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Foot type symmetry and change of foot structures from sitting to standing conditions


Foot symmetry and change in foot structure as a function of weight bearing status have not been investigated in a large cohort study. The foot structure of 1,054 incoming cadets at the US Military Academy (172 female, 18.5±1.1 years, 24.5±3.0 kg/m2) was examined. Arch Height Index (AHI) was assessed in sitting and standing condition, and its value was used to classify each foot into 3 foot types as previously described [1].


Based on standing AHI, 68.1%, 24.5%, and 7.5% of the study subjects’ left foot was categorized into planus, neutral, and cavus foot types, respectively. An asymmetrical foot type was observed in 28.6% of subjects in sitting and 23.6% standing conditions. Foot length increased from sitting to standing conditions; this change was significantly greater in cavus and neutral foot type groups than the planus group. In contrast, arch height flexibility (AHF) was significantly greater in the planus group than both cavus and neutral foot type groups.


Results of this study suggest the importance of controlling for weight bearing status when assessing foot structure or fitting footwear. Given that about a quarter of participants demonstrated an asymmetrical foot type, findings also suggest the importance of assessing both feet independently. Table 1.

Table 1 Mean arch height flexibility and change in foot length across the 3 foot type groups


  1. Hillstrom HJ, Song J, Kraszewski AP, Hafer JF, Moontanah R, Dufour AB, Chow BS, Deland JT: Foot type biomechanics part 1: structure and function of the asymptomatic foot. Gait Posture. 2013, 37: 445-51. 10.1016/j.gaitpost.2012.09.007.

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Volunteers from the New York College of Podiatric Medicine, Temple University School of Podiatric Medicine, the Hospital for Special Surgery, and novel GmbH were instrumental in the collection of these data. We appreciate the study participants and support of the United States Military Academy.

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Correspondence to Howard Hillstrom.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Hillstrom, H., Song, J., Neary, M. et al. Foot type symmetry and change of foot structures from sitting to standing conditions. J Foot Ankle Res 7 (Suppl 1), A34 (2014).

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