Prevalence and Types of Pes Planus in a Sample of Nigerian College Students
Corresponding Author(s) : Joseph Onuwa Umunnah
Jo.umunna@unizik.edu.ngs
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 9 No. 2 (2021): 2021 Volume - 9 Issue - 2
Abstract
Background:The arch index serves as an early warning sign of structural and functional defects at the foot in a given population and also useful in determining the prevalence of pes planus and possibly predicting pathologic foot condition.
Aim:The study aimed at evaluating the plantar arch index using Staheli’s plantar index method and determined the point prevalence, type, and gender distribution of pes planus. It also investigated the gender differences in the plantar arch index, and types of pes planus.
Method: This ex-post-facto study recruited 240 volunteers (120 males and 120 females) apparently healthy undergraduates, aged between 17-30 years old. Participants’ biodata were noted and their footprints collected using the ink method. Footprints were traced and selected foot dimensions were taken on the footprints. Plantar arch index for each foot was calculated using Staheli’s plantar index method where the plantar index (PI) equals the ratio of central region (A) to heel region (B) (PI=A/B). Data collected were summarized and analyzed using descriptive statistics of mean and standard deviation, percentage, Pearson’s Chi-square, and independent T-test. Alpha level was set at 0.05.
Result: The result showed a point prevalence of pes planus as 3.8%. Male participants had a significantly higher plantar arch index, but female participants had a higher prevalence of pes planus. Unilateral and rigid types of pes planus were more common than bilateral and flexible types respectively. Rigid pes planus was more common among males than females while the flexible type was more common among females than males. Also, unilateral pes planus was more common among females than males while the bilateral type was more common among males than females.
Keywords
Pes Planus
Staheli’s plantar index
Prevalence
1.
Joseph Onuwa Umunnah, Grace Chikodili Orji, Christian Arinze Okonkwo, Chigozie Ikenna Uchenwoke, Justina Adaora Okemuo. Prevalence and Types of Pes Planus in a Sample of Nigerian College Students. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2021 Jun. 14 [cited 2026 Apr. 27];9(2):259-65. Available from: https://ijamscr.com/ijamscr/article/view/1003
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References
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1. Hernandez AJ, Kimura LK, Laraya MHF, and Favaro E. Calculation of Staheli’s plantar arch index and prevalence of flat feet: a study with 100 children aged 5-9 years. Acta Orthop.2007;15(2):68-71.
2. Moore KL, Dalley AF. The foot in Clinically Oriented Anatomy.5thed, Lippincott Williams $ Wilkins Publications.United States and America; 2006. p. 658-68.
3. Sinnantamby CS. Lasts anatomy; regional and applied. 11thed.London: Elsevier Limited;2006. p. 145-66.
4. Greenstein GM. Clinical assessment of neuromusculardisorders.1997;68(12):1194-205.
5. Engel GM, Staheli LT. The natural history of torsion and other factors influencing gait in childhood. A study of the angle of gait, tibial torsion, knee angle, hip rotation, and development of the arch in normal children. ClinOrthop RelatRes.1974;99(99):12-7. doi: 10.1097/00003086-197403000-00002, PMID 4825705.
6. Igbigbi PS, MsamatiBC, Shariff MB. Arch Index as a predictor of pes planus: A comparative study of indigenous Kenyans and Tanzanians. J AmPodiatrMedAssoc.2005;95(3):273-6. doi: 10.7547/0950273, PMID 15901815.
7. Cappello T, Song KM. Determining treatment of flat feet in children. CurrOpinPediatr.1998;10(1):77-81. doi: 10.1097/00008480-199802000-00016, PMID 9529644.
8. Canale ST. Pes planus in Campbell’s Operative orthopedics.10thed. St Louis:Mosby;2003. p. 4017-42.
9. Igbigbi PS, Mpango L. Prevalence of pes planus among the students in Mbarara University of Science and Technology, Uganda, West African.JAnat. 1998;6:25-7.
10. Eluwa MA, Omine RB, Kpela TB, Ekanem TB, Akpantah AO. The incidence of pes planus among Akwa Ibom State students in the University of Calabar. Internet J Forensic Sci. 2009;3:2.
11. Chen CH, Huang MH, Chen TW, Weng MC, Lee CL, Wang GJ. The correlation between selected measurements from footprint and radiograph of flatfoot. Arch PhysMed Rehabil.2006;87(2):235-40. doi: 10.1016/j.apmr.2005.10.014, PMID 16442978.
12. Bertani A, Cappello A, Benedetti MG, Simoncini L, Catani F. Flat foot functional evaluation using pattern recognition of ground reaction data. ClinBiomech (Bristol Avon).1999;14(7):484-93. doi: 10.1016/s0268-0033(98)90099-7, PMID 10521632.
13. Cavanagh PR, RodgersMM. The arch index: a useful measure from footprints. J Biomech.1987;20(5):547-51. doi: 10.1016/0021-9290(87)90255-7, PMID 3611129.
14. Staheli LT, Chew DE, Corbett M. The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults.J BoneJoint Surg Am.1987;69(3):426-8. PMID 3818704.
15. Viladot A. Surgical treatment of the child’s flat foot. ClinOrthop RelatRes. 1992;283(283):34-8. PMID 1395267.
16. Volpon JB. Footprint Analysis During the Growth Period. J PediatrOrthop.1994;14(1):83-5. doi: 10.1097/01241398-199401000-00017.
17. Kanatli U, Yetkin H, Cila E. Footprint and Radiographic Analysis of the Feet. Journal of Pediatric Orthopaedics. 2001;21(2):225-8. doi: 10.1097/01241398-200103000-00018.
18. Hawes MR, Nachbauer W, Sovak D, Nigg BM. Footprint Parameters as a Measure of Arch Height. Foot & Ankle. 1992;13(1):22-6. doi: 10.1177/107110079201300104.
19. Mosca VS. Flexible flat foot and skew foot. The Journal of Bone & Joint Surgery1995;77(12):1937-45. doi: 10.2106/00004623-199512000-00021.
20. GilmourJC, Burns Y. The measurement of the medial longitudinal arch in children. Foot Ankle Int.2001;22(6):493-8. doi: 10.1177/107110070102200607, PMID 11475457.
21. Hanra A, Volpon JB. FotopodometriaMoire quantitative na avaliacao do arcoplantar longitudinal medial. RevBras Ortop.1995;30:609-14.
22. Cobey JC, Sella E. Standardizing methods of measurement of foot shape by including the effects of subtalar rotation. Foot Ankle.1981;2(1):30-6. doi: 10.1177/107110078100200106, PMID 7308911.
23. Mann RA, Thompson FM. Rupture of the posterior tibial tendon causing flat foot. Surgical treatment. J Bone Joint Surg Am.1985;67(4):556-61. doi: 10.2106/00004623-198567040-00009, PMID 3980501.
24. Didia BC, Omu ET, Obuoforibo AA. The use of footprint contact index II for classification of flat feet in a Nigerian population. Foot Ankle.1987;7(5):285-9. doi: 10.1177/107110078700700504, PMID 3583162.
25. Sá MR, Brandina K, Lobo da Costa PH, Rodriguez MD, Ávila AOV, Serrão JC, et al. Estudo descritivo de parâmetros antropométricos dos pés de crianças de. 2001;22:75-9:3-10anos de idade. Tecnicouro - Revista do Centro Tecnológico do Couro, Calçados e Afins (Rio Grande do Sul).
26. Didia BC, Asomugha AL. The incidence of flat foot among athletes in Port Harcourt. J Exp ClinAnat. 2004;3(2):58-9.
27. Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: a randomized clinical trial. BrMedJ.2008:337-735.
References
1. Hernandez AJ, Kimura LK, Laraya MHF, and Favaro E. Calculation of Staheli’s plantar arch index and prevalence of flat feet: a study with 100 children aged 5-9 years. Acta Orthop.2007;15(2):68-71.
2. Moore KL, Dalley AF. The foot in Clinically Oriented Anatomy.5thed, Lippincott Williams $ Wilkins Publications.United States and America; 2006. p. 658-68.
3. Sinnantamby CS. Lasts anatomy; regional and applied. 11thed.London: Elsevier Limited;2006. p. 145-66.
4. Greenstein GM. Clinical assessment of neuromusculardisorders.1997;68(12):1194-205.
5. Engel GM, Staheli LT. The natural history of torsion and other factors influencing gait in childhood. A study of the angle of gait, tibial torsion, knee angle, hip rotation, and development of the arch in normal children. ClinOrthop RelatRes.1974;99(99):12-7. doi: 10.1097/00003086-197403000-00002, PMID 4825705.
6. Igbigbi PS, MsamatiBC, Shariff MB. Arch Index as a predictor of pes planus: A comparative study of indigenous Kenyans and Tanzanians. J AmPodiatrMedAssoc.2005;95(3):273-6. doi: 10.7547/0950273, PMID 15901815.
7. Cappello T, Song KM. Determining treatment of flat feet in children. CurrOpinPediatr.1998;10(1):77-81. doi: 10.1097/00008480-199802000-00016, PMID 9529644.
