Occurrence of Chronic Low Back Pain in Individuals with Flat Feet- a Cross Sectional Study
Corresponding Author(s) : Susan Dsouza
susan@gmail.com
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 6 No. 1 (2018): 2018 Volume 6- Issue -1
Abstract
Background
Low back pain (LBP) is a widespread, expensive, and debilitating problem.1 Though LBP can be caused by acute injuries, biomechanical discrepancies have also been indicated. Approximately 80% of the general population has alterations in the feet; these kinematic changes affect the lower extremity kinetic chain and may lead to pathologies of the lower back later in life. The true prevalence of flatfoot is unknown, primarily because there is no consensus on the strict clinical or radiographic criteria for defining a flatfoot.
Objective
To identify the occurrence of flat feet in chronic low back subjects, determine the factors associated with occurrence of flat feet and to state the relationship between flat feet and chronic low back pain.
Methodology
Study proceeded after ethical clearance from the institutional ethical committee of Nitte University was granted. 71subjects satisfying the inclusion criteria from the period between April 2016 to februray 2017 were included. Assessment of all patients included study specific designed tool, NDT, FPI, VAS and Oswestry Low Back Pain Disability Questionnaire.
Results
The occurrence of flat feet according to the designed tool was 45.07 % in the right foot and 49.29% in the left foot. Severity of pain was not related to the plantar arch.
Conclusion
Presence of flat foot is a common phenomenon among the population with chronic LBP and hence, there exists a need for treatment of LBP to be directed towards the biomechanical corrections of the lower extremity kinetic chain. Future scope of Studies involving assessment of dynamic foot function as well as radiographs of lower extremity and larger sample size can be conducted.
Keywords
Kinectic chain
Biomechanical alteration
Mechanical pain
Pes planus
1.
Susan Dsouza. Occurrence of Chronic Low Back Pain in Individuals with Flat Feet- a Cross Sectional Study. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2020 Aug. 9 [cited 2026 May 1];6(1):32-9. Available from: https://ijamscr.com/ijamscr/article/view/480
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References
-
O'Leary CB, Cahill CR, Robinson AW, Barnes MJ, Hong J. A systematic review: The effects of podiatrical deviations on nonspecific chronic low back pain. J Back Musculoskeletal Rehabilitation. 26(2), 2013, 117-23.
[2]. Van Middelkoop M, Rubinstein S, Kuijpers T, Verhagen A, Ostelo R, Koes B. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. European Spine Journal. 20(1), 2010, 19-39.
[3]. Allen R. Last, Karen H. Chronic low back pain: evaluation and management. Am Fam Physician. 79(12), 2009, 1067-1074.
[4]. Burton AK, Tillotson KM, Main CJ, Hollis S. Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine. 20(6), 1995, 722-728.
[5]. Truchon M. Determinants of chronic disability related to low back pain: towards an integrative biopsychosocial model. Disability and Rehabilitation. 23(17), 2001, 758-767.
[6]. Balagué, Federico, et al. Non-specific low back pain.The Lancet 379.9814 2012, 482-491.
[7]. Hoy, Damian et al. The Global Burden Of Low Back Pain: Estimates From The Global Burden Of Disease 2010 Study. Annals of the Rheumatic Diseases 73(6), 2014, 968-974.
[8]. Van Tulder, Maurits et al. Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care. European Spine Journal. 15(S2), 2006, 169-191.
[9]. Borges C, Fernandes L, Bertoncello D. Correlacao entre alteracoes lombares e modificacoes no arco plantar em mulheres com dor lombar. Acta ortop bras. 21(3), 2013, 135-138.
[10]. Magee, David J, and Derrick Sueki. Orthopedic Physical Assessment. 1st ed. St. Louis, MO: Saunders, 2011.
[11]. Pauk J. Analysis and assessment of foot posture in children with flat feet. Proc Appl Math Mech. 9(1), 2009, 27-30.
