PES PLANUS & GENU VALGUM

Abstract

Pes planus (flat foot) is a musculoskeletal abnormality of lower limb, oftenassociated with some degree of malalignment at the knee i.e. genu valgum (knock knees). Inmajority of cases, these deformities resolve by themselves during infancy and childhood, butif they persist in adolescent age, then there is no chance of resolution and might pose seriousproblems for the individual in the future. Objectives: The objective of this study was to determinethe factors associated with pes planus and genu valgum in adolescents. The two main factorsunder investigation were physical activity and dietary habits of adolescents and their effect onthese lower limb musculoskeletal conditions. Material and methods: A case-control study wasconducted on 400 (161 cases and 239 controls) school- going adolescents (11-16 years). Aftercompleting the demographic data and recording the height and weight of each participant, thediagnosis of pes planus was made on the basis of physical examination and special tests. Thedata for genu valgum was collected by the measurement of clinical tibiofemoral angle. A selfreportquestionnaire was used to collect other relevant data such as the symptoms experiencedby the individuals. Data was analyzed on SPSS 21. Results: Out of 400 adolescents, therewere 171 males and 229 females. The physical activity level of cases was 2.17 ± 0.70, slightlyless than that of control group 2.32 ± 0.76. The diet score of cases (11.087 ± 3.75) did notdiffer much from that of controls (11.214 ± 3.75). Tibiofemoral angle of cases was 15.7 ± 3.42degrees valgus for controls it was 14.1 ± 3.49 degrees valgus. There was also a greater trendof cases towards overweight (12.8% cases and 7.43% controls) and obesity (5.84% cases and2.62% controls), whereas the frequency of controls was higher in underweight (19.8% casesand 27.5% controls) and healthy/ normal weight category (55.5% cases and 66.8% controls).Other associated symptoms such as foot pain, knee pain, trauma to foot and knee, difficultyin running and jumping activities etc were also found to be in higher frequency in cases ascompared to in controls along with significant gender differences. Conclusion: Our study resultsshowed that reduced physical activity can be a factor for causation of flat foot and knock-kneesbut the difference in diet habits was not very significant between cases and controls. Thereforeunhealthy diet is not a very considerable factor in the contribution to musculoskeletal conditionsin lower limb. There was a direct link between obesity and pes planus, along with a greater TFA.There was also a higher incidence of knee pain in the flat foot cases who complained of footpain along with various other associated symptoms.