Biomechanical Adaptations, Diagnostic Algorithms, and Preventive Physical Therapy and Prehabilitation Approaches in Pediatric Foot Deformities

An Erratum to this article was published on July 6, 2026. https://dergipark.org.tr/en/pub/jnlm/article/1984819

Abstract

Background: Pediatric foot deformities represent a critical spectrum of musculoskeletal disorders that significantly alter the lower extremity kinetic chain. Early identification and targeted preventive physical therapy and prehabilitation (PPT) are paramount during periods of developmental skeletal plasticity to prevent long-term functional impairment. Objective: This comprehensive review evaluates the biomechanical adaptations, multi-step diagnostic algorithms, and evidence-based efficacy of PPT protocols in managing pediatric foot deformities. Methods: A systematic synthesis of current literature was conducted, focusing on three-dimensional kinematic analyses, pedobarographic advancements, and conservative versus surgical modulation strategies in conditions including pediatric pes planovalgus (PPV), idiopathic toe-walking (ITW), pes cavovarus, and digital anomalies. Results: Recent prospective cohort and cross-sectional data confirm that structured PPT interventions—such as short foot exercises (SFE), kinetic chain-focused neuromuscular training, and customized rigid foot orthoses (FO)—significantly improve subtalar flexibility, stabilize medial longitudinal arch (MLA) indices, and optimize plantar pressure distribution. Furthermore, advanced diagnostic tools like the Foot Posture Index-6 (FPI-6) and 3D gait analysis successfully differentiate physiological variants from rigid pathologies and neurodevelopmental conditions like Autistic Toe-Walking (ATW). Conclusion: Effective pediatric foot management mandates transitioning from isolated anatomical assessments to comprehensive kinetic chain paradigms. Early-stage PPT minimizes surgical reliance and preserves long-term functional independence.

Keywords

• Pediatric foot development
• Pes planovalgus
• Idiopathic toe-walking
• Clubfoot
• Pedobarography

Pediatrik Ayak Deformitelerinde Biyomekanik Adaptasyonlar, Tanısal Algoritmalar ve Koruyucu Fizyoterapi ve Prehabilitasyon Yaklaşımları

An Erratum to this article was published on July 6, 2026. https://dergipark.org.tr/en/pub/jnlm/article/1984819

Abstract

Giriş: Pediatrik ayak deformiteleri, alt ekstremite kinetik zincirini önemli ölçüde değiştiren kas-iskelet sistemi bozukluklarının önemli bir grubunu oluşturmaktadır. Uzun vadeli fonksiyonel bozuklukları önlemek için, iskeletin gelişimsel plastisite dönemlerinde erken teşhis ile hedefe yönelik koruyucu fizyoterapi ve prehabilitasyon (KFP) hayati öneme sahiptir. Amaç: Bu kapsamlı derlemenin amacı, pediatrik ayak deformitelerinin tedavisinde KFP protokollerinin biyomekanik adaptasyonlarını, çok aşamalı tanı algoritmalarını ve kanıta dayalı etkinliğini değerlendirmektir. Yöntemler: Pediatrik pes planovalgus (PPV), idiyopatik parmak ucunda yürüme (İPY), pes kavovarus ve parmak anomalileri gibi durumlarda üç boyutlu kinematik analizler, pedobarografik testler, konservatif ve cerrahi modülasyon stratejileri üzerinde odaklanılarak mevcut literatürün sistematik bir sentezi yapılmıştır. Sonuçlar: Son prospektif kohort ve kesitsel veriler, kısa ayak egzersizleri, kinetik zincir odaklı nöromüsküler antrenman ve kişiye özel sert ayak ortezleri gibi yapılandırılmış KFP müdahalelerinin subtalar esnekliği önemli ölçüde iyileştirdiğini, medial uzun ark indekslerini stabilize ve plantar basınç dağılımını optimize ettiğini doğrulamaktadır. Ayrıca ayakta duruş endeksi-6 ve 3D yürüyüş analizi gibi gelişmiş tanı araçları, fizyolojik varyantları, rijit patolojilerden ve Otistik Parmak Üzerinde Yürüyüş gibi nörogelişimsel durumlardan başarıyla ayırt etmektedir. Sonuç: Etkili pediatrik ayak yönetimi, izole anatomik değerlendirmelerden kapsamlı kinetik zincir paradigmalarına geçişi gerektirmektedir. Erken aşamadaki KFP, cerrahiye olan ihtiyacı en aza indirir ve uzun vadeli fonksiyonel bağımsızlığı korur.

Keywords

• Pediatrik ayak gelişimi
• Pes planovalgus
• İdiyopatik parmak üzerinde yürüme
• Ayak bozukluğu
• Pedobarografi
• 3D yürüyüş analizi.

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