Susan D et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [32-39]
38
[12]. Buldt A, Murley G, Butterworth P, Levinger P, Menz H, Landorf K. Corrigendum to: The relationship between foot posture and lower limb kinematics during walking: A systematic review. Gait & Posture. 40(4), 2014, 735-736.
[13]. Lafuente Guijosa, Ana et al. "Plantar Fasciitis: Evidence-Based Review Of Treatment". Reumatología Clínica (English Edition) 3(4), 2007, 159-165.
[14]. Kaye, Robert A., and Melvin H. Jahss. "Foot Fellows Review: Tibialis Posterior: A Review Of Anatomy And Biomechanics In Relation To Support Of The Medial Longitudinal Arch". Foot & Ankle 11(4), 1991, 244-247.
[15]. Sadeghi-Demneh E, Jafarian F, Melvin J, Azadinia F, Shamsi F, Jafarpishe M. Flatfoot in School-Age Children: Prevalence and Associated Factors. Foot & Ankle Specialist. 8(3), 2015, 186-193.
[16]. Pauk, Jolanta et al. Epidemiologic Factors Affecting Plantar Arch Development In Children With Flat Feet. Journal of the American Podiatric Medical Association 102(2), 2012, 114-121.
[17]. Richie D. Biomechanics and Clinical Analysis of the Adult Acquired Flatfoot. Clinics in Podiatric Medicine and Surgery. 24(4), 2007, 617-644.
[18]. Catani F, Benedetti M, Montanari P, Pignotti E, Ceccarelli F, Ghetti M et al. Functional evaluation of gait in children with flat foot. Gait and Posture. 3(4), 1995, 287.
[19]. Kohls-Gatzoulis, J. Tibialis Posterior Dysfunction: A Common And Treatable Cause Of Adult Acquired Flatfoot. BMJ. 329, 2004, 1328-1333.
[20]. Rao S, Riskowski J, Hannan M. Musculoskeletal conditions of the foot and ankle: Assessments and treatment options. Best Practice & Research Clinical Rheumatology. 26(3), 2012, 345-368.
[21]. Cote KP, Brunet II ME, Gansneder BM, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. Journal of athletic training. 40(1), 2005, 41.
[22]. Shih Y, Chen C, Chen W, Lin H. Lower extremity kinematics in children with and without flexible flatfoot: a comparative study. BMC Musculoskeletal Disorders. 13(1), 2012, 31.
[23]. Brantingham, James W. et al. A Single-Blind Pilot Study to Determine Risk And Association Between Navicular Drop, Calcaneal Eversion, And Low Back Pain. Journal of Manipulative and Physiological Therapeutics 30(5), 2007, 380-385.
[24]. Amoozadeh F.et al. Surveying the relationship between flatfoot and chronic mechanical low back pain. Indian journal of fundamental and applied life sciences 5(1), 2015.
[25]. Kosashvili, Yona et al. "The Correlation Between Pes Planus And Anterior Knee Or Intermittent Low Back Pain". Foot & Ankle International 29(8), 2008, 910-913.
[26]. Balouchy et.al. Comparative Analysis of Lower Limb Alignments in Healthy Subjects and Subjects with Back Pain. Annals of Applied Sport Science. 3(2), 2015, 33-42.
[27]. Brantingham J, Lee Gilbert J, Shaik J, Globe G. Sagittal plane blockage of the foot, ankle and hallux and foot alignment-prevalence and association with low back pain. Journal of Chiropractic Medicine. 5(4), 2006, 123-127.
[28]. Carmody D, Bubra P, Keighley G, Rateesh S. Posterior tibial tendon dysfunction: An overlooked cause of foot deformity. J Fam Med Primary Care. 4(1), 2015, 26.
[29]. Shrader J, Popovich J, Gracey G, Danoff J. Navicular drop measurement in people with rheumatoid arthritis: Interrater and intrarater reliability. Phys Ther 85(7), 2005, 656-64.
