Annals of Rehabilitation Medicine

"Pes planus"

Original Articles

Pain & Musculoskeletal rehabilitation

Diagnostic Accuracy of Harris Imprint Index, Chippaux-Smirak Index, Staheli Index Compared With Talar-First Metatarsal Angle for Screening Arch of Foot: Siranya Paecharoen, Marut Arunakul, Nuttharat Tantivangphaisal; Ann Rehabil Med 2023;47(3):222-227. Published online June 1, 2023; DOI: https://doi.org/10.5535/arm.23015

Objective
To determine the diagnostic accuracy and reliability of the Harris imprint index (HII), Chippaux-Smirak index (CSI), and Staheli index (SI) compared with the talar-first metatarsal angle.
Methods
Data was collected at the orthotic and prosthetic clinic, Thammasat University Hospital from January 1, 2016 to August 31, 2020. The three footprints were measured by the rehabilitation physician and the orthotist. The talar-first metatarsal angle was measured by the foot and ankle orthopaedist.
Results
The data from 198 patients with 274 feet was analyzed. The diagnostic accuracy of the footprint triad showed that CSI was the most accurate in pes planus prediction, followed by HII and SI (area under the receiver operating characteristic curve [AUROC]=0.73, 0.68, 0.68, respectively). In pes cavus, HII was the most accurate, followed by SI and CSI (AUROC=0.71, 0.61, 0.60, respectively). For pes planus, the intra-observer reliability by Cohen’s Kappa was 0.92 for HII, 0.97 for CSI, and 0.93 for SI, the inter-observer reliability 0.82, 0.85, and 0.70, respectively. For pes cavus, the intra-observer reliability was 0.89 for HII, 0.95 for CSI, and 0.79 for SI, inter-observer reliability of 0.76, 0.77, and 0.66, respectively.
Conclusion
The accuracy of HII, CSI, and SI was fair in screening of pes planus and pes cavus. The intra- and inter-observer reliability were in the moderate to almost perfect range by Cohen’s Kappa.

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Efficacy of Comprehensive Foot Strengthening Program on Foot Biomechanics and Plantar Pressure to Reduce Lower Limb Injury Risk in Male Bhangra Dancers: A Randomized Controlled Trial Protocol
Sakshi Sadhu, Ramesh Chandra Patra
Journal of Dance Medicine & Science.2026; 30(1): 14. CrossRef
Effectiveness of a 3D-printed silicone medial arch support on foot pain in individuals with pes planus: A randomized controlled trial
Siranya Paecharoen, Somruethai Channasanon, Passakorn Tesavibul, Kan Ngamsopasirisakul, Nayada Choosawad, Siriporn Tanodekaew
Annals of Physical and Rehabilitation Medicine.2025; 68(7): 102007. CrossRef
Understanding the Link Among Footwear Suitability, Foot Biomechanics, and Body Image in Adolescents: A Cross-sectional Study
Busra Sezer, Sulenur Yildiz
JPO Journal of Prosthetics and Orthotics.2025;[Epub] CrossRef
Change in Plantar Pressure and Plain Radiography in Pediatric Flexible Flatfoot: A Retrospective Cohort Study
Sungjoon Kim, Yong Gyun Kim, Jun Yup Kim, Si-Bog Park, Kyu Hoon Lee
Annals of Rehabilitation Medicine.2024; 48(5): 352. CrossRef

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Flat Foot and Postural Harmony in 6-Year-Old Caucasians: What is Their Relationship?: Teresa Paolucci, Letizia Pezzi, Alice Mannocci, Giuseppe La Torre, Rosa Grazia Bellomo, Raoul Saggini; Ann Rehabil Med 2020;44(4):320-326. Published online July 28, 2020; DOI: https://doi.org/10.5535/arm.19091

Abstract
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Objective
To determine whether asymptomatic flexible flat feet show specific postural assessment with respect to neutral feet in 6-year-old children.
Methods
In this cross-sectional observational study, 164 subjects were observed and divided into two groups: 57 with flexible flat feet and 107 with neutral feet. A non-quantitative inspection by podoscopy and baropodometry were performed to evaluate plantar support, and a clinical examination to assess postural setting.
Results
The prevalence of flexible flat feet was 34.8%. The differenceinthe mean centre of pressure (CoP) between the two groups was significant (p=0.028), regarding the antero-posterior direction of CoP only. There was no significant differencein the presence of postural growth disharmony between the neutral and flat-feet groups.
Conclusion
The flattening of the plantar archseems to be linked to a displacement of CoP Y, more posterior in flat feet than in neutral feet; on the other hand, postural harmony in 6-year-old children during growth is not influenced by flat feet.

