Published: 2016-02-16

Foot arch condition in comparison with the muscular balance of lower limbs in children at school age of 6–14 years

Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland
Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland
Department of Clinical Psychology, Poznan University of Medical Sciences, Poland
Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland
children flat foot muscular length hamstring muscle


Introduction. Foot arch condition plays an important role in correct setting of lower limbs joints, proper muscles tone and well-being [1]. More and more frequently foot arch deviations affect population of school age children [2, 3]. It is based on anatomic knowledge that abnormal foot arch is strongly connected with the disturbed muscle tone of lower limb. The aim of the presented study is to evaluate the relation between the foot arch condition and muscular balance of the lower limbs.
Material and methods. Children were assessed using the Clarke’s angle and indicatory muscles length tests including: quadratus lumborum muscle, hamstring muscle, thigh adductors, piriformis muscle.
Results. Abnormal foot arch was showed by 70% of subject children. The greatest number of muscles length abnormality was observed in quadratus lumborum muscles. There was a statistically significant correlation between right hamstring muscle contraction and abnormal foot arch (p = 0.011).
Conclusions. Foot arch alternations increasingly more often appear in the greater number of school–age children. The assessment and therapy of abnormal foot arch should include the examination of muscular balance of the lower limbs.


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  1. Kasperczyk T. Wady postawy ciała. 4th end. Krakow, Wydawnictwo ”Kasper” s.c. 2004.
  2. La France M. Postural mirroring and intergroup relations. Pers Soc Psychol Bull. June 1985;2(1,1):207–217. 10.1177/0146167285112008.
  3. Bart O, Hajami D, Bar-Haim Y. Predicting school adjustment from motor abilities in kindergarten. Infant and Child Development. November/December 2007;16(6): 597–615. 10.1002/icd.514.
  4. Bochenek A, Reicher M. Anatomia człowieka Tom IV. Warszawa, Wydawnictwo Lekarskie PZWL; 1998.
  5. Woźniacka R, Bac A, Matusik S, Szczygieł E, Ciszek E. Body weight and the medial longitudinal foot arch: high-arched foot, a hidden problem? Eur J Pediatr. 2013; 172:683–691. 10.1007/s00431–013–1943–5.
  6. Hae-Chan P, Yang-Soo K, Sang-Hun S, Soo-Kyung L. The effect of complex training on the children with all of the deformities including forward head, rounded shoulder posture, and lumbar lordosis. J Exerc Rehabil. 2014 Jun 30;10(3):172–175; 10.12965/jer.140113. eCollection 2014.
  7. Mrozowiak M. Poziom i rodzaj zaburzeń postawy ciała w Polsce w latach 2004–2006.
  8. Permoda A, Permoda A, Chudak B. The problem of occurrence of faulty postures in children and adolescents in the city of Zielona Góra and the region. Zdr Publ 2010; 120(4):361–364.
  9. Homayouni K, Karimian H, Naseri M, Mohasel N. Prevalence of Flexible Flatfoot Among School-Age Girls. Shiraz E-Med J. 2015 February;16(2):e18005.
  10. Kratěnová J, Žejglicová K, Marek Malý M, Filipová V. Prevalence and Risk Factors of Poor Posture in School Children in the Czech Republic. J Sch Health. 2007 Mar; 77(3):131–137. 10.1111/j.1746–1561.2007.00182.x
  11. Gollenberg AL, Addo OY, Zhang Z, Hediger ML, Himes JH, Lee PA. In utero Exposure to Cigarette Smoking, Environmental Tobacco Smoke and Reproductive Hormones in US Girls Approaching Puberty. Horm Res Paediatr. 2015;83(1):10.1159/000369168. Epub 2015 Jan 24.
  12. Tomaszewska A, Pawlicka-Lisowska A. Evaluation of an influence of systematic motor activity on the body posture of young people. Pol Merkur Lekarski. 2014 May; 36(215):336–40. 24964512.
  13. Feigenbaum LA, Roach KE, Kaplan LD, Lesniak B, Cunningham S. The association of foot arch posture and prior history of shoulder or elbow surgery in elite-level baseball pitchers. J Orthop Sports Phys Ther. 2013 Nov; 43(11):814–820. 10.2519/jospt.2013.4504. Epub 2013 Sep 9.
  14. Pauk J, Ezerskiy V, Raso JV, Rogalski MJ. Epidemiologic factors affecting plantar arch development in children with flat feet. J Am Podiatr Med Assoc. 2012 Mar-Apr; 102(2):114–121. 10.7547/1020114.
  15. Pfeiffer M, Kotz R, Ledl T, Hauser G. Prevalence of Flat Foot in Preschool-Aged Children. PEDIATRICS 2006 August 1;2:63–639. 10.1542/peds.2005–2126.
  16. Obuchowicz A. Badanie podmiotowe i przedmiotowe w pediatrii. Warszawa, Wydawnictwo Lekarskie PZWL; 2010.