[30]. Sell K, Verity T, Worrell T, Pease B, Wigglesworth J. Two Measurement Techniques for Assessing Subtalar Joint Position: A Reliability Study. J Orthop Sports Phys Ther. 19(3), 1994, 162-167. [31]. Joos E, Peretz A, Beguin S, Famaey JP. Reliability and reproducibility of visual analogue scale and numeric rating scale for therapeutic evaluation of pain in rheumatic patients. J Rheumatol. 18(8), 1991, 1269-70.
[32]. Panichawit C, Bovonsunthonchai S, Vachalathiti R, Limpasutirachata K. Effects of Foot Muscles Training on Plantar Pressure Distribution during Gait, Foot Muscle Strength, and Foot Function in Persons with Flexible Flatfoot. J Med Assoc Thai. 98(5), 2015, S12-S7.
[33]. Evans A, Nicholson H, Zakarias N. The paediatric flat foot proforma (p-FFP): improved and abridged following a reproducibility study. Journal of Foot and Ankle Research. 2(1), 2009, 25.
Susan D et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [32-39]
39
[34]. Redmond A, Crosbie J, Ouvrier R. Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clinical Biomechanics. 21(1), 2006, 89-98.
[35]. Raymond W.J.G. Ostelo. Clinically important outcomes in low back pain, Best Practice & Research Clinical Rheumatology. 19(4), 2005, 593 – 607.
[36]. Kosashvili, Yona et al. "The Correlation Between Pes Planus And Anterior Knee Or Intermittent Low Back Pain". Foot & Ankle International 29(9), 2008, 910-913.
[37]. Menz HB, Munteanu SE. Validity of 3 clinical techniques for the measurement of static foot posture in older people.J Orthop Sports Phys Ther 35, 2005, 479_86.
[38]. Levine D, Whittle MW. The effects of pelvic movement on lumbar lordosis in the standing position. J Orthop Sports Phys Ther . 24, 1996, 130-135.
[39]. Hamel AJ, Sharkey NA, Buczek FL et al. Relative motions of the tibia, talus, and calcaneus during the stance phase of gait: a cadaver study. Gait Posture 20, 2004, 147-153.
[40]. Souza TR, Pinto RZ, Trede RG et al. Temporal couplings between rearfoot-shank complex and hip joint during walking. Clin Biomech 25, 2010, 745-758.
[41]. Baylis WJ, Rzonca EC. Functional and structural limb length discrepancies: evaluation and treatment. Clin Podiatr Med Surg 5, 1988, 509-520.
[42]. Sanner WH, Page JC, Tolboe HR et al. A study of ankle joint height changes with subtalar joint motion. J AmPodiatry Assoc 71, 1981, 158-161.
[43]. Dionne CE, Dunn KM, Croft PR et al. A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine 33, 2008, 95-103.
[44]. Deyo RA, Weinstein JN. Low back pain. N Engl J Med 344, 2001, 363-370.
References
O'Leary CB, Cahill CR, Robinson AW, Barnes MJ, Hong J. A systematic review: The effects of podiatrical deviations on nonspecific chronic low back pain. J Back Musculoskeletal Rehabilitation. 26(2), 2013, 117-23.
[2]. Van Middelkoop M, Rubinstein S, Kuijpers T, Verhagen A, Ostelo R, Koes B. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. European Spine Journal. 20(1), 2010, 19-39.
[3]. Allen R. Last, Karen H. Chronic low back pain: evaluation and management. Am Fam Physician. 79(12), 2009, 1067-1074.
[4]. Burton AK, Tillotson KM, Main CJ, Hollis S. Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine. 20(6), 1995, 722-728.
[5]. Truchon M. Determinants of chronic disability related to low back pain: towards an integrative biopsychosocial model. Disability and Rehabilitation. 23(17), 2001, 758-767.
[6]. Balagué, Federico, et al. Non-specific low back pain.The Lancet 379.9814 2012, 482-491.
[7]. Hoy, Damian et al. The Global Burden Of Low Back Pain: Estimates From The Global Burden Of Disease 2010 Study. Annals of the Rheumatic Diseases 73(6), 2014, 968-974.
