Influence of Age, Sex, and Anthropometric Determinants on the Foot Posture Index in a Pediatric Population

Background: The Foot Posture Index (FPI) is a clinical tool for diagnosis that aims to quantify the grade of a foot position as neutral, pronated, or supinated. Its purpose is to develop a simple six-factor method for rating foot posture with an easy and quantitative result. We evaluated possible differences in the FPI by sex and the influences of age, weight, height, foot size, and body mass index (BMI) on foot posture. Methods: In 150 asymptomatic children (79 boys and 71 girls) aged 8 to 13 years, we determined weight, height, BMI, and FPI in the bipedal, static, and relaxed position. The FPI was obtained as the sum of the scores (–2, –1, 0, 1, 2) given to each of the six criteria. Results: The mean ± SD FPI value for the total sample was 5.1 ± 2.1 (boys: 5.1 ± 2.2; girls: 5.2 ± 2.0), so there were no significant differences between the sexes (P = .636). Of the 150 feet examined, none had FPI values of very supinated or highly pronated, two were supinated (1.3%), 76 neutral (50.7%), and 72 pronated (48.0%). Of the total FPI values, 7.7% can be explained by anthropometric variables: height, weight, and foot size (r2 = 0.077; P < .010). Conclusions: The most frequent foot postures in the sample were neutral and pronated. Neither age nor BMI explained variations in the FPI.

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Comparative analysis of the foot position in children with symptomatic and asymptomatic flatfoot using the foot posture index (FPI-6)

Fundamental and Clinical Medicine ◽

10.23946/2500-0764-2020-5-4-76-83 ◽

2020 ◽

Vol 5 (4) ◽

pp. 76-83

Author(s):

N. A. Shabaldin ◽

A. V. Shabaldin ◽

F. V. Titov ◽

V. A. Kokina

Keyword(s):

Conservative Treatment ◽

The Body ◽

Healthy Children ◽

Lateral Projection ◽

Foot Posture Index ◽

Posture Index ◽

Efficient Approach ◽

Asymptomatic Children ◽

Foot Posture ◽

Foot Position

Aim. To compare the foot position in asymptomatic children and those who received conservative or surgical because of flatfoot.Materials and Methods. We consecutively recruited three patient groups: 112 healthy children, 74 children with a pronation position, and 80 children with an overpronation position of the foot. The Foot Posture Index (FPI – 6) was used for the clinical examination. Visual and manual clinical tests were used to determine the mobility of the foot joints. X-ray was performed in a standard lateral projection with a load; if necessary, multislice computed tomography of the foot was performed.Results. Healthy children commonly have pronation position of the foot during the first 10 years of life, with the further normalisation of the posture. In patients receiving conservative treatment of foot pronation, normalisation of the foot position was considerably less pronounced than in healthy children. Further, in those with overpronation position, there were no age-dependent changes in the posture and surgery was the only efficient approach to correct the flatfoot.Conclusion. FPI-6 is a highly sensitive tool for clinical diagnosis of flatfoot. Moderate pronation has a more favorable prognosis than the overpronation position, which is not corrected during the body growth or by the conservative treatment. Yet, surgery is a safe and efficient approach to relieve the pain syndrome and treat the flatfoot deformity.

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Criterion Validation of Four Criteria of the Foot Posture Index

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-94-1-31 ◽

2004 ◽

Vol 94 (1) ◽

pp. 31-38 ◽

Cited By ~ 32

Author(s):

Rolf Scharfbillig ◽

Angela M. Evans ◽

Alexander W. Copper ◽

Marie Williams ◽

Sheila Scutter ◽

...

