Proportion of flatfoot among primary school children and its association with Body Mass Index: a cross-sectional sample study

Abstract

INTRODUCTION

A flatfoot is common during childhood and is regarded as a part of normal foot development. Nevertheless, the persistence of flatfoot beyond early childhood may affect the biomechanics of lower limb, causing discomfort and pain. Although increased body weight has been identified as a potential contributing factor, evidence from Nepal remains limited. The study aims to determine the prevalence of flatfoot among children aged 6-10 years and assess its association with body mass index (BMI).

MATERIAL AND METHODS

A cross-sectional study was carried out among 361 children aged 6–10 years from selected schools in Ward 10 of Suryabinayak Municipality, Bhaktapur. Participants were recruited using a multistage cluster sampling technique. Body mass index was calculated and categorized using Centers for Disease Control and Prevention (CDC) age- and sex-specific percentiles. Flat foot was assessed from inked footprints using Staheli’s plantar arch index. Associations between flatfoot and demographic variables were analyzed using Chi-square test. A p-value of <0.05 was considered statistically significant.

RESULTS

The overall prevalence of flatfoot was 18.8%. Flatfoot was significantly associated with age (p< 0.05) and body mass index (p<0.05), with prevalence decreasing with increasing age and increasing across body mass index categories. Although flatfoot was more common in boys than girls, the association was not statistically significant (p = 0.096).

CONCLUSION

The prevalence of flatfoot is relatively high in primary school-aged children and is positively associated with body mass index. Promoting foot health screenings and healthy weight maintenance may help reducepotential biomechanical consequences of flatfoot.