[8]. Van Tulder, Maurits et al. Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care. European Spine Journal. 15(S2), 2006, 169-191.
[9]. Borges C, Fernandes L, Bertoncello D. Correlacao entre alteracoes lombares e modificacoes no arco plantar em mulheres com dor lombar. Acta ortop bras. 21(3), 2013, 135-138.
[10]. Magee, David J, and Derrick Sueki. Orthopedic Physical Assessment. 1st ed. St. Louis, MO: Saunders, 2011.
[11]. Pauk J. Analysis and assessment of foot posture in children with flat feet. Proc Appl Math Mech. 9(1), 2009, 27-30.
Susan D et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [32-39]
38
[12]. Buldt A, Murley G, Butterworth P, Levinger P, Menz H, Landorf K. Corrigendum to: The relationship between foot posture and lower limb kinematics during walking: A systematic review. Gait & Posture. 40(4), 2014, 735-736.
[13]. Lafuente Guijosa, Ana et al. "Plantar Fasciitis: Evidence-Based Review Of Treatment". Reumatología Clínica (English Edition) 3(4), 2007, 159-165.
[14]. Kaye, Robert A., and Melvin H. Jahss. "Foot Fellows Review: Tibialis Posterior: A Review Of Anatomy And Biomechanics In Relation To Support Of The Medial Longitudinal Arch". Foot & Ankle 11(4), 1991, 244-247.
[15]. Sadeghi-Demneh E, Jafarian F, Melvin J, Azadinia F, Shamsi F, Jafarpishe M. Flatfoot in School-Age Children: Prevalence and Associated Factors. Foot & Ankle Specialist. 8(3), 2015, 186-193.
[16]. Pauk, Jolanta et al. Epidemiologic Factors Affecting Plantar Arch Development In Children With Flat Feet. Journal of the American Podiatric Medical Association 102(2), 2012, 114-121.
[17]. Richie D. Biomechanics and Clinical Analysis of the Adult Acquired Flatfoot. Clinics in Podiatric Medicine and Surgery. 24(4), 2007, 617-644.
[18]. Catani F, Benedetti M, Montanari P, Pignotti E, Ceccarelli F, Ghetti M et al. Functional evaluation of gait in children with flat foot. Gait and Posture. 3(4), 1995, 287.
[19]. Kohls-Gatzoulis, J. Tibialis Posterior Dysfunction: A Common And Treatable Cause Of Adult Acquired Flatfoot. BMJ. 329, 2004, 1328-1333.
[20]. Rao S, Riskowski J, Hannan M. Musculoskeletal conditions of the foot and ankle: Assessments and treatment options. Best Practice & Research Clinical Rheumatology. 26(3), 2012, 345-368.
[21]. Cote KP, Brunet II ME, Gansneder BM, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. Journal of athletic training. 40(1), 2005, 41.
[22]. Shih Y, Chen C, Chen W, Lin H. Lower extremity kinematics in children with and without flexible flatfoot: a comparative study. BMC Musculoskeletal Disorders. 13(1), 2012, 31.
[23]. Brantingham, James W. et al. A Single-Blind Pilot Study to Determine Risk And Association Between Navicular Drop, Calcaneal Eversion, And Low Back Pain. Journal of Manipulative and Physiological Therapeutics 30(5), 2007, 380-385.
[24]. Amoozadeh F.et al. Surveying the relationship between flatfoot and chronic mechanical low back pain. Indian journal of fundamental and applied life sciences 5(1), 2015.
[25]. Kosashvili, Yona et al. "The Correlation Between Pes Planus And Anterior Knee Or Intermittent Low Back Pain". Foot & Ankle International 29(8), 2008, 910-913.
[26]. Balouchy et.al. Comparative Analysis of Lower Limb Alignments in Healthy Subjects and Subjects with Back Pain. Annals of Applied Sport Science. 3(2), 2015, 33-42.
