Sensitivity and specificity of normalized truncated navicular height in assessment of static foot posture in children aged 6–12 years

Abstract

Background: Normalized truncated navicular height (NTNH) is a non-invasive, easy to perform, and simple clinical measure of static foot posture. However, its sensitivity and specificity in evaluation of the static foot posture in children have not been investigated yet. Objective: To investigate the intra-rater reliability, sensitivity, and specificity of NTNH in evaluation of the static foot posture in children using radiographic measure as a gold standard measure. Methods: A cross-sectional study of a random sample of 300 school children aged 6–12 years old. Intra-rater reliability, minimal detectable change, sensitivity, and specificity of NTNH were investigated. NTNH as a clinical measure of static foot posture was calculated and compared to the radiographic measure and displayed on the receiver operating characteristic (ROC) curve. Results: NTNH demonstrated an intra-rater reliability of [Formula: see text]. The sensitivity and specificity of NTNH were 88.1% and 99.5%, respectively. The optimal cutoff point for the diagnosis of flat foot using NTNH in children aged 6–12 years is NTNH [Formula: see text]. Conclusion: NTNH is a sensitive and specific measure of static foot posture in the children aged 6–12 years. It is recommended to be used as a screening measure of static foot posture in children as it is easy, simple to perform, and a non-invasive clinical measure.

Understanding foot conditions, morphologies and functions in children: a current review

“…In a study by ( Hawke et al, 2016 ), basic data on 30 healthy, asymptomatic kids aged 7 to 15 were gathered, including height and weight (BMI), Beighton score, Foot Posture Index-6 (FPI), and lower extremity evaluation. A correlation between flat feet and joint flexibility was discovered, and internal foot rotation was associated with lower limb and overall body flexibility in healthy and asymptomatic children, but not related with the ankle flexibility ( Aboelnasr et al, 2019 ), which was consistent with a previous statement ( Hawke et al, 2016 ). This finding supported that neutral and internally rotated foot postures predominated over other foot postures, as reported by Evans ( Evans et al, 2012 ) that being overweight would not cause flat feet.…”

“…From the above analysis, it was clear that flatfoot may not be significantly correlated with changes in body mass index ( Hawke et al, 2016 ; Aboelnasr et al, 2019 ). In other words, weight gain may not lead to flatfoot.…”

“…From the results in Table 3 , ( Mauch et al, 2008 ), concluded that flatfoot occurred at a higher rate in overweight children than in other normal weight and ultralight weight. Although a considerable number of studies have concluded that weight gain during growth can indirectly or directly cause flat feet, (e.g., plantar pressure due to weight gain and flattening of the MLA), the foot prosthesis could maintain the longitudinal arch through compensatory mechanisms ( Aboelnasr et al, 2019 ). As the central nervous system matures in children, individuals would have better motor performance and balance.…”

“…investigated 2,569 Japanese kids between the age of 9–15 using the FPI-6, discovering that kids exhibited neutral or moderate internal rotation in standing posture, with a mean score of 3–3.4. Based on a sample of 140 children aged 7–10 years, ( Aboelnasr et al, 2019 ), used FPI-6 screening to identify a sample of 31 kids with flat feet. Basic anthropometric measurements were compared between subjects designated with flat feet, reporting that waist size was associated with foot morphology (although not significantly), but conversely, a “fatter” waist was less associated with flat feet.…”

The Influence of Age and Gender on Normalized Foot Arch Height in Childhood and Adolescence: Cross-sectional Study

“…A pes planus was assigned if IH /IL .345 or less; a rectus foot structure if greater than .345 22 . A previous study classi ed as pes planus when NH/IL were under or same .194 and rectus when NH/IL were over .194 23 .…”