Prevalence of Flat Foot in Primary School Students Aged 7-12 Years, in Zanjan City, Iran
Introduction: Physical conditions of people are among the essential components of their health. Any structural or physical changes of the human body can affect the performance of the individual. Flat foot is one of the most common problems in musculoskeletal disorders that can be addressed in childhood, and its complications can be reduced by providing appropriate and timely treatments. This study aimed to estimate the prevalence of flat foot in primary school students (aged 7-12 years) in Zanjan City, Iran to improve the effectiveness of interventions.
Materials and Methods: This research was a cross-sectional study to assess the prevalence of flat foot types among 1700 girls and boys students aged 7-12 years in the elementary schools of Zanjan City.
Results: A total of 900 male (53%) and 800 female (47%) students participated in this study. The samples’ Mean±SD age, height, and weight were 9.63±1.55 years, 132.93±13.42 cm, and 32.75±10.46 kg. The prevalence of different types of flat feet were as follows: 491 (28.9%) children with smooth flat foot, 12 (0.7%) children with rigid flat foot, and 1197 (70.4%) children without any type of flat feet. The ordinal regression model showed that the highest level of the flat foot was observed among the third-grade students with 33%, and the lowest level of the flat foot was among the second-grade students with 26.3%. Weight was the strongest predictor for the flat foot in the students. By 1 kg weight increase, the probability of flat foot increases by 1.065 times.
Conclusion: The prevalence of foot flat among primary school students in Zanjan City had a high rate. There is a significant relationship between the flat foot and weight , therefore nutritional interventions are necessary for these children.
2. Torkaman A. [Prevalence of scoliosis in secondary school students of Sanandaj in year 2000 (Persian)]. Scientific Journal of Kurdistan University of Medical Sciences. 2002; 6(3):20-3. https://www.sid.ir/fa/journal/ViewPaper.aspx?ID=12687
3. Dommisse GF. A re-assessment of patients previously treatedwith intravenous iron dextran. South African Medical Journal. 1972; 45(24): 663-7.
4. Symington J. Anatomy of acquired flat-foot. Journal of Anatomy and Physiology. 1884; 19(Pt 1):82.2-93. [PMID] [PMCID]
5. Mauch M, Grau S, Krauss I, Maiwald C, Horstmann T. Foot morphology of normal, underweight and overweight children. International Journal of Obesity. 2008; 32(7):1068-75. [DOI:10.1038/ijo.2008.52] [PMID]
6. Domzalski M, Kwapisz AŁ, Król A, Jedrzejewski K. [The role of plantar calcaneonavicular ligament complex in the development of the adult flat foot--anatomical study (Polish)]. Chirurgia Narzadow Ruchu I Ortopedia Polska. 2007; 72(4):265-8. [PMID]
7. Riccio V, Porpora G, Riccio I. [Pediatric flat foot: A review (Italian)]. La Pediatria Medica e Chirurgica. 2009; 31(5):201-4. [PMID]
8. Tryfonidis M, Jackson W, Mansour R, Cooke PH, Teh J, Ostlere S, et al. Acquired adult flat foot due to isolated plantar calcaneonavicular (spring) ligament insufficiency with a normal tibialis posterior tendon. Foot and Ankle Surgery. 2008; 14(2):89-95. [DOI:10.1016/j.fas.2007.11.005] [PMID]
9. Meehan RE, Brage M. Adult acquired flat foot deformity: Clinical and radiographic examination. Foot and Ankle Surgery. 2003; 8(3): 431-52. [DOI:10.1016/S1083-7515(03)00019-6]
10. Elftman NW. Nonsurgical treatment of adult acquired flat foot deformity. Foot and Ankle Surgery. 2003; 8(3):473-89. [DOI:10.1016/S1083-7515(03)00119-0]
11. Rose GK, Welton EA, Marshall T. The diagnosis of flat foot in the child. The Journal of Bone and Joint Surgery. British volume. 1985; 67-B(1):71-8. [DOI:10.1302/0301-620X.67B1.3968149] [PMID]
12. Abdel-Fattah MM, Hassanin MM, Felembane FA, Nassaane MT. Flat foot among Saudi Arabian army recruits: Prevalence and risk factors. Eastern Mediterranean Health Journal. 2006; 12(1-2): 211-7. [PMID]
13. Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M. Prevalence of flat foot in preschool-aged children. Pediatrics. 2006; 118(2):634-9. [DOI:10.1542/peds.2005-2126] [PMID]