Keyword(s):

Linear Model ◽

Generalized Linear Model ◽

Initial Study ◽

Radiographic Images ◽

Foot Posture Index ◽

Posture Index ◽

Criterion Validation ◽

Foot Posture ◽

Final Score ◽

Foot Position

The Foot Posture Index is a new multidimensional and multiplanar tool aimed at quantifying the degree of pronation to supination of the foot, comprising eight criteria that sum to produce a final “score” of foot posture. In an initial study involving 31 subjects, angulations measured from dorsoplantar and lateral radiographs were compared with the corresponding Foot Posture Index criteria using Spearman’s rho and the generalized linear model of analysis of variance. Eleven of the participants from Study 1 completed a second study in which wedges were used to alter foot position to determine whether changes to foot position were sensitively reflected in Foot Posture Index criterion scores and associated radiographic images. Study 1 demonstrated a significant correlation for only one criterion (talar head palpation), while Study 2 demonstrated intrasubject sensitivity to overall changes from supinated to pronated and supinated to resting positions but insensitivity to changes from resting to pronated positions. The results suggest that although the Foot Posture Index could be a useful tool to broadly classify foot postures, it is not sensitive to all small movements when assessed by this method. (J Am Podiatr Med Assoc 94(1): 31-38, 2004)

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El Índice de Postura del Pie: revisión de la literatura

Revista Andaluza de Medicina del Deporte ◽

10.33155/j.ramd.2017.05.001 ◽

2018 ◽

Vol 0 (Avance Online) ◽

Author(s):

José Algaba del Castillo ◽

Manuel Coheña Jiménez ◽

Amanda Páez Tudela ◽

María del Rocío Ruiz García

Keyword(s):

Lower Limb ◽

Diverse Populations ◽

Journal Articles ◽

Inclusion Criteria ◽

Clinical Tool ◽

Foot Posture Index ◽

Posture Index ◽

The World ◽

Foot Posture

Resumen Objetivo: Realizar una revisión sobre la herramienta clínica de clasificación de la postura del pie en estática, Índice de Postura del Pie, para una mejor comprensión de su uso y aplicabilidad. Método: Revisión bibliográfica sobre el “Foot Posture Index”. Fueron consultados un total de 48 trabajos entre artículos de revista, libros y tesis doctorales. Se descartaron 18, por no cumplir los criterios de inclusión propuestos. Resultados: Se han utilizado 30 textos en castellano e inglés, en los que se relaciona el Índice de Postura del Pie, su fiabilidad en poblaciones diversas y su uso en el mundo de las Ciencias del Deporte. Conclusiones: El Índice de Postura del Pie es una herramienta fácil, fiable, y validada científicamente. Queda demostrada su aplicabilidad en todo tipo de poblaciones, sin existir limitaciones ante situaciones patológicas del miembro inferior. Existen datos que avalan su uso como predictor de lesiones, así como, para la mejora de las aptitudes del deportista. Abstract Objective: To carry out a review on the clinical tool of classification of the position of the foot in static, Foot Posture Index, for a better understanding of its use and applicability. Method: Bibliographical review on the Foot Posture Index. A total of 48 papers were consulted among journal articles, books and doctoral theses. 18 were discarded because they did not meet the inclusion criteria proposed. Results: 30 texts have been used in Spanish and English, in which the classification of the foot has been related to the Foot Posture Index, its reliability in diverse populations and its use in the world of Sport Sciences. Conclusions: The Foot Posture Index is an easy, reliable and scientifically validated tool. Its applicability has been demonstrated in all types of populations, without specific limitations to altered or pathological situations of the lower limb. Data have been obtained that support its use as a predictor of injuries, as well as for the improvement of the athlete's abilities. Resumo Objetivo: Realizar uma revisão sobre a ferramenta de classificação clínica Índice de Postura do Pé, para uma melhor compreensão do seu uso e aplicabilidade. Método: Revisão bibliográfica sobre o “Foot Posture Index”. Foram consultados um total de 48 trabalhos entre artigos de revistas, livros e teses de doutorado. Foram descartadas 18, por não cumprir os critérios de inclusão propostos. Resultados: Foram utilizados 30 textos em castelhano e inglês que se relacionaram com o Índice de Postura do Pé, sua fiabilidade em populações diversas e sua utilização no mundo das Ciências do Esporte. Conclusões: O Índice de Postura do Pé é uma ferramenta fácil, fiável e com validade científica. Sua aplicabilidade é demostrada em todos os tipos de populações, sem existir limitações ante a situações patológicas do membro inferior. Existem dados que avaliam o seu uso como preditor de lesões, assim como, para a melhora da performance desportiva.

