Accuracy of the flexible flatfoot measurement in a Paediatric Population. Results of a cross-sectional study

Abstract

Background. Flatfoot is a common posture in children’s feet. The posture of the foot depends on age, and the time when the longitudinal arch is formed is not yet known precisely. Mostly, non-dynamic assessment of children’s feet is performed in clinical practice to classify foot posture and excluding pathological feet. This includes: visual assessment, anthropometric measurements (resting calcaneal stance position angle (RCSP), Navicular Drop Test (ND)), Foot Posture Index (FPI-6), various footprint-based analyses (Chippaux-Smirak Index (CSI), Staheli Arch Index (SI), etc.) and radiological examinations – calcaneal pitch angle (CP), talocalcaneal angle (TCA), lateral first metatarsal angle (TMA). However, there is no concensus in clinical practice and researcher’s community as to whether FPI-6, ND, RCSP, SI, CSI or X-ray measurements and clinical measurements could be used as a best clinical, radiological measuring tools for paediatric flat foot. Aim. To investigate the relationship between the 6-item version of the foot posture index and other clinical, foot anthropometric, radiological measurements for foot position in children at 5–8 years. Methods. A total of 300 participants with a mean age of 6.4 ± 1.14 years were enrolled in the study. Children were examined physically, clinically, radiologically to measure Foot Posture Index and Navicular Drop Test, resting calcaneal stance position angle, Chippaux-Smirak Index, Staheli Index, calcaneal pitch angle, talocalcaneal angle, lateral first metatarsal angle. Tibial torsions, internal rotation of hip as an indirect method of femoral anteversion and Beighton Scale were analysed for factors associated with flat foot prevalence. Results. The study included children with normal and flexible flat feet. Statistical analysis showed a significant FPI score correlation with other parameters (SI, CSI, RCSP, ND, CP, TMA, TCA showed strong and moderate correlat[...].