Table 3.
Summary of included studies
| Author (date) | Study code | N | Study design | Study aim | Participants | Mean age (SD), range in years* | Ethnicity or Country of study | Foot posture measure used |
|---|---|---|---|---|---|---|---|---|
| Abolarin et al. (2011) | [45] | 560 | Cross-sectional | To determine the role of age and type of foot wear as predictors of flatfoot | School children | 6–12 | Nigerian | Instep |
| Aharonson, Arcan & Steinback (1992) | [53] | 82 | Case-series | To establish foot-ground pressure patterns | Children with flexible flat foot | 4–6 | Caucasian | Rearfoot eversion |
| Foot ground pressure | ||||||||
| Plantarflexion of talus angle | ||||||||
| Calcaneal pitch angle | ||||||||
| AP talocalcaneal angle | ||||||||
| Bok et al. (2016) | [33] | 21 | Cohort | To evaluate the effects of different foot orthoses inversion angles on plantar pressure during gait | Children with flexible flat foot | 9.9 (1.6), 8–13 | South Korean | Rearfoot eversion (plus one of the following) |
| AP talocalcaneal angle | ||||||||
| Lateral talocalcaneal angle | ||||||||
| Talus-first metatarsal angle | ||||||||
| Calcaneal pitch angle | ||||||||
| Chang et al. (2014) | [46] | 1228 | Cohort | To establish a new classification of flatfoot by characteristics of frequency distribution in footprint indices | School children | 7.3 (1.1), 6–10 | Taiwanese | Staheli arch index |
| Chippaux-Smirak index | ||||||||
| Chen et al. (2011) | [34] | 1319 | Cohort | To analyse and compare footprint measures of preschool aged children | Children with flexible flat foot | 5.2, 3–6 | Taiwan | Clarke’s angle |
| Chippaux-Smirak Index | ||||||||
| Staheli arch index | ||||||||
| Chen et al. (2014) | [56] | 605 | Cohort | To determine the prevalence of flatfoot in children with delayed motor development | Children with & without developmental coordination disorder | 4.4, 3–7 | Taiwanese | Chippaux-Smirak index |
| Chen et al. (2015) | [54] | 21 | Cohort | To investigate the effects of foot wear on joint range of motion, ground reaction forces and muscle activity | Children with & without flat foot | 6.3, 5–11 | Taiwanese | Arch index |
| Drefus et al. (2017) | [47] | 30 | Cross-sectional | To determine the intra and inter-rater reliability of the Arch height index | Children | 9.6 (2.0), 6–12 | United States | Rearfoot eversion |
| Arch height index (sitting/standing) | ||||||||
| Evans and Karimi (2015) | [29] | 728 | Cross-sectional | To explore the relationship between foot posture and body mass | Over and normal weight children | 9.1 (2.4), 3–15 | Australia and United Kingdom | FPI-6 |
| Ezema et al. (2014) | [48] | 474 | Cross-sectional | To determine associated personal characteristics of flatfooted school children | Children | 6–10 | Nigerian | Staheli arch index |
| Galli et al. (2014) | [35] | 70 | Cohort | To determine if children with Down syndrome were characterised by an accentuated external foot rotation in gait | Children with & without Down syndrome | 9.6 (1.7), 4–14 | Italy | Arch index |
| Galli et al. (2015) | [36] | 64 | Cohort | To characterise quantitatively the foot-ground contact parameters during static upright standing | Children with & without cerebral palsy | 8.6 (2.4), 5–13 | Italy | Arch index |
| García-Rodríguez et al. (1999) | [49] | 1181 | Cross-sectional | To estimate prevalence and number of unnecessary treatments of flatfooted children | School children | 4–13 | Spanish | Plantar footprint |
| Kothari et al. (2016) | [50] | 95 | Cross-sectional | To investigate the relationship between foot posture and the proximal joints | Children with & without flat foot | 11 (2.9), 8–15 | United Kingdom | Arch height index |
