Flat feet occurrence among young school-age children and its association with body mass index values.

Our aim with this study was to establish the prevalence of flat foot in a population of 3- to 6-year-old children to evaluate cofactors such as age, weight, and gender and to estimate the number of unnecessary treatments performed. A total of 835 children (411 girls and 424 boys) were included in this study. The clinical diagnosis of flat foot was based on a valgus position of the heel and a poor formation of the arch. Feet of the children were scanned (while they were in a standing position) by using a laser surface scanner, and rearfoot angle was measured. Rearfoot angle was defined as the angle of the upper Achilles tendon and the distal extension of the rearfoot. Prevalence of flexible flat foot in the group of 3- to 6-year-old children was 44%. Prevalence of pathological flat foot was < 1%. Ten percent of the children were wearing arch supports. The prevalence of flat foot decreases significantly with age: in the group of 3-year-old children 54% showed a flat foot, whereas in the group of 6-year-old children only 24% had a flat foot. Average rearfoot angle was 5.5 degrees of valgus. Boys had a significant greater tendency for flat foot than girls: the prevalence of flat foot in boys was 52% and 36% in girls. Thirteen percent of the children were overweight or obese. Significant differences in prevalence of flat foot between overweight, obese, and normal-weight children were observed. This study is the first to use a three-dimensional laser surface scanner to measure the rearfoot valgus in preschool-aged children. The data demonstrate that the prevalence of flat foot is influenced by 3 factors: age, gender, and weight. In overweight children and in boys, a highly significant prevalence of flat foot was observed; in addition, a retarded development of the medial arch in the boys was discovered. At the time of the study, > 90% of the treatments were unnecessary.

The purpose of this study is to compare the plantar foot pressure and the center of pressure (COP) pathway of normal and flat feet while crossing an obstacle at different heights. Nineteen subjects (10 normal feet, 9 flat feet) participated in this study. The plantar foot surface was divided into the following seven regions for pressure measurement: two toe regions, three forefoot regions, one midfoot region, and one heel region. A one-way ANOVA with repeated measurements was used to compare the plantar foot pressure of normal and flat feet according to the obstacle height. The trend analysis showed a quadratic trend during level walking for the normal foot group, but a linear trend appeared as the obstacle height increased. In the flat foot group, the trend analysis showed a linear trend regardless of the obstacle height. In the 2nd-3rd metatarsal head region, the plantar pressure of the flat foot group increased more than the normal foot group as the obstacle height increased; however, in the 4th-5th metatarsal head region, the plantar pressure in flat feet was lower than in normal feet. In the heel region, the plantar pressure in both groups generally increased as the obstacle height increased, but the plantar pressure in the flat foot group was lower than in the normal foot group. We believe that, due to a loss of longitudinal arch, the COP path and plantar pressure of flat feet may be different from normal feet when crossing obstacles of different heights.

Flat arches in children usually become proper arches and high arches as the child progresses through adolescence and into adulthood. Only if the deformity persists or presents in adolescence or adulthood is it considered abnormal. We sought to determine the incidence of flatfoot in schoolchildren and to make an anthropometric comparison between flat and normal feet with respect to age and sex in the Hausa ethnic group of Nigeria. Two hundred 9- to 14-year-old students (100 boys and 100 girls) were studied. Navicular height, medial malleolar height, lateral malleolar height, foot length, and transverse arch length were measured with a ruler, marker, and measuring tape. Statistical analysis was conducted using analysis of variance and independent-samples t tests (P < .05). The overall prevalence of flatfoot was 10% (n = 20) (7% in boys [n = 7] and 13% in girls [n = 13]). Statistically significant differences were found in all of the measured parameters except foot length. This study showed that flatfoot has a higher incidence in girls than in boys in the Hausa ethnic group, with the incidence decreasing with age. Girls had a higher incidence of flatfoot than boys, and it was also influenced by age.

