出率为19.8%,高弓足的检出率为3.9%。多元logistic回归分析表明,BMI升高(OR=1.113,95%CI:1.057~1.172)、低年龄(以6岁为参照,4岁:OR=2.223,95%CI:1.599~3.091;5岁:OR=1.377,95%CI:1.027~1.847)、课外活动<2h/d (OR=3.271,95%CI:2.501~4.280)以及有家族史(OR=1.494,95%CI:1.108~2.016)为扁平足发生危险因素;对于高弓足,BMI降低(OR=0.701,95%CI:0.606~0.810)、课外活动<2h/d(OR=5.532,95%CI:3.272~9.352)、有家族史(OR=9.118,95%CI:4.852~17.135)是其危险因素,而乡村地区(OR=0.373,95%CI:0.215~0.646)是其保护因素。结论 BMI偏高、课外活动时长偏少儿童更容易出现扁平足,课外活动时长偏少也容易导致高弓足。学龄前儿童应加强足底肌肉功能锻炼,保持适宜体重,以降低扁平足及高弓足的发生风险。
Abstract
Objective To investigate plantar pressure distribution patterns in preschool children attending childcare institutions in Tongzhou District, Beijing, and to estimate the detection rates of flatfoot and high-arched foot, so as to provide clinical evidence for flatfoot prevention. Methods In 2024, a plantar pressure screening was conducted among 1 935 preschool children aged 4 - 6 years from eight childcare institutions in Tongzhou District, Beijing.Differences in sex, family history, age, region, body mass index (BMI), and daily extracurricular physical activity duration were compared across foot types.Multivariate logistic regression was used to identify factors associated with foot type. Results The detection rates of flatfoot and high-arched foot were 19.8% and 3.9%, respectively.Higher BMI (OR=1.113, 95%CI: 1.057 - 1.172), younger age (reference: 6 years old; 4 years old: OR=2.223, 95%CI: 1.599 - 3.091; 5 years old: OR=1.377, 95%CI: 1.027 - 1.847),<2 h/d of extracurricular physical activity (OR=3.271, 95%CI: 2.501 - 4.280), and family history (OR=1.494, 95%CI: 1.108 - 2.016) were risk factors for flatfoot.For high-arched foot, lower BMI (OR=0.701, 95%CI: 0.606 - 0.810), <2 h/d of extracurricular physical activity (OR=5.532, 95%CI: 3.272 - 9.352), and family history (OR=9.118, 95%CI: 4.852 - 17.135) were risk factors, whereas rural residence was a protective factor (OR=0.373, 95%CI: 0.215 - 0.646). Conclusions Preschool children with higher BMI and shorter extracurricular physical activity time are more likely to have flatfoot, and insufficient extracurricular physical activity is also associated with a higher likelihood of high-arched foot. Strengthening plantar muscle function and maintaining an appropriate body weight may help reduce the risk of flatfoot and high-arched foot in preschool children.
关键词
学龄前儿童 /
足底压力测试 /
扁平足 /
高弓足
Key words
preschool children /
plantar pressure test /
flatfoot /
high-arched foot
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 郭朋,罗聪.儿童扁平足病因、检测方法和治疗现状[J].医学信息, 2018,31(5):56-61.
Guo P,Luo C.The Cause,detection method and treatment status of children′s flat foot[J].Medical Information, 2018,31(5):56-61.(in Chinese)
[2] Yin J, Zhao H, Zhuang G, et al.Flexible flatfoot of 6-13-year-old children: A cross-sectional study[J].J Orthop Sci,2018,23(3):552-556.
[3] James WM, Haldar A.Hindfoot fusions in the cavovarus foot: What is the key for a successful outcome?[J].Foot Ankle Clin, 2023,28(4):805-818.
[4] Almutairi A, Bani MA,Bin ST et al.The prevalence and factors associated with low back pain among people with flat feet[J].Int J Gen Med,2021,20(14):3677-3685.