[27]. Brantingham J, Lee Gilbert J, Shaik J, Globe G. Sagittal plane blockage of the foot, ankle and hallux and foot alignment-prevalence and association with low back pain. Journal of Chiropractic Medicine. 5(4), 2006, 123-127.
[28]. Carmody D, Bubra P, Keighley G, Rateesh S. Posterior tibial tendon dysfunction: An overlooked cause of foot deformity. J Fam Med Primary Care. 4(1), 2015, 26.
[29]. Shrader J, Popovich J, Gracey G, Danoff J. Navicular drop measurement in people with rheumatoid arthritis: Interrater and intrarater reliability. Phys Ther 85(7), 2005, 656-64.
[30]. Sell K, Verity T, Worrell T, Pease B, Wigglesworth J. Two Measurement Techniques for Assessing Subtalar Joint Position: A Reliability Study. J Orthop Sports Phys Ther. 19(3), 1994, 162-167. [31]. Joos E, Peretz A, Beguin S, Famaey JP. Reliability and reproducibility of visual analogue scale and numeric rating scale for therapeutic evaluation of pain in rheumatic patients. J Rheumatol. 18(8), 1991, 1269-70.
[32]. Panichawit C, Bovonsunthonchai S, Vachalathiti R, Limpasutirachata K. Effects of Foot Muscles Training on Plantar Pressure Distribution during Gait, Foot Muscle Strength, and Foot Function in Persons with Flexible Flatfoot. J Med Assoc Thai. 98(5), 2015, S12-S7.
[33]. Evans A, Nicholson H, Zakarias N. The paediatric flat foot proforma (p-FFP): improved and abridged following a reproducibility study. Journal of Foot and Ankle Research. 2(1), 2009, 25.
Susan D et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [32-39]
39
[34]. Redmond A, Crosbie J, Ouvrier R. Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clinical Biomechanics. 21(1), 2006, 89-98.
[35]. Raymond W.J.G. Ostelo. Clinically important outcomes in low back pain, Best Practice & Research Clinical Rheumatology. 19(4), 2005, 593 – 607.
[36]. Kosashvili, Yona et al. "The Correlation Between Pes Planus And Anterior Knee Or Intermittent Low Back Pain". Foot & Ankle International 29(9), 2008, 910-913.
[37]. Menz HB, Munteanu SE. Validity of 3 clinical techniques for the measurement of static foot posture in older people.J Orthop Sports Phys Ther 35, 2005, 479_86.
[38]. Levine D, Whittle MW. The effects of pelvic movement on lumbar lordosis in the standing position. J Orthop Sports Phys Ther . 24, 1996, 130-135.
[39]. Hamel AJ, Sharkey NA, Buczek FL et al. Relative motions of the tibia, talus, and calcaneus during the stance phase of gait: a cadaver study. Gait Posture 20, 2004, 147-153.
[40]. Souza TR, Pinto RZ, Trede RG et al. Temporal couplings between rearfoot-shank complex and hip joint during walking. Clin Biomech 25, 2010, 745-758.
[41]. Baylis WJ, Rzonca EC. Functional and structural limb length discrepancies: evaluation and treatment. Clin Podiatr Med Surg 5, 1988, 509-520.
[42]. Sanner WH, Page JC, Tolboe HR et al. A study of ankle joint height changes with subtalar joint motion. J AmPodiatry Assoc 71, 1981, 158-161.
[43]. Dionne CE, Dunn KM, Croft PR et al. A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine 33, 2008, 95-103.
[44]. Deyo RA, Weinstein JN. Low back pain. N Engl J Med 344, 2001, 363-370.
[2]. Van Middelkoop M, Rubinstein S, Kuijpers T, Verhagen A, Ostelo R, Koes B. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. European Spine Journal. 20(1), 2010, 19-39.
[3]. Allen R. Last, Karen H. Chronic low back pain: evaluation and management. Am Fam Physician. 79(12), 2009, 1067-1074.
[4]. Burton AK, Tillotson KM, Main CJ, Hollis S. Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine. 20(6), 1995, 722-728.