Background: Flat foot is a deformity in which patients lack standard arches in the soles of the foot. Flat foot improves with age. This study was designed to determine the prevalence of flexible flat foot among male school children in Tehran, Iran. Methods: A total of 1539 male school children were included in this study. Students were examined for the flatness of the sole of the foot as well as its degree and type. Flat foot was diagnosed on inspecting a poor formation of the arch. The severity of flatness was classified according to Denis criteria. Results: Among 1512 children whose foot condition was recorded, 80.7% had normal/grade 1 sole, 16.7% had 2nd degree flat feet, and 2.6% had 3rd degree flat feet. Prevalence of genu varum was 16.1% and prevalence of genu valgum was 2.7% (P = 0.504). The prevalence of flat foot decreased significantly with age; in the group of 11-year-old boys and younger, 23.1% showed a grade 2 and grade 3 flat foot, whereas in the group of 12-year-old boys and older, only 13.6% hada grade 2 and grade 3 flat foot (P &lt; 0.001). Conclusion: In this study, a significant relationship was found between weight gain and body mass index (BMI) with flat feet. There is a significant association between passing the age of 12 years and a decrease in flat foot. Also, the association between flat foot with weight and height of children was examined separately, and it was found that weight could significantly be a poor predictor of flat feet.

Background: The measurements used in diagnosing biomechanical pathologies vary greatly. The aim of this study was to determine the concordance between Clarke's angle and Chippaux-Smirak index, and to determine the validity of Clarke's angle using the Chippaux-Smirak index as a reference.Methods: Observational study in a random population sample (n= 1,002) in A Coruña (Spain). After informed patient consent and ethical review approval, a study was conducted of anthropometric variables, Charlson comorbidity score, and podiatric examination (Clarke's angle and Chippaux-Smirak index). Descriptive analysis and multivariate logistic regression were performed. Results: The prevalence of flat feet, using a podoscope, was 19.0% for the left foot and 18.9% for the right foot, increasing with age. The prevalence of flat feet according to the Chippaux-Smirak index or Clarke's angle increases significantly, reaching 62.0% and 29.7% respectively. The concordance (kappa I) between the indices according to age groups varied between 0.25-0.33 (left foot) and 0.21-0.30 (right foot). The intraclass correlation coefficient (ICC) between the Chippaux-Smirak index and Clarke's angle was -0.445 (left foot) and -0.424 (right foot). After adjusting for age, body mass index (BMI), comorbidity score and gender, the only variable with an independent effect to predict discordance was the BMI (OR= 0.969; 95% CI: 0.940-0.998).Conclusion: There is little concordance between the indices studied for the purpose of diagnosing foot arch pathologies. In turn, Clarke's angle has a limited sensitivity in diagnosing flat feet, using the Chippaux-Smirak index as a reference. This discordance decreases with higher BMI values.

