Comparison of multiple flatfoot indicators in 5-8-year-old children.

Saidas Žukauskas,Emilis Čekanauskas,Vidmantas Barauskas

doi:10.1515/med-2021-0227

Saidas Žukauskas, Emilis Čekanauskas + Show 1 more

Open Access

https://doi.org/10.1515/med-2021-0227

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Abstract

BackgroundThe foot posture is age dependent. The purpose of this study was to investigate the relationship between the 6-item version of the foot posture index (FPI) and other clinical, foot anthropometric, radiological measurements for the foot position in 5–8-year-old children.MethodsA total of 301 participants with a mean age of 6.4 ± 1.14 years were enrolled in the study. Children were examined physically, clinically, and radiologically to measure the FPI and navicular drop (ND) test, resting calcaneal stance position (RCSP) angle, Chippaux–Smirak index (CSI), Staheli index (SI), calcaneal pitch (CP) angle, talocalcaneal angle (TCA), and the first lateral metatarsal angle. Tibial torsions, internal rotation of the hip as an indirect method of femoral anteversion, and Beighton scale were analyzed for factors associated with flatfoot prevalence.ResultsThe study included children with normal and flexible flatfeet. Statistical analysis showed a significant FPI score correlation with other parameters (SI, CSI, RCSP, ND, CP, TMA, and TCA showed strong and moderate correlations, p < 0.001). Overall, the strongest associates are CSI (β = 0.34) and ND (β = 0.28). Other indicators have relatively small relationships with the FPI.ConclusionA positive correlation was observed between FPI-6 and ND test, CSI in 5–8-year-old children. All three prominent foot posture indicators (FPI-6, ND, and CSI) might be used as a primary or preferred tool in clinical practice.

Highlights

Flatfoot is a common foot posture in children and a frequent concern for parents by the appearance of children’s feet [1,2]
We demonstrated that the Navicular drop (ND) and footprint indexes – Chippaux–Smirak index (CSI) and Staheli arch index (SI) – had the strongest correlations with foot posture index (FPI)-6 in flatfoot children and a moderate relationship in non-flatfoot children
A positive correlation was observed between FPI-6 and ND test, CSI in 5–8-year-old children

Summary

Introduction

Flatfoot is a common foot posture in children and a frequent concern for parents by the appearance of children’s feet [1,2]. A non-dynamic assessment of children’s feet is performed to classify foot posture excluding pathological feet [1,5]. This includes four main methods of assessment: (a) non-quantitative visual assessment, (b) anthropometric measurements (resting calcaneal stance position [RCSP] angle, navicular drop [ND] test, and medial longitudinal arch angle), (c) various footprint-based analysis (Chippaux–Smirak index [CSI], Staheli arch index [SI], etc.), and (d) radiological examinations with various measurements. This includes MRI, ultrasound, and laser scanners [5–8]. Previous studies showed that FPI-6 is a reliable test for measuring the foot position; it has acquired popularity over the years [1,4,5,11,12]

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