[5]. Truchon M. Determinants of chronic disability related to low back pain: towards an integrative biopsychosocial model. Disability and Rehabilitation. 23(17), 2001, 758-767.
[6]. Balagué, Federico, et al. Non-specific low back pain.The Lancet 379.9814 2012, 482-491.
[7]. Hoy, Damian et al. The Global Burden Of Low Back Pain: Estimates From The Global Burden Of Disease 2010 Study. Annals of the Rheumatic Diseases 73(6), 2014, 968-974.
[8]. Van Tulder, Maurits et al. Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care. European Spine Journal. 15(S2), 2006, 169-191.
[9]. Borges C, Fernandes L, Bertoncello D. Correlacao entre alteracoes lombares e modificacoes no arco plantar em mulheres com dor lombar. Acta ortop bras. 21(3), 2013, 135-138.
[10]. Magee, David J, and Derrick Sueki. Orthopedic Physical Assessment. 1st ed. St. Louis, MO: Saunders, 2011.
[11]. Pauk J. Analysis and assessment of foot posture in children with flat feet. Proc Appl Math Mech. 9(1), 2009, 27-30.
Susan D et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [32-39]
38
[12]. Buldt A, Murley G, Butterworth P, Levinger P, Menz H, Landorf K. Corrigendum to: The relationship between foot posture and lower limb kinematics during walking: A systematic review. Gait & Posture. 40(4), 2014, 735-736.
[13]. Lafuente Guijosa, Ana et al. "Plantar Fasciitis: Evidence-Based Review Of Treatment". Reumatología Clínica (English Edition) 3(4), 2007, 159-165.
[14]. Kaye, Robert A., and Melvin H. Jahss. "Foot Fellows Review: Tibialis Posterior: A Review Of Anatomy And Biomechanics In Relation To Support Of The Medial Longitudinal Arch". Foot & Ankle 11(4), 1991, 244-247.
[15]. Sadeghi-Demneh E, Jafarian F, Melvin J, Azadinia F, Shamsi F, Jafarpishe M. Flatfoot in School-Age Children: Prevalence and Associated Factors. Foot & Ankle Specialist. 8(3), 2015, 186-193.
[16]. Pauk, Jolanta et al. Epidemiologic Factors Affecting Plantar Arch Development In Children With Flat Feet. Journal of the American Podiatric Medical Association 102(2), 2012, 114-121.
[17]. Richie D. Biomechanics and Clinical Analysis of the Adult Acquired Flatfoot. Clinics in Podiatric Medicine and Surgery. 24(4), 2007, 617-644.
[18]. Catani F, Benedetti M, Montanari P, Pignotti E, Ceccarelli F, Ghetti M et al. Functional evaluation of gait in children with flat foot. Gait and Posture. 3(4), 1995, 287.
[19]. Kohls-Gatzoulis, J. Tibialis Posterior Dysfunction: A Common And Treatable Cause Of Adult Acquired Flatfoot. BMJ. 329, 2004, 1328-1333.
[20]. Rao S, Riskowski J, Hannan M. Musculoskeletal conditions of the foot and ankle: Assessments and treatment options. Best Practice & Research Clinical Rheumatology. 26(3), 2012, 345-368.
[21]. Cote KP, Brunet II ME, Gansneder BM, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. Journal of athletic training. 40(1), 2005, 41.
[22]. Shih Y, Chen C, Chen W, Lin H. Lower extremity kinematics in children with and without flexible flatfoot: a comparative study. BMC Musculoskeletal Disorders. 13(1), 2012, 31.
[23]. Brantingham, James W. et al. A Single-Blind Pilot Study to Determine Risk And Association Between Navicular Drop, Calcaneal Eversion, And Low Back Pain. Journal of Manipulative and Physiological Therapeutics 30(5), 2007, 380-385.
[24]. Amoozadeh F.et al. Surveying the relationship between flatfoot and chronic mechanical low back pain. Indian journal of fundamental and applied life sciences 5(1), 2015.