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Normal Values of the Foot Posture Index in a Young Adult Spanish Population

Journal of the American Podiatric Medical Association ◽

10.7547/8750-7315-105.1.42 ◽

2015 ◽

Vol 105 (1) ◽

pp. 42-46 ◽

Cited By ~ 8

Author(s):

Gabriel Gijon-Nogueron ◽

Raquel Sanchez-Rodriguez ◽

Eva Lopezosa-Reca ◽

Jose Antonio Cervera-Marin ◽

Rodrigo Martinez-Quintana ◽

...

Keyword(s):

Young Adult ◽

Normal Values ◽

Normal Range ◽

New Classification ◽

Healthy Young Adult ◽

Foot Posture Index ◽

Posture Index ◽

Foot Posture ◽

The Mean ◽

The Difference

Background Although the appearance of foot or lower-limb pathologies is etiologically multifactorial, foot postures in pronation or supination have been related to certain diseases such as patellofemoral syndrome and plantar fasciitis. The objective of the present study was to determine the normal values of foot posture in a healthy young adult Spanish sample, and to identify individuals at risk of developing some foot pathology. Methods The Foot Posture Index (FPI) was determined in a sample of 635 (304 men, 331 women) healthy young adults (ages 18–30 years). The FPI raw score was transformed into a logit score, and a new classification was obtained with the mean ± 2 SD to identify the 5% of the sample with potentially pathologic feet. Results The normal range of the FPI was −1 to +6, and FPI values from +10 to +12 and −6 to −12 could be classified as indicating potentially pathologic feet. The women's logit FPI (0.50 ± 1.4, raw FPI +3) was higher than the men's (0.25 ± 1.6, raw FPI +2), with the difference being significant (P = 0.038). No statistically significant differences were found between body mass index groups (P = 0.141). Conclusions The normal FPI range goes from just one point of supination to a certain degree of pronation (+6). The identification of 35 individuals with potentially pathologic feet may help in the implementation of a preventive plan to avoid the appearance of foot disorders.

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The Foot Posture Index

Journal of the American Podiatric Medical Association ◽

10.7547/1030400 ◽

2013 ◽

Vol 103 (5) ◽

pp. 400-404 ◽

Cited By ~ 5

Author(s):

Raquel Sánchez Rodríguez ◽

Alfonso Martínez Nova ◽

Elena Escamilla Martínez ◽

Beatriz Gómez Martín ◽

Rodrigo Martínez Quintana ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Multiple Regression Model ◽

Limited Evidence ◽

Foot Posture Index ◽

Posture Index ◽

Foot Posture ◽

The Mean ◽

The Difference ◽

Neutral Posture

Background: The Foot Posture Index (FPI) quantifies foot posture on the basis of six criteria. Although the male foot is longer and broader than the female foot, limited evidence exists about the differences in foot posture between the sexes and which are its biological and anthropometric determinants. We sought to evaluate possible sex differences in the FPI and the determinants influencing foot posture. Methods: In 400 individuals (201 men and 199 women), the FPI was determined in the static bipedal stance and relaxed position. The FPI was obtained as the sum of the scores (−2, −1, 0, 1, or 2) given to each of six criteria. A multiple regression model was constructed of the overall FPI against age, weight, height, body mass index, and foot size. Results: The mean ± SD FPI was 2.0 ± 4.3 overall, 1.6 ± 4.5 for men, and 2.4 ± 4.1 for women, with the difference being nonsignificant (P = .142). The neutral posture was the most frequent (57.3%). A greater proportion of women had neutral and pronated feet, and a greater proportion of men had supinated and highly supinated feet, with the differences being nonsignificant (P = .143). Foot size, height, and body mass index together explained 10.1% of the overall FPI value (P < .001). Conclusions: The most frequent posture was neutral with a certain degree of pronation, with no differences in FPI values between men and women. Participants with larger foot sizes had higher FPI values, whereas taller and heavier participants had lower FPI values. (J Am Podiatr Med Assoc 103(5): 400–404, 2013)

