Evidence map›Paper›PMID 40841947›Full record

ArticleJournal of orthopaedic surgery and research2025

Prevalence and functional impact of flexible flatfoot in school-aged children: a cross-sectional clinical and postural assessment.

Saleh M Kardm, Ziad Ahmed Alanazi, Tariq Abdullah S Aldugman, Ravi Shankar Reddy, Ajay Prashad Gautam

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Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Saleh M KardmDepartment of Surgery, Najran University, Najran, Saudi Arabia.
Ziad Ahmed AlanaziDepartment of Surgery, Orthopedic Division, College of Medicine, Jouf University, Sakaka, Saudi Arabia.
Tariq Abdullah S AldugmanDepartment of Surgery, College of Medicine, Najran University, Najran, Saudi Arabia. taaldugman@nu.edu.sa.
Ravi Shankar ReddyProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia. rshankar@kku.edu.sa.
Ajay Prashad GautamProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.

Funding

Deanship of Scientific Research, King Khalid University RGP.2/22/46.
6 · The paper itself

Abstract

backgroundFlexible flatfoot is a prevalent musculoskeletal condition in pediatric populations, often regarded as a benign and self-limiting developmental variation. However, persistent cases may contribute to discomfort, functional limitations, and reduced physical activity levels. Despite its frequency, few studies have comprehensively evaluated its functional impact using standardized clinical and functional assessment tools in school-aged children.

objectivesThis study aimed to (1) determine the prevalence of flexible flatfoot among children aged 6-12 years using standardized clinical criteria and the Foot Posture Index-6 (FPI-6); and (2) evaluate its functional implications by analyzing associations with pain intensity, physical activity levels, and body mass index (BMI).

methodsA cross-sectional clinical study was conducted among 326 school-aged children. Flexible flatfoot was diagnosed based on clinical examination and an FPI-6 score > + 6. Pain was measured using the Visual Analogue Scale (VAS), physical activity using the Physical Activity Questionnaire for Children (PAQ-C), and BMI using standard anthropometric techniques.

resultsFlexible flatfoot was identified in 98 children (30.06%; 95% CI: 25.08-35.04), with a predominance of bilateral cases and higher prevalence among males. Affected children showed significantly higher VAS pain scores (4.12 ± 1.03 vs. 2.91 ± 0.89; p < 0.001), lower PAQ-C physical activity scores (2.53 ± 0.54 vs. 3.05 ± 0.61; p < 0.001), and elevated FPI-6 and BMI values compared to their non-flatfooted peers. Multiple regression analyses identified FPI-6 scores and BMI as independent predictors of both pain and reduced physical activity, accounting for 31% and 26% of the variance, respectively.

conclusionFlexible flatfoot in school-aged children is significantly associated with increased pain perception, decreased physical activity, and elevated BMI. These findings underscore the importance of early detection and functional assessment, particularly in children with modifiable risk factors such as obesity and sedentary behavior, to support timely and targeted musculoskeletal interventions.

Indexed as

FlatfootPostureBody Mass IndexChildCross-Sectional StudiesExerciseFemaleHumansMalePain MeasurementPrevalenceBMIChildrenFlexible flatfootFoot posture indexPainPediatric musculoskeletal disordersPhysical activity

Identifiers

PMID40841947
PMCPMC12369048

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.