Introduction: Since the use of medical insole is recommended as one of the strategies to deal with the potential for joint injuries, Flatfoot is one of the most common abnormalities in body structure that Due to the decrease in the height of the medial longitudinal arch of the foot and its functional defect, the increases risk of joint damage due to changes in the transfer of ground reaction forces. One of the treatment options that is suggested is the use of a medical insole. The purpose of this study was to investigate the effect of two different forms of silicone insoles on the peak of the ground reaction force, loading rate and time to stability in the landing-jumping-landing skill of active young women with flat foot. Materials and methods: 28 women with a history of regular activity exercise were divided into two groups of 14 (flat foot and normal foot). The subjects landed two legs on a level with a height of 0.5 m on the forwards of the first force plate, jumped without stopping and landed on second force plate. In this study, two types of silicone insoles were used that support the entire sole of the foot (type I), and only the inner portion of the foot and the medial longitudinal arch (Type II). The flat foot subjects performed without using the insole and using two types of insoles. The Data Analysis of data Evaluation of Variables were done by MATLAB software. Also its statistical analysis was done by using spss ( P ≤0.05). Results: The results of statistical analysis of variance analysis showed a significant difference in the amount of ground reaction forces in all three axes between normal and flat foot subjects, while the use of medical insoles only in outer medial- lateral & anterior- posterior directions has been significant. The rate of loading at the first landing showed a significant difference between the subjects with flat foot and normal foot. But there was no significant effect after using the medical insole. However, there was no significant difference between the time to stability in the two groups of flat foot and normal foot. Conclusion: According to the results of the study, it can be said that flat foot abnormality in high intensity plometric skill has effect on the ground reaction forces in all three directions, and the use of a Type I insole can reduce the amount of force in all three directions. On the other hand, the decrease in the height of the longitudinal arch of the foot is associated with the rate of loading during the landing, which is identified as a risk factor for joint and muscular damage. But the use of silicone insoles cannot effect on the rate of loading. The results of this study indicate that the time to stability in active subject does not correlate with the height of the medial longitudinal arch, or the time to stability is corrected in the active subjects with flat feet with the help of compensatory mechanisms. Keywords : Flat Foot, Kinetic, Insole

Flat foot is a condition which pedal arch is absent. This condition is count physiological if found in infants and children at a certain age due to incomplete development of bone structure and surrounding tissue. Flat foot is a common condition in pediatrics, which affects about 20% to 30% of the world's population. The prevalence of flat foot will decrease concomitantly with age. At two years old, 94% of children experience flat foot and only 4% at ten years old experience this condition. Most children will show complete and normal development of the sole foot at 12 years old. Pedal arch is one of the important parts that affect the anatomical structure of the lower limb and foot biomechanical. This study aims to compare the anatomical structure of the pedal arch in patients with flat foot and normal foot from Arch Height Index (AHI), Plantar Arch Index, Calcaneal Pitch Angle (CP), Talo-Horizontal Angle (TH), and Meary’s talus-first metatarsal (T-1MT). This study is an analytical study with a cross sectional approach using a sample of 30 elementary school students in Denpasar. The data obtained were analyzed using descriptive analysis and comparative test. In this study, we found significant differences in the plantar arch index and calcaneal pitch angle between students with normal foot and flat foot. We also found no significant differences in AHI, T-1MT and TH between students with normal foot and flat foot.

Background: The prevalence of flatfoot is various among each age group, and whether children with flatfoot should receive treatment or not is still controversial. Most studies of flatfoot in Taiwan place emphases on children but not on teenagers. This research aimed to establish a database of a prevalence of flatfoot among Taiwanese local teenagers. Methods: Five hundred forty-four 12- to 14-year-old teenagers in Taoyuan were enrolled in this study. Footprint analysis methods were used to diagnose a flatfoot (plantar arch index more than 1.15 or Denis grade equal or more than grade 1 or footprint index less than 1 cm). The height, body weight, and body mass index were recorded and compared using independent t tests to identify the statistical significances between teenagers with and without a flatfoot. Results: The prevalence of flatfoot in teenagers in Taoyuan, Taiwan, ranged from 11.6% to 37.6%. This variation was attributed to the different footprint analysis methods used. The prevalence of flatfoot was highly correlated with body weight and body mass index. Conclusions: The prevalence of flatfoot in teenagers in Taoyuan, Taiwan, was relatively higher than that reported in other studies. The causes may be the initial differences between races and the increased body weight of teenagers in Taiwan. These hypotheses need further studies to confirm.

BackgroundFlat foot, as one of the common foot deformities can affect gait biomechanics and risk of lower extremity injury. Fatigue, as a high load task, can also change biomechanical parameters of locomotion. Studying normal and flat footed individuals under high load tasks such as fatigue can elucidate their differences more easily.ObjectivesIn this study, center of pressure (CoP) changes were studied between individuals with flat and normal feet after fatigue. CoP is one of the important gait measures which can show various biomechanical behaviors of different foot shapes.MethodsSeventeen subjects with normal feet and 17 with flat feet walked across two force plates before and after a functional fatigue protocol. Standard deviation of CoP in mediolateral direction (SD of CoPx) and in anteroposterior direction (SD of CoPy), overall mean velocity of CoP and length of CoP construction line of both groups were analyzed. The values of SD of CoPy and length of CoP construction line were normalized to individual foot lengths prior to statistical analyses.ResultsThere were no significant between-subject effects for all CoP measures. The only significant finding was the within-subject effect for the SD of CoPy (P = 0.008) with a large effect size (partial eta squared = 0.21). Fatigue resulted in lower SD of CoPy in both groups.ConclusionsLower SD of CoPy indicates less fluctuation of CoPy and a probable less center of mass movement which could reduce the risk of injury. Furthermore, the similar fatigue response in both groups of individuals with normal and flat feet indicates a similar biomechanical behavior despite their different foot arch height.

The study compared lower extremity kinematics and kinetics between male subjects with flat and normal feet when landing on both feet from platforms at different heights. Ten subjects with a flat feet arch and 10 subjects with a normal foot arch were recruited. They performed a double limb drop landing from 20, 40, and 60 cm onto a force-plate. A three-dimensional motion analysis system, force plates, and electromyography were used to analyze lower extremity kinetic and kinematic data. The GRF and angle of sagittal plane significantly increased with landing height in the flat foot group. In particular, hip joint angles at a height of 60 cm were significantly greater. The electromyography values were significantly higher for the tibialis anterior and vastus lateralis muscles, but were significantly lower in the abductor hallucis, gastrocnemius, and biceps femoris muscles in the flat foot group. GRF, joint angles, and muscle activity patterns in the lower extremities increases more with height in flat footed individuals than in people with a normal foot arch. Flat feet may aggravate the risk of shock on landing from a height; this might be ameliorated by a compensatory strategy at the hip joints to facilitate load distribution.

To examine self-reported physical activity levels from the International Physical Activity Questionnaire (IPAQ) as an independent predictor of dual-energy x-ray absorptiometry (DXA)-measured percent body fat (%BF) from body mass index (BMI), gender, and race. Two hundred and seventy-eight students, aged 18-24 yr, volunteered to participate. There were 133 males (85 white and 48 black) and 145 females (77 white and 68 black). Total activity levels were quantified in MET hours per week (MET h wk(-1)) using the IPAQ short form. Height and weight were measured, and BMI values were calculated (kg m(-2)). %BF was assessed using DXA. Linear regression analysis was used to develop and compare a body fat prediction equation with (full) and without (reduced) the variable MET-h.wk. Both models included BMI, gender, and race as predictor variables. The prediction sum of squares (PRESS) statistic was used to cross-validate both models, and the individual predictive accuracy was compared using modified Bland-Altman plots. Mean +/- SD values were as follows: BMI = 24.4 +/- 4.1 kg m(-2), %BF = 24.5 +/- 9.3%, and MET h wk(-1) = 37.4 +/- 21.9. Gender, BMI, and race explained 81% of the variance in %BF, with a root mean square error (RMSE) of 4.07. The full model with MET-h.wk improved the prediction of %BF by 2% (R2 = 0.83, RMSE = 3.87). When cross-validated, the corresponding PRESS statistics for the reduced and full model were 4.10 and 3.90, respectively. Bland-Altman limits of agreement were greater for the reduced model compared with the full model (-8.09, 8.10 vs -7.67, 7.68). These results suggest that %BF can be predicted with greater precision and accuracy in a young adult population when MET-h.wk are included in addition to BMI, gender, and race.