| Morrison, Ferrari & Smillie (2013) | [28] | 22 | Quasi-RCT | To report clinical findings of foot posture and lower limb hypermobility and evaluate the impact of foot orthoses on spatio-temporal gait parameters. | Male children with developmental coordination disorder | Median age 7.5, 6–11 | United Kingdom | FPI-6 |
| Nikolaidou & Boudolos (2006) | [37] | 132 | Cohort | To develop a footprint-based classification technique for the rational classification of foot types | School children | 10.4 (0.9), 9–11 | Greek | Arch index |
| Chippaux-Smirak index | ||||||||
| Martirosov’s K index | ||||||||
| Clarke’s angle | ||||||||
| Pau et al. (2016) | [30] | 130 | Cohort | To screen plantar pressures during level walking with a backpack among normal, overweight and obese school children | Overweight, obese and normal weight children | 9.3 (2.0), 6–13 | Italian | Arch index |
| Pauk, Ihnatouski & Najafi (2014) | [38] | 93 | Cohort | To assess differences in plantar pressure distributions and reliability of the Clarke’s angle | Children with & without flat foot | 12.6 (1.9), 9–16 | Poland | Clarke’s angle |
| Calcaneal pitch | ||||||||
| Calcaneal first metatarsal angle | ||||||||
| Pauk & Szymul (2014) | [55] | 73 | Case-control | Comparing vertical ground reaction force data between flat and neutrally aligned feet | Children with & without flat foot | 10.8 (3.6), 4–18 | Poland | Clarke’s angle |
| Rearfoot eversion | ||||||||
| Pfeiffer et al. (2006) | [39] | 835 | Cohort | To establish prevalence and cofactors of flatfoot, and estimate number of unnecessary interventions received | Children | 3–6 | Austrian | Rearfoot eversion |
| Reimers, Pedersen & Brodersen (1995) | [40] | 759 | Cohort | To establish foot deformity and triceps surae length in Danish children | Children and adolescents | 3–17 | Denmark | Chippaux-Smirak index |
| Selby-Silverstein, Hillstrom & Palisano (2001) | [41] | 26 | Cohort | To determine if foot orthoses immediately affected gait of children with Down syndrome or excessively pronated feet | Children with flat foot, with & without Down syndrome | 3–6 | North American | Rearfoot eversion |
| Stavlas et al. (2005) | [51] | 5866 | Cross-sectional | To determine foot morphology evolution in children between 6 and 17 years of age | Children | 6–17 | Greek | Footprint evaluation |
| Tashiro et al. (2015) | [52] | 619 | Cross-sectional | To investigate the relationship between toe grip strength and foot posture | Children | 11.2 (0.7), 10–12 | Japan | Staheli arch index |
| Twomey et al. (2010) | [42] | 52 | Cohort | To investigate differences in kinematics during walking gait | Children with & without flat foot | 11.2 (1.2), 9–12 | Not reported | Clarke’s angle |
| Arch index | ||||||||
| Navicular height | ||||||||
| Villarroya et al. (2009) | [31] | 116 | Case-control | To evaluate the measures of, and foot arch types, in different weight children using radiographic and footprint indices | Obese & non-obese children | Boys 12.4 (1.6), Girls 11.9 (1.5), 9–16.5 | Spanish | Clarke’s angle |
| Chippaux-Smirak index | ||||||||
| Calcaneal pitch | ||||||||
| Talus-first metatarsal angle | ||||||||
| Yan et al. (2013) | [32] | 100 | Case-control | To examine changes in dynamic plantar pressure distribution in children of different weight | Obese & non-obese children | 10.3 (0.7), 7–12 | China | Arch index |
*where available
AP – anteroposterior, FPI-6 – foot posture index – 6 item, LAC - longitudinal axis of calcaneus, LAF - longitudinal axis of foot, MLA – medial longitudinal arch, NR – not reported, mm – millimetres
Additional information regarding foot posture parametres can be found in Additional file 2