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Table 1 Study characteristics

From: The typically developing paediatric foot: how flat should it be? A systematic review

Authors

Study Type

Study aim

Population

N Participants (Boys:Girls)

Age range in years

(mean ± SD)

Foot posture measures

Bertsch et al. [23]

Longitudinal Cohort

Evaluate plantar pressure data in infants to understand the maturation of the lower extremity and therefore differentiate pathological disorders

German infants, new walkers (Data collected longitudinally over 12 months)

42 (20:22)

10–17 months (14.8 ± 1.8) months at first exam

Foot shape index % (midfoot width/length)

Bosch et al. [24]

Longitudinal Cohort

Establish a plantar pressure database of infants for analysis of individual clinical cases

German infants, new walkers (Data collected longitudinally over 4 years)

43–90 (NR)

NR (15.3 ± 2.3)months at first exam

Foot form index % (midfoot width/length)

Chang et al. [36]

Cross-sectional

To use a 3D scanner to evaluate the arch of pre-school children and describe the flexibility of the arch

Taiwanese kindergarten children

44 (24:20)

2–6 (NR)

Navicular height computed from ‘Peripher 3D Scanner’

Delgado-Abellán et al. [38]

Cross-sectional

To analyse age and gender differences in foot morphology in Spanish school aged children

Spanish school children

1031 (497:534)

6–12 (NR)

Arch height computed from 3D foot digitiser

Didia et al. [27]

Cross-sectional

To create a data base of foot arch characteristics of a Nigerian population

Nigerian school children

990 (458:532)

5–14 (8.6 ± 1.9)a

Contact index II

Dowling et al. [62]

Cross-sectional

To determine whether a pedograph could be used to predict plantar pressures of the feet of primary school children

Australian, pre-pubertal children

51 (22:29)

NR (8.4 ± 1.0)

Clarke’s angle Chippaux-Smirak index

El et al. [45]

Cross-sectional

To analyse the longitudinal arch morphology and related factors including hypermobility, age, gender and rearfoot alignment in primary school children

Turkish primary school children

579 (299:280)

6–12 (9.23 ± 1.66)

Rearfoot angle

Staheli arch index

Evans [40]

Cross-sectional

To investigate the relationship between flat foot posture and body weight and related anthropometric measurements in school aged children

Australian, primary school children

140 (68:72)

7–10 (8.71 ± 0.91)

FPI-6

Evans and Karimi [42]

Cross-sectional

Examine the relationship between body mass index and foot posture in children

Five data sets including Australian and United Kingdom children

728 (375:353)

3–15 (9.07 ± 2.38)

FPI-6

Forriol and Pascual [28]

Cross-sectional

To investigate the development of the footprint according to age, gender, growth and foot type

Spanish children

1676 (663:1013)

3–17 (NR)

Clarke’s angle Chippaux-Smirak index

Gijon-Nogueron et al. [43]

Cross-sectional

To establish normative FPI-6 reference values for children aged 6–11 years

Spanish children

1762 (863:899)

6–11 (8.28 ± 1.72)

FPI-6

Gill et al. [48]

Cross-sectional

Examine the relationship between foot arch height and walking characteristics in children and adults

American children

254 (121:133)

18 (10:8)

2–17 (9.13 ± 3.26)

4–8 (6.22 ± 1.26)

Chippaux-Smirak index

Keimig index

Gilmour and Burns [29]

Cross-sectional

Examine the influence of gender, limb preference and body weight in relation to the medial longitudinal arch in children

Australian children

272 (128:144)

5.5–10.9 (8.4 ± 1.7)

Arch index

Navicular height

Hallemans et al. [46]

Cross-sectional

To perform a longitudinal study investigating foot function changes within the first 5 months of walking

Belgian toddlers

10 (3:7)

10–15 (12.6 ± 1.7) months

Foot form index % (width/length)

Hawke et al. [41]

Cross-sectional

A post hoc analysis to explore the relationships between foot posture, flexibility and body mass in children

New Zealander children; 90% Caucasian, 7% Asian, 3% Maori.

30 (10:20)

7–15 (10.7 ± 2.3)

FPI-6

Igbigbi and Msamati [32]

Cross-sectional

To determine the arch index, classify the arch type and report the incidence of pes planus amongst the Malawian population

Indigenous Malawian teenagers

305 (139:166)

13–17 (NR)

Arch index

Igbigbi et al. [33]

Cross-sectional

To determine the AI, classify the arch type and report the incidence of pes planus amongst a Kenyan and Tanzanian population

Kenyan teenagers

Tanzanian teenagers

314 (174:140)

249 (135:114)

13–17 (NR)

Arch index

Jankowicz-Szymanska and Mikolajczyk [49]

Longitudinal Cohort

To investigate the changes in the height of the medial longitudinal and transverse arches of the foot over a 2-year follow-up

Polish kindergarten children

207 (102:105)

3.5–4.49 (NR) at first exam

Clarke’s angle

Gamma angle

Mauch et al. [61]

Cross-sectional

To investigate the shape of children’s feet and assess if a difference exists between the feet of German and Australian children

Australian pre and primary school children

German pre and primary school children

86 (34:52)

419 (190:229)

86 (34:52)

419 (190:229)

3–5 (4.3 ± 0.6)

7–12 (9.6 ± 1.4)

3–5 (4.2 ± 0.7)

7–12 (9.6 ± 1.4)

Clarke’s angle

Chippaux-Smirak index

Jankowicz-Szymanska and Mikolajczyk [49]

Cross-sectional

To assess the somatic features and to determine the correlation between skin fold thickness and MLA height and knee position children

Polish primary school children

90 (45:45)

7 (NR)

Clarke’s angle

Morita et al. [63]

 

To investigate muscle strength and arch height and explore the relationships between these measures and lower limb physical performance

Japanese primary school children

301 (146:155)

Third grade n = 158

(8.6 ± 0.5)

Fifth grade

N = 143

(10.6 ± 0.5)

Foot arch height (FAH) – height of navicular tuberosity to ground

Foot arch index – (FAH/foot length × 100)

Morrison et al. [37]

Cross-sectional

To evaluate the impact of excessive body mass on the anthropometric structure of the prepubescent foot

Scottish primary school children

200 (90:110)

9–12

(10.4 ± 0.9) ♂

(10.1 ± 0.8) ♀

Navicular height

Muller et al. [4]

Cross-sectional

To measure the static and dynamic foot characteristics in infants and children to establish foot structure and function in different age groups

German children

7788 (3738:4050)

1–13 (7.2 ± 2.9)

Arch index

Nikolaidou and Boudolos [44]

Cross-sectional

To establish a footprint-based classification technique for the rational classification of foot types in young schoolchildren

Greek school children

132 (67:65)

NR (10.4 ± 0.9)

Arch index

Martirosov’s K index

Chippaux-Smirak index

Clarke’s angle

Pfeiffer et al. [3]

Cross-sectional

To establish the prevalence of flat foot in a population of 3–6 year olds, evaluating cofactors including age, gender and weight

Austrian children

835 (424:411)

3–6 (4.4 ± 0.9)

Rearfoot angle

Pinto et al. [47]

Cross-sectional

To evaluate whether a footprint taken during the Jack test could be quantified in children 2–5 years

Brazilian children

60 (35:25)

2–5 (3.4 ± NR)

Volpon footprint

Valenti footprint

Redmond et al. [39]

Cross-sectional

To establish normative FPI reference values for use in research and clinical decision making

3 accumulated data sets; data sets inclusive of 4, 5 and 9

Ethnicity un-known

397

3–17 (8.5 ± NR)

FPI-6

Sacco et al. [25]

Longitudinal Cohort

To compare the anthropometric characteristics of children’s feet from 3–10 years between German and Brazilian populations

(Data reordered longitudinally for 9 years)

German children

Brazilian children

51–94 (NR)

391 (183:208)

3–10 (NR)

3–10 (NR)

Chippaux-Smirak index

Staheli arch index

Sadeghi-Demneh et al. [35]

Cross-sectional

Determine the prevalence of flatfoot among elementary and secondary school children. Evaluating also age, gender, joint laxity and obesity

Iranian children

667 (340:327)

7–14 (10.6 ± 2.3)

Arch index

Rearfoot angle

Arch angle

Tong and Kong [30]

Longitudinal cohort

To examine the medial longitudinal arch of children during development and explore the relationship between different footwear use

Singaporean children

111 (52:59)

(6.9 ± 0.3)

Arch index

Sobel et al. [34]

Cross-sectional

Determine the rearfoot angle in children in different age groups

African American children

150 (52:98)

6–12 (10.79 ± 2.75)

Rearfoot angle

Tudor et al. [64]

Cross-sectional

To determine if there is an association between the severity of foot flatness and motor skills necessary for sport performance

Croatian children

218 (106:112)

11–15 (13.07 ± 1.24)

Arch index

Unger and Rosenbaum [26]

Cross-sectional

To evaluate the foot shape statically and dynamically during walking

German Infant new walkers

42 (20:22)

NR

Arch index

Foot shape index % (width/length)

Waseda et al. [22]

Cross-sectional

To establish standardised values of foot length and arch height in children and adolescents

Japanese school children

10,155 (5311:4844)

6–18 (NR)

Navicular height

Arch height ratio