Foot Structure and Function in Habitually Barefoot and Shod Adolescents in Kenya.

Habitually barefoot (HB) children from the Kalenjin tribe of Kenya are known for their high physical activity levels. To date, there has been no comprehensive assessment of foot structure and function in these highly active and HB children/adolescents and link with overuse injuries. PURPOSE: The aim of this research is to assess foot structure, foot function, injury and physical activity levels in Kenyan children and adolescents who are HB compared with those who were habitually shod (HS). METHODS: Foot structure, function, injury prevalence, and physical activity levels were studied using two studies with equal numbers of HS and HB. HS and HB children and adolescents were matched for age, sex, and body mass. Foot arch characteristics, foot strength, and lower-limb injury prevalence were investigated in Study 1 (n = 76). Heel bone stiffness, Achilles tendon moment arm length and physical activity levels in Study 2 (n=62). Foot muscle strength was measured using a strength device TKK 3360 and heel bone stiffness by bone ultrasonometry. The moment arm length of the Achilles tendon was estimated from photographs and physical activity was assessed using questionnaires and accelerometers. RESULTS: Foot shortening strength was greater in HB (4.8 ± 1.9 kg vs 3.5 ± 1.8 kg, P < 0.01). Navicular drop was greater in HB (0.53 ± 0.32 cm vs 0.39 ± 0.19 cm, P < 0.05). Calcaneus stiffness index was greater (right 113.5 ± 17.1 vs 100.5 ± 116.8, P < 0.01 left 109.8 ± 15.7 vs 101.7 ± 18.7, P < 0.05) and Achilles tendon moment arm shorter in HB (right, 3.4 ± 0.4 vs 3.6 ± 0.4 cm, P < 0.05; left, 3.4 ± 0.5 vs 3.7 ± 0.4 cm, P < 0.01). Lower-limb injury prevalence was 8% in HB and 61% in HS. HB subjects spent more time engaged in moderate to vigorous physical activity (60 ± 26 min·d vs 31 ± 13 min·d; P < 0.001). CONCLUSIONS: Significant differences observed in foot parameters, injury prevalence and general foot health between HB and HS suggest that footwear conditions may impact on foot structure and function and general foot health. HB children and adolescents spent more time engaged in moderate to vigorous physical activity and less time sedentary than HS children and adolescents.

Sensorimotor function in preschool-aged children with expressive language disorder.

AIM: The aim of the study was to evaluate functional motor performance and haptic object recognition in 5-year-old children with mild expressive language disorder (ELD) in comparison with age- and gender-matched healthy children. METHODS: The subjects were classified by speech-language pathologist using The Reynell Developmental Language Scales III and Boehm Test of Basic Concepts: Preschool as children with mild ELD (n=29, incl. 23 boys and 6 girls) and children with typical language development as controls (n=29, incl. 23 boys and 6 girls). The children were examined for manual dexterity, ball skills, static and dynamic balance by Movement-ABC, haptic object recognition (HOR), hand-grip strength (HGS) and vertical jumping performance. RESULTS: Children with mild ELD demonstrated significantly higher scores (i.e., inferior performance) in all subtests of M-ABC (all p values <0.05), in haptic object recognition (p<0.01) and vertical jumping height (p<0.05) compared to controls. However, no statistically significant differences (p>0.05) emerged from HGS. Boys with mild ELD demonstrated higher results in impairment score (p<0.001), ball skills (p<0.01) and balance (p<0.01) of M-ABC, as well as in HOR (p<0.05). Girls with mild ELD showed higher impairment score (p<0.05) with lower percentile (p<0.05) in M-ABC, indicating inferior motor performance, and lower HGS for the non-dominant hand (p<0.05). Seven out of 29 (24.1%) children with mild ELD had definite or borderline motor difficulties, while only one child in control group (3.4%) demonstrated borderline motor difficulties. CONCLUSIONS: Children with mild expressive language disorder do not perform as well as controls in tests of functional motor skills, but their results in tests demanding maximal muscle force generation are in level with typically developing children. Boys and girls with mild ELD demonstrated higher impairment scores in M-ABC, indicating the need to follow their overall development more closely.