  17. Villarroya MA, Manuel Esquivel J, Tomás C, Buenafé A, Moreno L. Foot structure in overweight and obese children. Int J Pediatr Obes. 2008;3(1):39–45. 10.1080/17477160701520298.
  18. Villarroya MA, Esquivel JM, Tomás C, Moreno LA, Buenafé A, Bueno G. Assessment of the medial longitudinal arch in children and adolescents with obesity: footprints and radiographic study. Eur J Pediatr. 2009 May;168(5):559–67. 10.1007/s00431–008–0789–8. Epub 2008 Aug 27.
  19. Chen KC, Yeh CJ, Kuo JF, Hsieh CL, Yang SF, Wang CH. Footprint analysis of flatfoot in preschool-aged children. Eur J Pediatr. 2011;170(5):611–7. 10.1007/s00431–010–1330–4.
  20. Buckup K. Clinical Tests for the Musculoskeletal System: Examinations – Signs – Phenomena. 2dn edt. Thieme Medical Publishers; 2008.
  21. El O, Akcali O, Kosay E, Kaner B, Arslan Y, Sagol E, Soylev S, Iyidogan D, Cinar N, Peker O. Flexible flatfoot and related factors in primary school children: a report of a screening study. Rheumatol Int. 2006;26:1050–1053.
  22. Chen JP, Chung MJ, Wang MJ. Flatfoot prevalence and foot dimensions of 5 to 13 year old children in Taiwan. Foot Ankle Int. 2009;30(4):326–332.
  23. Forriol F, Pascual J. Footprint analysis between three and seventeen years of age. Foot Ankle.1990;11(2):101–104. 10.1177/107110079001100208.
  24. Mickle KJ, Steele JR. The feet of overweight and obese young children: Are they flat or fat? Obesity 2006 Nov; 14:1949–53.
  25. Brzeska P, Sokołowska E, Baumgart M. Zmiany postawy ciała u dzieci w wieku przedszkolnym w ciągu roku. Zeszyty naukowe Uniwersytetu Szczecińskiego Nr 771, Prace Instytutu Kultury Fizycznej Nr 28; 2012:205–213.
  26. Janiszewska R, Tuzinek S, Nowak S, Biniaszewski T, Ratyńska A. Nieprawidłowości postawy ciała u dzieci 6–12 letnich – uczniów szkół podstawowych z Radomian – badania pilotażowe. Probl Hig Epidemiol. 2009,90(3): 342–346.
  27. Harris EJ. The natural history and pathophysiology of flexible flatfoot. Clin Pod Med Surg. 2010;27:1–23. 10.1016/j.cpm.2009.09.002.
  28. Stavlas P, Grivas TB, Constantinos M, Vasiliadis E, Polyzois V. The evaluation of foot morphology in children between 6 and 17 years of age: a cross-sectional study based on footprints in a Mediterranean population. J Foot Ankle Surg. 2005;44(6):424–428.
  29. Walczak M, Napiontek M. Stopa płaska statyczna dziecięca – kontrowersyjny temat. Chirurgia Narządów Ruchu i Ortopedia Polska. 2003;68(4):261–267.
  30. Kania-Gudzio T, Wernicka M. Ocena postawy ciała dzieci w wieku 7–15 lat na podstawie wybranej losowo szkoły z miasta Poznania. Nowiny Lekarskie. 2002;71(2–3): 151–159.
  31. Umar MB, Tafida RU. Prevalence of flatfoot and anthropometric comparison between flat and normal feet in the Hausa ethnic group of Nigeria. J Am Podiatr Med Assoc. 2013 Sep-Oct;103(5):369–373. 10.7547/1030369.
  32. Staheli LT, Chew DE, Corbett M. The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults. J Bone Jt Surg Am. 1987;69: 426–428.
  33. Garcia-Rodriguez A et al. Flexible fiat foot in children: a real problem? Pediatrics, 1999;6:1–3.
  34. Bernhardt DB. Prenatal and postnatal growth and development of the foot and ankle. Phys Ther. 1988 Dec; 68(12):1831–9. 10.7547/87507315–85–12–753.
  35. Volpon JB. Footprint analysis during the growth period. J. Pediatr. Orthop. 1994;14:83–85.
  36. Chang JH, Wang SH, Kuo CL, Shen HC, Hong YW, Lin LC. Prevalence of flexible flatfoot in Taiwanese school-aged children in relation to obesity, gender, and age. Eur J Pediatr. 2010;169:447–452.
  37. Pita-Fernández S, González-Martín C, Seoane-Pillado T, López-Calvino B, Pértega-Díaz S, Gil-Guillén V. Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older. J Epidemiol. 2015;25(2):148–54. 10.2188/jea.JE20140082. Epub 2014 Nov 8.
  38. Moon DK, Gurnett CA, Aferol H, Siegel MJ, Commean PK, Dobbs MB. Soft-Tissue Abnormalities Associated with Treatment-Resistant and Treatment-Responsive Clubfoot: Findings of MRI Analysis. J Bone Joint Surg Am. 2014 Aug 6;96(15):1249–1256.
  39. Thomas W. Myers Anatomy Trains. Myofascial Meridians for Manual and Movement Therapists. 2nd edt. Churchil Livingstone, Elsevier. 2009.
  40. Ippolito E, Dragoni M, Antonicoli M, Farsetti P, Simonetti G, Masala S. An MRI volumetric study for leg muscles in congenital clubfoot. J Child Orthop. 2012 Oct;6(5):433–8. 10.1007/s11832–012–0444–9. Epub 2012 Oct 5.

How to Cite

Skowron N, Malak R, Mojs E, Samborski W. Foot arch condition in comparison with the muscular balance of lower limbs in children at school age of 6–14 years. JMS [Internet]. 2016Feb.16 [cited 2020Aug.5];84(2):85-9. Available from: