Heel inversion on heel rise: A reliable sign of pediatric flatfoot decompensation

Q2 Health Professions

Foot Pub Date : 2025-12-01 Epub Date: 2025-09-26 DOI:10.1016/j.foot.2025.102207

Harald Böhm , Jakob Ender , Andreas Brand , Frank Braatz , Ferdinand Wagner

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引用次数: 0

Abstract

Background

The heel rise test (HRT) is widely used to evaluate triceps surae strength and to detect posterior tibial tendon dysfunction, a key factor in flatfoot pathology. In children with flexible flatfoot, the presence or absence of heel inversion during push-off is an important clinical sign that distinguishes muscularly compensated from decompensated feet. Identifying decompensated flatfoot is clinically relevant, as it is associated with impaired gait mechanics, reduced plantarflexor performance, and potential balance deficits. This study examined whether heel inversion observed during a standardized bilateral HRT can serve as a reliable indicator of decompensated flatfoot during walking.

Methods

We analyzed 358 feet from children and adolescents (aged 7–17) with idiopathic flexible flatfeet. Heel positions during HRT were rated on a five-point scale (-2 to +2), and results were correlated with 3D gait analysis.

Results

Reliability analysis showed high reliability and consistency. A positive HRT (neutral/everted heel) indicated decompensation in 77 % of cases, with 100 % of everted heels decompensated. However, 28 % of feet with negative HRT results (heel inversion) were also decompensated.

Conclusion

The HRT score is a reliable tool for assessing foot function during gait. It correlates with hindfoot-to-tibia inversion and foot kinematics, where lower scores indicate greater eversion, forefoot supination, and abduction. The HRT score provides a simple, quick measure of flatfoot severity.

查看原文本刊更多论文

脚跟上升时脚跟倒置：儿童扁平足失代偿的可靠标志。

背景：足跟上升试验（HRT）被广泛用于评估肱三头肌表面强度和检测胫骨后腱功能障碍，这是扁平足病理的关键因素。对于柔性扁平足患儿，蹬蹬时足跟内翻的存在与否是区分肌肉代偿与失代偿足的重要临床标志。鉴别失代偿性扁平足具有临床意义，因为它与步态力学受损、跖屈肌功能降低和潜在的平衡缺陷有关。本研究考察了在标准化双侧HRT中观察到的足跟内翻是否可以作为步行时失代偿扁平足的可靠指标。方法：我们分析了358英尺的儿童和青少年（7-17岁）特发性柔性扁平足。HRT期间脚跟位置按五分制（-2至+2）进行评分，结果与3D步态分析相关。结果：信度分析显示具有较高的信度和一致性。HRT阳性（中性/外翻跟）表明77 %的病例失代偿，100 %的外翻跟失代偿。然而，28% % HRT结果阴性的足部（脚跟内翻）也出现失代偿。结论：HRT评分是评估步态过程中足部功能的可靠工具。它与后脚到胫骨内翻和足部运动学相关，得分越低表明外翻、前脚旋后和外展越大。HRT评分提供了一种简单、快速的测量平足严重程度的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot Health Professions-Podiatry

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： The Foot is an international peer-reviewed journal covering all aspects of scientific approaches and medical and surgical treatment of the foot. The Foot aims to provide a multidisciplinary platform for all specialties involved in treating disorders of the foot. At present it is the only journal which provides this inter-disciplinary opportunity. Primary research papers cover a wide range of disorders of the foot and their treatment, including diabetes, vascular disease, neurological, dermatological and infectious conditions, sports injuries, biomechanics, bioengineering, orthoses and prostheses.