Background and Study Aim. Excessive physical activity poses a risk of injury, particularly when coupled with high exercise intensity. Factors such as Body Mass Index (BMI) and foot morphology may contribute to this risk. This study seeks to evaluate the relationship between BMI, foot shape, and the likelihood of injury among sports students. Material and Methods. A total of 119 sports students, comprising 33 females and 86 males, participated in this study. Purposive sampling was employed to select participants. BMI was determined using height and weight measurements, while foot shape was assessed through footprint measurements. The Functional Movement Screening (FMS) instrument, encompassing 7 movements: Deep Squats, Hurdle Steps, Inline Lunges, Shoulder Mobility, Active Straight Leg Raises, Trunk Stability Push-ups, and Rotary Stability, was utilized to assess injury risk. Data analysis was conducted using Microsoft Excel and IBM SPSS v.25.0, employing descriptive statistics. Results. Based on data analysis, the FMS value in females shows a mean of 18.7 and a standard deviation of 1.21. At the same time, the FMS value in males shows 18.5 and a standard deviation of 1.41. BMI values in females showed a mean of 21.6 and a standard deviation of 3.03. At the same time, BMI values in males showed a mean of 22.9 and a standard deviation of 4.62. The results were that all FMS scores were ≥14. While of BMI measurements, some samples obtained ˂18 kg/m² and ˃30kg/m². BMI measurements according to gender were mainly in the normal weight category. However, those who fall into the obesity category are primarily males. With the results of measuring the foot's shape, the percentage of flat feet is only 0.84% in females and 7.59 in males, while the rest of the sample has a normal foot shape. Conclusions. Individuals with a BMI in the overweight to obese category are more susceptible to high-category injuries, likely due to limited motion range. However, the study did not find evidence linking flat foot shape to high-category injury risk. This inability to establish a correlation may be attributed to the predominantly normal foot shape observed in the sample, resulting in a prediction of low-category injury risk.

This study sought to assess the prevalence of flat feet in primary school children and to find correlations among arch height, ankle dorsiflexion range of motion (ROM), and obesity level. The 400 children aged 10 to 12 years who took part in the study had their body height, weight, and fat percentage measured. Based on these measurements, body mass index was calculated and weight status was categorized for all of the participants. The height of the longitudinal arch of the foot was measured on a computerized podoscope and given in Clarke's angles. Dorsiflexion ROM was assessed with the child in the nonweightbearing sitting position with the knees 90° flexed. The arithmetic mean and standard deviation were implemented to analyze the data. Intergroup differences were assessed by Mann-Whitney U, Kruskal-Wallis, and post hoc Tukey tests. Significance was accepted at P = .05. Flat feet were found in 36% of participants; limited ROM was found in both feet in 25% of participants and in one foot in 12%. No significant differences in dorsiflexion ROM in children with high-arched, normal, and flat feet were revealed. Excessive body weight was disclosed in 21% of participants. Overweight and obese children had significantly lower foot arches and notably smaller ankle dorsiflexion ROM than those with normal weight. Ankle dorsiflexion ROM is similar in children with high-arched, normal, and flat feet. However, limited dorsiflexion ROM is more often found in children with excessive weight.

Weight bearing ankle dorsiflexion range of motion in idiopathic pes cavus compared to normal and pes planus feet

About 326 elementary school boys and 299 elementary school girls of an age ranging from 6 to 13 are included in this flat foot prevalence study. Results of the study are categorized in three groups, namely city centers, rural areas and suburbs. For the assessment of flat foot, footprint test is used. Prevalence of flat foot was 35.5% among girls and 28.5% among boys. Flat foot was associated with child age, residency and body mass index (BMI). Flat foot prevalence was highest among 6-year-old children, and lowest among 11-year and older children (P < 0.05). Flat foot prevalence was lower among children living in rural areas and children with low BMI value (P = 0.001). More overweight and at risk of overweight children had flat foot compared to normal and underweight children (P < 0.05). Familial predisposition was also noted for flat foot; 16.1% of children with flat foot had a familial history of flat foot, while this rate was only 5.6% in families of healthy subjects (P = 0.001).