Clin Orthop Surg.  2014 Dec;6(4):410-419. 10.4055/cios.2014.6.4.410.

Salient Features of the Maasai Foot: Analysis of 1,096 Maasai Subjects

Affiliations
  • 1Department of Orthopaedic Surgery, Mount Meru Regional Hospital, Arusha, Tanzania. osddr8151@gmail.com
  • 2Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
  • 3Rensselaer Polytechnic Institute, Troy, NY, USA.

Abstract

BACKGROUND
The Maasai are the most widely known African ethnic group located in Kenya and northern Tanzania. Most spend their days either barefoot or in their traditional shoes made of car tires. Although they walk long distances of up to sixty kilometers a day, they do not suffer from any foot ailments. Little is known about their foot structure and gait. The goal of this investigation was to characterize various aspects of Maasai foot in standing and walking.
METHODS
Foot length, calf circumference, hindfoot alignment, step length, cadence, and walking velocity were obtained from 1,096 adult Maasai people (545 males and 551 females; mean age, 40.28 +/- 14.69 years; age range, 16 to 65 years). All included subjects were from rural areas, where the primary terrain was sandy soil, who spend most of their lifetime barefoot, walking. They all denied any medical history or previous symptoms related to foot problems. A trained clinician scanned all feet for deformities. Static (standing) and dynamic (walking) Harris mat footprints were taken to determine the distribution of forefoot pressure patterns during walking.
RESULTS
The average foot length was 250.14 +/- 18.12 mm (range, 210 to 295 mm) and calf circumference was 32.50 +/- 3.22 cm (range, 25 to 41 cm). The mean hindfoot alignment was 6.21degrees +/- 1.55degrees of valgus. Sixty-four subjects (5.84%) had bilateral flat-shaped feet with a low medial longitudinal arch that exactly matched the broad pattern of their static footprints. Step length, cadence, and walking velocity were 426.45 +/- 88.73 cm (range, 200 to 690 cm), 94.35 steps/min (range, 72 to 111 steps/min), and 40.16 +/- 8.36 m/min (range, 18.20 to 63.36 m/min), respectively. A total of 83.39% subjects showed unilateral or bilateral deformities of multiple toes regardless of age. The most frequent deformity was clawing (98.79%) of which the highest incidence occurred with the fifth toe (93.23%). Dynamic footprints showed even pressure patterns throughout the forefoot (64.87%), followed by lateral forefoot pressure concentration patterns (21.81%).
CONCLUSIONS
Our study shows the distinct parameters that provide more insight into the Maasai foot.

Keyword

Maasai; Maasai foot; Surface anatomy

MeSH Terms

Adolescent
Adult
Aged
Biomechanical Phenomena
Ethnic Groups
Female
Foot/*anatomy & histology/*physiology
Foot Deformities, Acquired/*epidemiology/ethnology
Gait/*physiology
Humans
Kenya
Male
Middle Aged
Rural Population
Tanzania
Walking/*physiology
Young Adult

Figure

  • Fig. 1 Maasai traditional shoes made of car tires.

  • Fig. 2 Frequency distribution of subjects with regard to arch height.

  • Fig. 3 Frequency distribution of claw toes in the Maasai population.

  • Fig. 4 Frequency distribution of mallet toes in the Maasai population.

  • Fig. 5 Anterior (A) and lateral (B) aspecs of multiple claw toe deformity show soft corn lesion on the 5th proximal interphalangeal joint.

  • Fig. 6 Step length (A), cadence (B), and walking velocity (C) of each age and sex group. G1: 16 to 25 yr, G2: 26 to 35 yr, G3: 36 to 45 yr, G4: 46 to 55 yr, G5: 56 to 65 yr.

  • Fig. 7 (A) Broad footprint pattern. (B) High arched footprint pattern.

  • Fig. 8 Medial (A), middle (B), lateral (C), and even (D) dynamic forefoot pressure concentration.

  • Fig. 9 Distribution of a dynamic forefoot pressure concentration of each age group for overall (A), male (B), and female (C). G1: 16 to 25 yr, G2: 26 to 35 yr, G3: 36 to 45 yr, G4: 46 to 55 yr, G5: 56 to 65 yr.


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