6-7歲兒童之足弓指標追蹤

Abstract

扁平足常見於兒童，很多家長都會擔心孩童的足弓發展情形，但目前並沒有文獻針對足弓發展或是足弓扁化做相關的討論。本研究也探討慣用邊與足弓，因為大腦結構的關係，有九成的人慣用邊為右側且右側的運動表現較佳，目前還沒有文獻使用雙足分類探討足弓在左右足的發展與特性。另一方面，目前文獻對於扁平足相關因子的調查都缺乏控制變數，少了變數控制將無法顯示出真正足弓的相關因子。 因 此本研究目的為1.5年追蹤調查探討足弓發展或足弓扁化所具有的特性，橫斷面探討扁平足相關因子與三項體適能的相關性藉由控制年紀、性別並且探討扁平足與慣用邊對棒上單足平衡能力之影響。 此研究藉由1.5年追蹤調查同一族群孩童，547位兒童年紀6-7歲。 施測者採集足印、柔軟度分析和量測三項體適能：立定跳遠、20 公尺衝刺與棒上單足站立之平衡。使用統計方法單因子變異數分析、獨立樣本t檢定、相依樣本t檢定與卡方檢定分析橫斷面扁平足相關因子與三項體適能的相關性與慣用邊對於棒上單足平衡能力的影響，並且追蹤分析身體參數了解足弓發展或扁化之特性。 橫斷面結果顯示，藉由控制年紀與性別發現，6-7歲男女童扁平足只會受到BMI的影響，扁平足BMI較高，然而在三項體適能表現上是沒有差異的。藉由雙足的分類、慣用邊與分組的方式，觀察到扁平足的棒上單足平衡能力較差，棒上單足平衡能力也會受到左右足影響，右足棒上單足平衡能力有較佳的趨勢。追蹤調查方面，足弓發育與身高的成長量有著密切的關係; 足弓的扁化與身高成長量、韌帶鬆緊度、體重與BMI增加量有相關性。 從結果可以歸納出兩個方向。對於扁平的兒童，我們應該要注意其身高變化量; 對於非扁平足的兒童，我們不僅僅要注意體重與BMI的增長量，也必須要注意身高成長量與韌帶的鬆緊度。單足扁平兒童中，非慣用邊與扁平在棒上單足平衡表現有較差的趨勢，只有左足扁平族群棒上單足站立平衡表現較差，但該組兒童在其他平衡測試上是否也較差則需要更多的研究來瞭解。

Flatfoot is a common phenomenon in children. There is a noteworthy concern amongst parents for foot arch development of their children. However, existing research has largely ignored the role of arch development. Because of the fact that 90% of individuals are right brain dominant, there is a need to take into account brain dominance when evaluating the flatfoot data. As such, our study focuses on not only the flatfoot data in itself, but also taking into consideration the effects of brain side dominance. In the past, there have been many methods for categorizing flatfoot. However, none have investigated using both feet of individuals while considering brain dominance, foot arch, and physical fitness performance simultaneously. This study seeks to investigate the association foot arch development or deterioration through the use of a longitudinal survey, in order to investigate dominance, flatfoot and three test of physical fitness by controlling the age, gender of the test subjects. This study is a cohort study, using a 1.5 years follow-up of 547 children aged 6-7 years old. The data collected by field researchers included footprints, joint laxity and three tests of physical fitness, including standing long jump, 20-meter dash, and one leg standing balance. Staheli’s arch index (SAI) was computed from the footprints and statistical techniques were employed to establish an association factor. When both feet of subjects are used in the categorization of flatfoot, the result of our findings showed that individuals with flatfoot displayed inferior one leg standing balance performance. The performance of one leg standing balance was also affected by right and left foot dominance, where the left foot performed inferiorly to the right foot in the one leg standing balance task. By controlling age and gender, flatfoot was also found to be associated with BMI. In the longitudinal survey, foot arch development/deterioration was also discovered to be associated with the change of height of the subjects. Moreover, foot arch deterioration was also determined to be associated with weight and BMI of individuals. From the conclusion of our study, there are two major findings. Firstly, for children with flatfoot, extra attention should be placed to their change in height. On the other hand, for non-flatfoot children, emphasis should be placed on changes in their weight, BMI, height, and heelcord. Secondly, in the case of one leg flatfoot, children with non-dominant foot as their flatfoot would tend to show less satisfying result on balance performance. Similarly, children with left flatfoot would also tend to show less satisfying result on the test of standing alone on the bar. However, whether or not this trend is observed in other balance test requires further studies.