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Foot Arch Posture Development in Children and Adolescents aged 6 to 19 Years: A Cross-sectional Descriptive Study
Yousef Mahmoudzadeh
Payame Noor University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0232-3722
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The arch height index (AHI) is a commonly used method for measuring foot arch posture. However, there are little studies have investigated the natural growth and normative values of the foot arch using the AHI. The objective of this study was to establish normative and cut-off values for foot arch posture and to identify factors influencing foot arch posture across childhood and adolescence.
Methods: In this cross-sectional study, a sample of 3532 healthy children and adolescents (1804 boys, 1728 girls; aged 6 to 19 years) was recruited for the navicular height (NH) and AHI measurements and anthropometry assessment (weight, height, BMI and foot length). Data were explored descriptively and graphically, comparisons between groups used t-tests or ANOVA model as appropriate and a multiple regressions was conducted. The 95% and 68% prediction intervals were used as cut-off values.
Results : approximately 69% had a normal AHI range, 12% low arched foot, 3% severely low arched, 14% high arched and 1.8% severely high arched foot. The mean (SD) AHI was 15.16 (2.61). Very little gender bias was found for AHI values, being higher in males 15.32 (2.54) than in females 15.0 (2.68) ( p = .019). Regression showed approximately 3%, 0.3% and 2% of the AHI change was explained by age, BMI and foot length, respectively. The mean NH significantly increased from the age of 6 (2.62 cm) to 19 (4.20 cm).
Conclusions: This study confirms that the ‘flexible flatfoot’ or low arched foot decreases with age. Simultaneously, increase of high arched foot type and shift in foot posture towards more normal foot type are also confirmed. BMI does not seem to be an important determinant of children foot arch posture. Keywords: Foot posture, Navicular height, Arch height index, Normative values, Medial longitudinal arch, Foot arch development, Children, Adolescents
Keywords
arch height index (AHI), foot arch posture, childhood , adolescence
Figure 1
Figure 1
Figure 2
Figure 2
Due to technical limitations, all tables are only available as a download in the Supplemental Files section.
This is a list of supplementary files associated with this preprint. Click to download.
- Table1.docx
Demographic characteristics and anthropometrics (N = 3532) SD: standard deviation; CI: confidence intervals; BMI: body mass index; kg: kilogram; cm: centimetre; FL: foot length; NH: navicular height; AHI: arch height index (AHI (%) = NH/FL x100)
- Table1.docx
Demographic characteristics and anthropometrics (N = 3532) SD: standard deviation; CI: confidence intervals; BMI: body mass index; kg: kilogram; cm: centimetre; FL: foot length; NH: navicular height; AHI: arch height index (AHI (%) = NH/FL x100)
- Table2.docx
Mean and standard deviation of FL, NH and AHI for age and gender (N = 3532) The arch height index (AHI) correspond to the NHx100/FL (%). FL: foot length; NH: navicular height: AHI: arch height index; N: Number of Participants
- Table2.docx
Mean and standard deviation of FL, NH and AHI for age and gender (N = 3532) The arch height index (AHI) correspond to the NHx100/FL (%). FL: foot length; NH: navicular height: AHI: arch height index; N: Number of Participants
- Table3.docx
Cut-off values for AHI, showing normal range and AHI outside normal range (Mean AHI [SD]: 15.16 [2.61]) AHI, Arch height index; N, number; SD, standard deviation
- Table3.docx
Cut-off values for AHI, showing normal range and AHI outside normal range (Mean AHI [SD]: 15.16 [2.61]) AHI, Arch height index; N, number; SD, standard deviation
- Table4.docx
Arch height index (AHI) categories for each year of age Data are presented as number (%). N, number
- Table4.docx
Arch height index (AHI) categories for each year of age Data are presented as number (%). N, number
- Table5.docx
Associations between age and anthropometric characteristics with NH and AHI Multivariate linear regression analysis of the association between age (years), BMI (kg/m2) and foot length (cm) with navicular height (NH) and arch height index (AHI). B coefficients with standard error (SE) were determined. P values < 0.05 were statistically significant for these analyses. CI: confidence intervals; BMI: body mass index
- Table5.docx
Associations between age and anthropometric characteristics with NH and AHI Multivariate linear regression analysis of the association between age (years), BMI (kg/m2) and foot length (cm) with navicular height (NH) and arch height index (AHI). B coefficients with standard error (SE) were determined. P values < 0.05 were statistically significant for these analyses. CI: confidence intervals; BMI: body mass index
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CURRENT STATUS: Under Revision
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Posted 08 Dec, 2020
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Editorial decision: Major revision
On 06 Jan, 2021
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Received 05 Jan, 2021
Review #1 received
Received 15 Dec, 2020
Reviewer #2 agreed
On 08 Dec, 2020
Reviewers invited
Invitations sent on 08 Dec, 2020
Reviewer #1 agreed
On 08 Dec, 2020
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On 29 Nov, 2020
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On 29 Nov, 2020
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On 29 Nov, 2020
First submitted
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This preprint is under consideration at Journal of Foot and Ankle Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Foot Arch Posture Development in Children and Adolescents aged 6 to 19 Years: A Cross-sectional Descriptive Study
Yousef Mahmoudzadeh
Payame Noor University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0232-3722
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 08 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 06 Jan, 2021
Review #2 received
Received 05 Jan, 2021
Review #1 received
Received 15 Dec, 2020
Reviewer #2 agreed
On 08 Dec, 2020
Reviewers invited
Invitations sent on 08 Dec, 2020
Reviewer #1 agreed
On 08 Dec, 2020
Editor assigned
On 29 Nov, 2020
Submission checks complete
On 29 Nov, 2020
Editor invited
On 29 Nov, 2020
First submitted
On 27 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The arch height index (AHI) is a commonly used method for measuring foot arch posture. However, there are little studies have investigated the natural growth and normative values of the foot arch using the AHI. The objective of this study was to establish normative and cut-off values for foot arch posture and to identify factors influencing foot arch posture across childhood and adolescence.
Methods: In this cross-sectional study, a sample of 3532 healthy children and adolescents (1804 boys, 1728 girls; aged 6 to 19 years) was recruited for the navicular height (NH) and AHI measurements and anthropometry assessment (weight, height, BMI and foot length). Data were explored descriptively and graphically, comparisons between groups used t-tests or ANOVA model as appropriate and a multiple regressions was conducted. The 95% and 68% prediction intervals were used as cut-off values.
Results : approximately 69% had a normal AHI range, 12% low arched foot, 3% severely low arched, 14% high arched and 1.8% severely high arched foot. The mean (SD) AHI was 15.16 (2.61). Very little gender bias was found for AHI values, being higher in males 15.32 (2.54) than in females 15.0 (2.68) ( p = .019). Regression showed approximately 3%, 0.3% and 2% of the AHI change was explained by age, BMI and foot length, respectively. The mean NH significantly increased from the age of 6 (2.62 cm) to 19 (4.20 cm).
Conclusions: This study confirms that the ‘flexible flatfoot’ or low arched foot decreases with age. Simultaneously, increase of high arched foot type and shift in foot posture towards more normal foot type are also confirmed. BMI does not seem to be an important determinant of children foot arch posture. Keywords: Foot posture, Navicular height, Arch height index, Normative values, Medial longitudinal arch, Foot arch development, Children, Adolescents
Figure 1
Figure 1
Figure 2
Figure 2
Due to technical limitations, all tables are only available as a download in the Supplemental Files section.