[25]. Kosashvili, Yona et al. "The Correlation Between Pes Planus And Anterior Knee Or Intermittent Low Back Pain". Foot & Ankle International 29(8), 2008, 910-913.
[26]. Balouchy et.al. Comparative Analysis of Lower Limb Alignments in Healthy Subjects and Subjects with Back Pain. Annals of Applied Sport Science. 3(2), 2015, 33-42.
[27]. Brantingham J, Lee Gilbert J, Shaik J, Globe G. Sagittal plane blockage of the foot, ankle and hallux and foot alignment-prevalence and association with low back pain. Journal of Chiropractic Medicine. 5(4), 2006, 123-127.
[28]. Carmody D, Bubra P, Keighley G, Rateesh S. Posterior tibial tendon dysfunction: An overlooked cause of foot deformity. J Fam Med Primary Care. 4(1), 2015, 26.
[29]. Shrader J, Popovich J, Gracey G, Danoff J. Navicular drop measurement in people with rheumatoid arthritis: Interrater and intrarater reliability. Phys Ther 85(7), 2005, 656-64.
[30]. Sell K, Verity T, Worrell T, Pease B, Wigglesworth J. Two Measurement Techniques for Assessing Subtalar Joint Position: A Reliability Study. J Orthop Sports Phys Ther. 19(3), 1994, 162-167. [31]. Joos E, Peretz A, Beguin S, Famaey JP. Reliability and reproducibility of visual analogue scale and numeric rating scale for therapeutic evaluation of pain in rheumatic patients. J Rheumatol. 18(8), 1991, 1269-70.
[32]. Panichawit C, Bovonsunthonchai S, Vachalathiti R, Limpasutirachata K. Effects of Foot Muscles Training on Plantar Pressure Distribution during Gait, Foot Muscle Strength, and Foot Function in Persons with Flexible Flatfoot. J Med Assoc Thai. 98(5), 2015, S12-S7.
[33]. Evans A, Nicholson H, Zakarias N. The paediatric flat foot proforma (p-FFP): improved and abridged following a reproducibility study. Journal of Foot and Ankle Research. 2(1), 2009, 25.
Susan D et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [32-39]
39
[34]. Redmond A, Crosbie J, Ouvrier R. Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clinical Biomechanics. 21(1), 2006, 89-98.
[35]. Raymond W.J.G. Ostelo. Clinically important outcomes in low back pain, Best Practice & Research Clinical Rheumatology. 19(4), 2005, 593 – 607.
[36]. Kosashvili, Yona et al. "The Correlation Between Pes Planus And Anterior Knee Or Intermittent Low Back Pain". Foot & Ankle International 29(9), 2008, 910-913.
[37]. Menz HB, Munteanu SE. Validity of 3 clinical techniques for the measurement of static foot posture in older people.J Orthop Sports Phys Ther 35, 2005, 479_86.
[38]. Levine D, Whittle MW. The effects of pelvic movement on lumbar lordosis in the standing position. J Orthop Sports Phys Ther . 24, 1996, 130-135.
[39]. Hamel AJ, Sharkey NA, Buczek FL et al. Relative motions of the tibia, talus, and calcaneus during the stance phase of gait: a cadaver study. Gait Posture 20, 2004, 147-153.
[40]. Souza TR, Pinto RZ, Trede RG et al. Temporal couplings between rearfoot-shank complex and hip joint during walking. Clin Biomech 25, 2010, 745-758.
[41]. Baylis WJ, Rzonca EC. Functional and structural limb length discrepancies: evaluation and treatment. Clin Podiatr Med Surg 5, 1988, 509-520.
[42]. Sanner WH, Page JC, Tolboe HR et al. A study of ankle joint height changes with subtalar joint motion. J AmPodiatry Assoc 71, 1981, 158-161.
[43]. Dionne CE, Dunn KM, Croft PR et al. A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine 33, 2008, 95-103.
[44]. Deyo RA, Weinstein JN. Low back pain. N Engl J Med 344, 2001, 363-370.