Monitoring the Role of Physical Activity in Children with Flat Feet by Assessing Subtalar Flexibility and Plantar Arch Index

Abstract

Flat foot is a common pediatric foot deformity which involves subtalar flexibility; it can affect the plantar arch. This study analyzes the evolution of two parameters, i.e., plantar index arch and subtalar flexibility, before and after physiotherapy and orthoses interventions, and examines the correlation between these two parameters. Methods: The study included 30 participants (17 boys, 12 girls, average age 9.37 ± 1.42 years) with bilateral flat foot. We made two groups, each with 15 subjects. Assessments of the subtalar flexibility and plantar arch index used RSScan the platform, and were undertaken at two time points. Therapeutic interventions: Group 1—short foot exercises (SFE); Group 2—SFE and insoles. Statistical analyses included Student’s t-test, Cohen’s D coefficient, Pearson and Sperman correlation. Results: Group 1—subtalar flexibility decreased for the left and right feet by 28.6% and 15.9% respectively, indicating good evolution for the left foot. For both feet, a decrease of the plantar index arch was observed. Group 2—subtalar flexibility decreased for the right and left feet by 43.4% and 37.7% respectively, indicating a good evolution for the right foot. For both feet, a decrease of plantar index arch was observed. Between groups, subtalar flexibility evolved well for Group 2; this was attributed to mixt intervention, physical therapy and orthosis. For plantar arch index, differences were not significant between the two groups. We observed an inverse correlation between subtalar flexibility and plantar arch index. Conclusions: Improvement of plantar index arch in static and dynamic situations creates the premise of a good therapeutic intervention and increases foot balance and postural control. The parameter which showed the most beneficial influence was the evolution is subtalar flexibility.

Are flat feet a disadvantage in performing unilateral and bilateral explosive power and dynamic balance tests in boys? A school-based study

“…First, by using a cross-sectional design, we cannot determine the causal association between flat feet and physical performance. It is possible that children with lower levels of physical activity may suffer from overweight/obesity, which in addition may lead to flatter feet [ 21 ]. Second, we only included boys in our study, and our results must be interpreted with caution.…”

“…Previous studies have shown that age [ 13 ], body mass index [ 4 , 5 ], peak height velocity [ 20 ] and physical activity [ 21 ] may mediate the association between flat footedness and physical performance, which we included in adjusted models. Age was self-reported.…”

"The Benefits of Physical Therapy in the Rehabilitation of Flat Feet in Autism Students between the ages of 10 and 14"

“…On the other hand some researchers demonstrate that physiotherapeutic and orthoses interventions result in improved subtalar flexibility and plantar arch index due to their ability to reduce the compensatory role of muscle groups that promote inversion and increase the role of the long perionier muscle [48] .…”

Really Asymptomatic? Health-Related Quality of Life and Objective Clinical Foot Characteristics among 5–10-Year-Old Children with a Flexible FlatFoot

“…Paediatric flexible flatfoot is usually described as a foot posture with a deficiency in, or the insufficiency of, a longitudinal arch in the midfoot [1,2]. It is regarded as an anatomical variation in the foot structure [3], and clinicians have simply divided this foot posture into painless (asymptomatic flexible flatfoot) and painful (symptomatic flexible flatfoot) [4][5][6][7][8]. This was due to the fact that paediatric flexible flatfoot follows a history of natural improvement over time [8,9] and also because it is easier to reach an agreement for treatment in a child with a symptomatic flexible flatfoot [10].…”