8. Canale ST. Pes planus in Campbell’s Operative orthopedics.10thed. St Louis:Mosby;2003. p. 4017-42.
9. Igbigbi PS, Mpango L. Prevalence of pes planus among the students in Mbarara University of Science and Technology, Uganda, West African.JAnat. 1998;6:25-7.
10. Eluwa MA, Omine RB, Kpela TB, Ekanem TB, Akpantah AO. The incidence of pes planus among Akwa Ibom State students in the University of Calabar. Internet J Forensic Sci. 2009;3:2.
11. Chen CH, Huang MH, Chen TW, Weng MC, Lee CL, Wang GJ. The correlation between selected measurements from footprint and radiograph of flatfoot. Arch PhysMed Rehabil.2006;87(2):235-40. doi: 10.1016/j.apmr.2005.10.014, PMID 16442978.
12. Bertani A, Cappello A, Benedetti MG, Simoncini L, Catani F. Flat foot functional evaluation using pattern recognition of ground reaction data. ClinBiomech (Bristol Avon).1999;14(7):484-93. doi: 10.1016/s0268-0033(98)90099-7, PMID 10521632.
13. Cavanagh PR, RodgersMM. The arch index: a useful measure from footprints. J Biomech.1987;20(5):547-51. doi: 10.1016/0021-9290(87)90255-7, PMID 3611129.
14. Staheli LT, Chew DE, Corbett M. The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults.J BoneJoint Surg Am.1987;69(3):426-8. PMID 3818704.
15. Viladot A. Surgical treatment of the child’s flat foot. ClinOrthop RelatRes. 1992;283(283):34-8. PMID 1395267.
16. Volpon JB. Footprint Analysis During the Growth Period. J PediatrOrthop.1994;14(1):83-5. doi: 10.1097/01241398-199401000-00017.
17. Kanatli U, Yetkin H, Cila E. Footprint and Radiographic Analysis of the Feet. Journal of Pediatric Orthopaedics. 2001;21(2):225-8. doi: 10.1097/01241398-200103000-00018.
18. Hawes MR, Nachbauer W, Sovak D, Nigg BM. Footprint Parameters as a Measure of Arch Height. Foot & Ankle. 1992;13(1):22-6. doi: 10.1177/107110079201300104.
19. Mosca VS. Flexible flat foot and skew foot. The Journal of Bone & Joint Surgery1995;77(12):1937-45. doi: 10.2106/00004623-199512000-00021.
20. GilmourJC, Burns Y. The measurement of the medial longitudinal arch in children. Foot Ankle Int.2001;22(6):493-8. doi: 10.1177/107110070102200607, PMID 11475457.
21. Hanra A, Volpon JB. FotopodometriaMoire quantitative na avaliacao do arcoplantar longitudinal medial. RevBras Ortop.1995;30:609-14.
22. Cobey JC, Sella E. Standardizing methods of measurement of foot shape by including the effects of subtalar rotation. Foot Ankle.1981;2(1):30-6. doi: 10.1177/107110078100200106, PMID 7308911.
23. Mann RA, Thompson FM. Rupture of the posterior tibial tendon causing flat foot. Surgical treatment. J Bone Joint Surg Am.1985;67(4):556-61. doi: 10.2106/00004623-198567040-00009, PMID 3980501.
24. Didia BC, Omu ET, Obuoforibo AA. The use of footprint contact index II for classification of flat feet in a Nigerian population. Foot Ankle.1987;7(5):285-9. doi: 10.1177/107110078700700504, PMID 3583162.
25. Sá MR, Brandina K, Lobo da Costa PH, Rodriguez MD, Ávila AOV, Serrão JC, et al. Estudo descritivo de parâmetros antropométricos dos pés de crianças de. 2001;22:75-9:3-10anos de idade. Tecnicouro - Revista do Centro Tecnológico do Couro, Calçados e Afins (Rio Grande do Sul).
26. Didia BC, Asomugha AL. The incidence of flat foot among athletes in Port Harcourt. J Exp ClinAnat. 2004;3(2):58-9.
27. Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: a randomized clinical trial. BrMedJ.2008:337-735.
2. Moore KL, Dalley AF. The foot in Clinically Oriented Anatomy.5thed, Lippincott Williams $ Wilkins Publications.United States and America; 2006. p. 658-68.
3. Sinnantamby CS. Lasts anatomy; regional and applied. 11thed.London: Elsevier Limited;2006. p. 145-66.
4. Greenstein GM. Clinical assessment of neuromusculardisorders.1997;68(12):1194-205.
5. Engel GM, Staheli LT. The natural history of torsion and other factors influencing gait in childhood. A study of the angle of gait, tibial torsion, knee angle, hip rotation, and development of the arch in normal children. ClinOrthop RelatRes.1974;99(99):12-7. doi: 10.1097/00003086-197403000-00002, PMID 4825705.