14. Takao M, Komatsu F, Oae K, Miyamoto W, Uchio Y, Ochi M, et al. Proximal oblique-domed osteotomy of the first metatarsal for the treatment of hallux valgus associate with flat foot: Effect to the correction of the longitudinal arch of the foot. Archives of Orthopaedic and Trauma Surgery. 2007; 127(8):685-90. [DOI:10.1007/s00402-007-0362-3] [PMID]
15. Toolan BC. The treatment of failed reconstruction for adult acquired flat foot deformity. Foot and Ankle Clinics. 2003; 8(3):647-54. [DOI:10.1016/S1083-7515(03)00118-9]
16. Hunt AE, Smith RM. Mechanics and control of the flat versus normal foot during the stance phase of walking. Clinical Biomechanics. 2004; 19(4):391-7. [DOI:10.1016/j.clinbiomech.2003.12.010] [PMID]
17. Fabry G. Clinical practice. Static, axial, and rotational deformities of the lower extremities in children. European Journal of Pediatrics. 2010; 169(5):529-34. [DOI:10.1007/s00431-009-1122-x] [PMID]
18. Evans AM, Rome K, Peet L. The foot posture index, ankle lunge test, Beighton scale and the lower limb assessment score in healthy children: A reliability study. Journal of Foot and Ankle Research. 2012; 5:1. [DOI:10.1186/1757-1146-5-1] [PMID] [PMCID]
19. Krul M, van der Wouden JC, Schellevis FG, van Suijlekom-Smit LWA, Koes BW. Foot problems in children presented to the family physician: A comparison between 1987 and 2001. Family Practice. 2009; 26(3):174-9. [DOI:10.1093/fampra/cmp018] [PMID]
20. Lin CJ, Lai KA, Kuan TS, Chou YL. Correlating factors and clinical significance of flexible flatfoot in preschool children. Journal of Pediatric Orthopaedics. 2001; 21(3):378-82. [DOI:10.1097/01241398-200105000-00022] [PMID]
21. Must A, Dallal GE, Dietz WH. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness. The American Journal of Clinical Nutrition. 1991; 53(4):839-46. [DOI:10.1093/ajcn/53.4.839] [PMID]
22. Halabchi F, Mazaheri R, Mirshahi M, Abbasian L. Pediatric flexible flatfoot; clinical aspects and algorithmic approach. Iranian Journal of Pediatrics. 2013; 23(3):247-60. [PMID] [PMCID]
23. Milenković S, Živković M, Bubanj S, Živković D, Stanković R, Bubanj R, et al. Incidence of flat foot in high school students. Facta Universitatis Series: Physical Education and Sport. 2011; 9(3):275-81. http://facta.junis.ni.ac.rs/pe/pe201103/pe201103-06.pdf
24. Karimi MT, Fereshtenejad N, Fatemeh Pol. [The impact of foot insole on the energy consumption of flat foot subjects during walking (Persian)]. Journal of Research in Rehabilitation Sciences. 2011; 7(5):652-60. https://www.sid.ir/fa/journal/ViewPaper.aspx?ID=158733
25. Alamy B. [An epidemiologic study of flat foot in Iran (Persian)]. Tehran University Medical Journal. 1997; 55(3-4):78-83. http://tumj.tums.ac.ir/article-1-1658-en.html
26. Kamali N, Haji Ahmadi M, Janmohamadi N, Kamali AA. [Prevalence of flat foot in elementary, guidance and high school students (Babol 2005-2006) (Persian)]. Journal of Babol University of Medical Sciences. 2008; 9(6):50-4. http://jbums.org/article-1-2494-fa.html
27. Eluwa MA, Omini RB, Kpela T, Ekanem TB, Akpantah AO. The incidence of pes planus amongst Akwa Ibom state students in the University of Calabar. The Internet Journal of Forensic Science. 2009; 3(2). https://www.researchgate.net/publication/258975875
28. Askary Kachoosangy R, Aliabadi F, Ghorbani M. Prevalence of flat foot: Comparison between male and female primary school students. Iranian Rehabilitation Journal. 2013; 11(2):22-4. http://irj.uswr.ac.ir/article-1-300-en.html
29. Daneshmandi H, Rahnema N, Mehdizadeh R. Relationship between obesity and flatfoot in high-school boys and girls. International Journal of Sports Science and Engineering. 2009; 3(1):43-9. https://pdfs.semanticscholar.org/b3b9/3257879714cc819a5fc4c24593d3ebb9c429.pdf
30. Tachdjian MO. Flexible pes planovalgus (flatfoot). In: Tachdjian MO. Pediatric Orthopedics, Vol. 4. 2nd ed. Philadelphia: W.B. Saunders; 1990. https://books.google.com/books?id=M-NsAAAAMAAJ&dq
31. Horieh Galini. The relationship between overweight and flat foot in primary school girl students. International Journal of Sport Studies. 2015; 5(5):559-62.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.