Effect of calcaneal eversion on standing and walking in children

The objectives of this study were to examine the immediate effect of excessive calcaneal eversion on the gait parameters of lower extremity peak joint kinematics, temporal spatial characteristics, biomechanical performance and balance skills during standing and walking. A convenience sample of 50 children, ages 6 years to 10 years with typical development, were tested with a counterbalanced repeated measures design in three conditions: no wedges, 5° wedges and 10° wedges. These wedges were affixed to the subject's bare feet to evert the rearfoot resulting in pronation during walking. Results indicated that peak joint kinematics and temporal spatial gait characteristics did not differ across conditions. Biomechanical performance, as measured by vertical sacral displacement during walking was diminished in the 10° compared to the no wedge conditions (p = .001) but not in the 5° compared to the no wedge conditions or in the 10° compared to the 5° conditions. Balance skills were significantly decreased in the 5° compared to the no wedge condition (p = .002) and in the 10° compared to the no wedge conditions (p < .001), but not in the 5° compared to the 10° conditions. The results indicate that the subjects adapted to the wedges and produced their preferred joint kinematics and temporal spatial characteristics when walking. Subjects were unable to adapt as well for biomechanical performance. Balance skills, more novel and challenging than walking for these children, were the most affected by the wedges. These findings should be applied cautiously to children with neuromuscular and musculoskeletal impairments who may not have the adaptation abilities of children with typical development. Excessive calcaneal eversion in these children may create an additional problem for their joint kinematics and temporal spatial characteristics when walking. However, excessive calcaneal eversion is more likely to impact biomechanical performance during walking and balance skills in children both with and without movement disorders. Therefore, intervention to address excessive calcaneal eversion may be indicated to enhance biomechanical performance during walking and standing and walking balance skills.