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The Relationship Between The Degree Of Arcus Pedis And The Degree Of Vertebral Curve In Children
Adnan Faris Naufal, Nuristiqomah Dwi Putri , Arif Setiawan, Pramudya Kurnia, Anida Azkia Fitri
FISIO MU: Physiotherapy Evidences.2025; 6(1): 92. CrossRef
Postural deficiencies prevalence and correlation with foot conditions, body composition, and coordination, in Romanian preadolescents children: descriptive observational study
Silviu Vlad, Doriana I. Ciobanu, Julia Fulop, Nicola Matei, Dana I. Cristea, Mariana Szabo-Alexi, Florin N. Blaga, Dorina Ianc, Alexandru B. Ilies
Frontiers in Pediatrics.2025;[Epub] CrossRef
Effect of Thoracic Kyphosis and Lumbar Lordosis on the Distribution of Ground Reaction Forces on the Feet
Arkadiusz Żurawski, Zbigniew Śliwiński, Edyta Suliga, Grzegorz Śliwiński, Żaneta Wypych, Wojciech Kiebzak
Orthopedic Research and Reviews.2022; Volume 14: 187. CrossRef
Kappa Active Orthosis: a preliminary biomechanical study on the immediate effect of a novel orthotic intervention for pediatric flexible flat foot
Paolo RONCONI, Massimiliano MURGIA, Teresa PAOLUCCI, Michelina ARMANDO, Eugenio DI STANISLAO, Federica CAMUNCOLI, Manuela GALLI
Minerva Orthopedics.2021;[Epub] CrossRef

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Biomechanic Analysis of Lower Extremities in Children and Teenagers with Pes Planus.: Shin, Jung Bin , Kim, Seong Woo , You, Sung , Lee, Sun Kyoung , Kim, Hyoung Seop; J Korean Acad Rehabil Med 2008;32(2):154-159.

Abstract
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Objective: To analyze the biomechanics of young patients with flat foot or malalignment syndrome of lower extremities and to provide some information and strategies in examining and treating them for other researchers or successive studies.

Method: Between January 2004 and March 2006, 274 patients were engaged who had been diagnosed as flatfoot in 586 patients aged between 0 and 18. All patients were examined physically by one physiatrist to find other biomechanic abnormalities of lower extremities and to measure resting calcaneal stance position (RCSP) angle, bimalleolar angle (BMA). To detect the existence of scoliosis and the difference in leg length, radiographs were taken of the spine and the lower extremities. Flat foot was defined as when either of the feet had lower than −4° degrees of RCSP angle.

Results: When comparing the value of RCSP angle between right side and left side, the left side was more pronated than the right side. The value of RCSP angle increased in proportion to age but there are other factors that caused the persistence of foot pronation and ligament laxity. The value of BMA tends to increase in proportion to age. The foot was more pronated, the tibia of the same side was more rotated internally and tibia of the other side was more rotated externally. The most common combined biomechanic abnormality of lower extremities was toe-in gait.

Conclusion: Because the biomechanic effect of a foot could influence the leg, pelvis of the same side and the other side lower extremity, the flat foot should be regarded as an element of malalignment syndrome, anatomical abnormality, and also functional impairment. (J Korean Acad Rehab Med 2008; 32: 154-159)

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Change of Radiologic Indicators during Putting Foot Orthosis on Flatfoot in Children with Cerebral Palsy.: Lee, Sang Hyo , Kim, Hyun Dong , Lee, Nam Ju; J Korean Acad Rehabil Med 2004;28(6):542-548.

Abstract
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Objective
To identify change of the radiologic indicators known to reflect height of medial longitudinal arch between with and without foot orthosis on flatfoot in children with cerebral palsy. Method: 15 children with cerebral palsy, which were diagnosed as pes planus by bio-mechanical examination and foot print test, were participated in this study. Initial radiologic study (foot anteroposterior and lateral view with standing position) had been done with shoe only and then second radiologic study with shoe and foot orthosis as same method. 3 months after, third radiologic study were performed with shoe only. Radiologic indicators were measured at each radiologic studies. Radiologic indicators measured at intial study were compared with both second andthird study. Results: In comparing initial radiologic study with second, consistently changed radiologic indicators toward corrective direction were calcaneometatarsal angle, navicular height, arch height ratio, arch height angle, talometatarsal angle in anteroposterior view. The other five indicators were variable in increase or decrease of change. There were no interval changes of radiologic indicators comparing at initial study with third study. Conclusion: Calcaneometatarsal angle, arch height ratio, arch height angle, and talometatarsal angle were consistently changed, simply measurable radiologic indicators for evaluation of pes planus in children with cerebral palsy. (J Korean Acad Rehab Med 2004; 28: 542-548)