6. Igbigbi PS, MsamatiBC, Shariff MB. Arch Index as a predictor of pes planus: A comparative study of indigenous Kenyans and Tanzanians. J AmPodiatrMedAssoc.2005;95(3):273-6. doi: 10.7547/0950273, PMID 15901815.
7. Cappello T, Song KM. Determining treatment of flat feet in children. CurrOpinPediatr.1998;10(1):77-81. doi: 10.1097/00008480-199802000-00016, PMID 9529644.
8. Canale ST. Pes planus in Campbell’s Operative orthopedics.10thed. St Louis:Mosby;2003. p. 4017-42.
9. Igbigbi PS, Mpango L. Prevalence of pes planus among the students in Mbarara University of Science and Technology, Uganda, West African.JAnat. 1998;6:25-7.
10. Eluwa MA, Omine RB, Kpela TB, Ekanem TB, Akpantah AO. The incidence of pes planus among Akwa Ibom State students in the University of Calabar. Internet J Forensic Sci. 2009;3:2.
11. Chen CH, Huang MH, Chen TW, Weng MC, Lee CL, Wang GJ. The correlation between selected measurements from footprint and radiograph of flatfoot. Arch PhysMed Rehabil.2006;87(2):235-40. doi: 10.1016/j.apmr.2005.10.014, PMID 16442978.
12. Bertani A, Cappello A, Benedetti MG, Simoncini L, Catani F. Flat foot functional evaluation using pattern recognition of ground reaction data. ClinBiomech (Bristol Avon).1999;14(7):484-93. doi: 10.1016/s0268-0033(98)90099-7, PMID 10521632.
13. Cavanagh PR, RodgersMM. The arch index: a useful measure from footprints. J Biomech.1987;20(5):547-51. doi: 10.1016/0021-9290(87)90255-7, PMID 3611129.
14. Staheli LT, Chew DE, Corbett M. The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults.J BoneJoint Surg Am.1987;69(3):426-8. PMID 3818704.
15. Viladot A. Surgical treatment of the child’s flat foot. ClinOrthop RelatRes. 1992;283(283):34-8. PMID 1395267.
16. Volpon JB. Footprint Analysis During the Growth Period. J PediatrOrthop.1994;14(1):83-5. doi: 10.1097/01241398-199401000-00017.
17. Kanatli U, Yetkin H, Cila E. Footprint and Radiographic Analysis of the Feet. Journal of Pediatric Orthopaedics. 2001;21(2):225-8. doi: 10.1097/01241398-200103000-00018.
18. Hawes MR, Nachbauer W, Sovak D, Nigg BM. Footprint Parameters as a Measure of Arch Height. Foot & Ankle. 1992;13(1):22-6. doi: 10.1177/107110079201300104.
19. Mosca VS. Flexible flat foot and skew foot. The Journal of Bone & Joint Surgery1995;77(12):1937-45. doi: 10.2106/00004623-199512000-00021.
20. GilmourJC, Burns Y. The measurement of the medial longitudinal arch in children. Foot Ankle Int.2001;22(6):493-8. doi: 10.1177/107110070102200607, PMID 11475457.
21. Hanra A, Volpon JB. FotopodometriaMoire quantitative na avaliacao do arcoplantar longitudinal medial. RevBras Ortop.1995;30:609-14.
22. Cobey JC, Sella E. Standardizing methods of measurement of foot shape by including the effects of subtalar rotation. Foot Ankle.1981;2(1):30-6. doi: 10.1177/107110078100200106, PMID 7308911.
23. Mann RA, Thompson FM. Rupture of the posterior tibial tendon causing flat foot. Surgical treatment. J Bone Joint Surg Am.1985;67(4):556-61. doi: 10.2106/00004623-198567040-00009, PMID 3980501.
24. Didia BC, Omu ET, Obuoforibo AA. The use of footprint contact index II for classification of flat feet in a Nigerian population. Foot Ankle.1987;7(5):285-9. doi: 10.1177/107110078700700504, PMID 3583162.
25. Sá MR, Brandina K, Lobo da Costa PH, Rodriguez MD, Ávila AOV, Serrão JC, et al. Estudo descritivo de parâmetros antropométricos dos pés de crianças de. 2001;22:75-9:3-10anos de idade. Tecnicouro - Revista do Centro Tecnológico do Couro, Calçados e Afins (Rio Grande do Sul).
26. Didia BC, Asomugha AL. The incidence of flat foot among athletes in Port Harcourt. J Exp ClinAnat. 2004;3(2):58-9.
27. Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: a randomized clinical trial. BrMedJ.2008:337-735.