[5] 温晓东,刘承义,聂光华,等.截骨联合软组织平衡治疗进行性神经性腓骨肌萎缩症致柔韧性高弓足畸形[J].中华骨与关节外科杂志,2024,17(12):1112-1118.
Wen XD,Liu CY,Nie GH,et al.Osteotomy combined with soft tissue balancing for flexible cavovarus foot deformity secondary to Charcot-Marie-Tooth disease[J].Chin J Bone Joint Surg,2024,17(12):1112-1118.(in Chinese)
[6] 金宗学.矫形鞋垫和运动干预对9-10岁男童扁平足矫正效果及其机制[D].北京:北京体育大学,2018.
Jin ZX.The effect and mechanism of orthopedic insoles and exercise intervention on flat foot[D].Beijing:Beijing Sport University,2018.(in Chinese)
[7] Pallamar M, Bock P, Kranzl A,et al.Does the way of weight-bearing matter? Single-leg and both-leg standing radiographic and pedobarographic differences in pediatric flatfoot[J].Gait Posture,2022,93(3):135-141.
[8] 郭俊超,王亚伟,樊瑜波,等.6~7岁儿童扁平足的生物力学特点[J].中国康复医学杂志,2023,38(4):495-499.
Guo JC,Wang YW,Fan YB,et al.Biomechanical behavior of 6 -7 years children flatfoot[J].Chinese Journal of Rehabilitation Medicine,2023,38(4):495-499.(in Chinese)
[9] 韩炳善,袁媛.西安市2 074名学龄前儿童扁平足发生情况[J].中国学校卫生,2019,40(7):1097-1098
Han BS,Yuan Y.The occurrence of flat feet in 2 074 preschool children in Xi′an city[J].Chin J Sch Health,2019,40(7):1097-1098.(in Chinese)
[10] Xu L, Gu H, Zhang Y, et al.Risk factors of flatfoot in children: A systematic review and meta-analysis[J].Int J Environ Res Public Health, 2022,19(14):8247.
[11] 冯爽,王朝晖,王栋,等.西安市3岁以下婴幼儿足部发育水平研究[J].中国儿童保健杂志,2024,32(4):440-444.
Feng S,Wang ZH,Wang D,et al.Characteristics of foot development in children under 3 years old in Xi′an City[J].Chin J Child Health Care,2024,32(4):440-444.(in Chinese)
[12] 姜帅,史燕,胡燕,等.3~12岁健康儿童足底压力参数年龄分布特征[J].中华儿科杂志,2025,63(5):505-510.
Jiang S,Shi Y,Hu Y,et al.Age-specific distribution characteristics of plantar pressure parameters in healthy children aged 3-12 years[J].Chin J Pediatr,2025,63(5):505-510.(in Chinese)
[13] Elmonem A,Negamy E,Mahran M,et al.Clinical and radiological outcomes of corrective exercises and neuromuscular electrical stimulation in children with flexible flatfeet: A randomized controlled trial[J].Gait Posture,2021,88(7):297-303.
[14] 张英杰,吴桐,刘璐赟,等.昆明市部分小学学龄期儿童扁平足患病筛查分析[J].昆明医科大学学报,2023,44(1):31-34.
Zhang YJ,Wu T,Liu LY,et al.Screening analysis of flat foot disease in school-age children in Kunming city[J].Journal of Kunming Medical University,2023,44(1):31-34.(in Chinese)
[15] 陈盼盼,刘夕东,韩林林,等.学龄儿童柔软性扁平足足底压力分布特征[J].中国康复,2021,36(4):226-230.
Chen PP,Liu XD,Han LL,et al.Characteristics of plantar pressure distribution of school-age children with flexible flatfoot[J].Chinese Journal of Rehabilitation,2021,36(4):226-230.(in Chinese)
基金
北京市通州区科技计划项目(KJ2024CX037)
PDF(602 KB)