Motor skills, haptic perception and social abilities in children with mild speech disorders.

AIM: The aim of the study was to evaluate motor skills, haptic object recognition and social interaction in 5-year-old children with mild specific expressive language impairment (expressive-SLI) and articulation disorder (AD) in comparison of age- and gender matched healthy children. METHODS: Twenty nine children (23 boys and 6 girls) with expressive-SLI, 27 children (20 boys and 7 girls) with AD and 30 children (23 boys and 7 girls) with typically developing language as controls participated in our study. The children were examined for manual dexterity, ball skills, static and dynamic balance by M-ABC test, haptic object recognition and for social interaction by questionnaire completed by teachers. RESULTS: Children with mild expressive-SLI demonstrated significantly poorer results in all subtests of motor skills (p<0.05), in haptic object recognition and social interaction (p<0.01) compared to controls. There were no statistically significant differences (p>0.05) in measured parameters between children with AD and controls. Children with expressive-SLI performed considerably poorer compared to AD group in balance subtest (p<0.05), and in overall M-ABC test (p<0.01). CONCLUSIONS: In children with mild expressive-SLI the functional motor performance, haptic perception and social interaction are considerably more affected than in children with AD. Although motor difficulties in speech production are prevalent in AD, it is localised and does not involve children's general motor skills, haptic perception or social interaction.

Quadriceps femoris muscle function prior and after total knee arthroplasty in women with knee osteoarthritis.

PURPOSE: The aim of the present study was to evaluate an isometric voluntary force generation and relaxation capacity of the quadriceps femoris (QF) muscle prior and after total knee arthroplasty (TKA). METHODS: Isometric maximal voluntary contraction force, rate of force development, voluntary activation, half-relaxation time, and latency of contraction of the QF muscle were recorded in 12 female patients (aged 49-68 years) with knee osteoarthritis one day before, 3 and 6 months following TKA in the operated and nonoperated leg. Knee pain intensity was assessed by visual analog scale, and Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire was used to assess knee problems during daily living. RESULTS: A significant decrease in knee pain and significant increase in KOOS were established after TKA. Maximal voluntary isometric force in the operated leg was lower (P < 0.05) before, 3 and 6 months after TKA as compared to the nonoperated leg. Rate of force development of the QF muscle in the operated leg compared to the nonoperated leg was significantly lower (P < 0.05) 3 and 6 months after TKA. Voluntary activation, latency of contraction, and half-relaxation time of the QF muscle did not differ significantly before, 3 and 6 months after TKA. CONCLUSIONS: The present study indicated reduced maximal and explosive strength of quadriceps femoris muscle in the operated leg 3 and 6 months after TKA with no significant changes in voluntary activation, and capacity for rapid contraction and relaxation. LEVEL OF EVIDENCE: Prospective comparative study, Level II.

Motor performance and haptic perception in preschool boys with specific impairment of expressive language.

AIM: The aim of this study was to investigate motor performance and haptic object recognition (HOR) in 5-year-old boys with minor to moderate specific impairment of expressive language (expressive-SLI). METHODS: Twenty-eight boys with expressive-SLI and 26 boys with typical language development as controls were recruited from ordinary kindergartens. An assessment of the voluntary isometric force production and relaxation capacity of the leg extensor muscles, manual dexterity, ball skills, balance and HOR was performed and the results were compared with those for age-matched control group. RESULTS: Reaction times to voluntary contraction and relaxation of the leg extensor muscles as well as manual dexterity did not differ significantly in the measured groups. Boys with expressive-SLI demonstrated poorer results in ball skills (p < 0.01), balance (p < 0.01), less leg extensors strength (p < 0.05) and made considerably more (p < 0.001) errors in haptic perception test when compared to controls. CONCLUSIONS: Deviations in gross-motor performance and haptic perception are very common in children with minor to moderate expressive-SLI, being embodied especially in less muscle strength of lower extremities, poorer ball skills, balance and HOR.