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

Open Med (Wars). 2021 Feb 1;16(1):246-256. doi: 10.1515/med-2021-0227. eCollection 2021.

Abstract

Background: The 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.

Methods: A 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.

Results: The 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.

Conclusion: A 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.

Keywords: Chippaux–Smirak index; foot assessment; foot posture index; foot prints; pediatric flatfoot.