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The Foot Posture Index in Men Practicing Three Sports Different in Their Biomechanical Gestures

Journal of the American Podiatric Medical Association ◽

10.7547/0003-0538-104.2.154 ◽

2014 ◽

Vol 104 (2) ◽

pp. 154-158 ◽

Cited By ~ 9

Author(s):

Alfonso Martínez-Nova ◽

Eduardo Gómez-Blázquez ◽

Elena Escamilla-Martínez ◽

Pedro Pérez-Soriano ◽

Gabriel Gijon-Nogueron ◽

...

Keyword(s):

Analysis Of Variance ◽

Diagnostic Tool ◽

Head Position ◽

Basketball Players ◽

Male Athletes ◽

Foot Posture Index ◽

Posture Index ◽

Talar Head ◽

Foot Posture ◽

The Mean

Background The technical gestures characteristic of certain sports may lead to one type of foot being more prevalent than the others. The Foot Posture Index (FPI) has been used as a diagnostic tool for support postures in various sports, but the differences in these postures between sports of distinct gestures in their actions are far from completely understood. Methods The overall FPI, obtained as the sum of the scores of its six individual criteria, was determined in 90 male athletes (30 runners, 30 basketball players, and 30 handball players) in static bipedal stance and relaxed position. Analysis of variance was used to find significant differences among the three sports in the total FPI and its six criteria. Results The mean ± SD FPI was 2.9 ± 2.8 in runners, 3.9 ± 4.1 in basketball players, and −0.4 ± 6.9 in handball players, with significant differences among these groups (P = .008). Significant differences were also found in the talar head position and talonavicular prominence values between handball players and runners (P = .001 and P = .004, respectively) and between handball and basketball players (P = .002 and P = .006, respectively). Conclusions Runners and basketball players had neutral feet, whereas handball players had supinated feet. The differences in foot posture seem to be mainly determined by two of the FPI criteria: talar head position and talonavicular prominence.

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Reliability of the Foot Posture Index and Traditional Measures of Foot Position

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-93-3-203 ◽

2003 ◽

Vol 93 (3) ◽

pp. 203-213 ◽

Cited By ~ 107

Author(s):

Angela M. Evans ◽

Alexander W. Copper ◽

Rolf W. Scharfbillig ◽

Sheila D. Scutter ◽

Marie T. Williams

Keyword(s):

Repeated Measures ◽

Interrater Reliability ◽

Age Groups ◽

Reliable Measure ◽

Foot Posture Index ◽

Posture Index ◽

Foot Length ◽

Foot Posture ◽

Foot Position ◽

Adequate Reliability

Repeatable measures are essential for clinicians and researchers alike. Both need baseline measures that are reliable, as intervention effects cannot be accurately identified without consistent measures. The intrarater and interrater reliability of the new Foot Posture Index and current podiatric measures of foot position were assessed using a same-subject, repeated-measures study design across three age groups. The Foot Posture Index total score showed moderate reliability overall, demonstrating better reliability than most other current measures, although navicular height (normalized for foot length) was the single most reliable measure in adults. None of the tested measures exhibited adequate reliability in young children, and, with less-than-desirable reliability being demonstrated, most measures need to be interpreted accordingly when repeated measures are involved. (J Am Podiatr Med Assoc 93(3): 203-213, 2003)

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Establishing normative foot posture index values for the paediatric population: a cross-sectional study

Journal of Foot and Ankle Research ◽

10.1186/s13047-016-0156-3 ◽

2016 ◽

Vol 9 (1) ◽

Cited By ~ 17

Author(s):

Gabriel Gijon-Nogueron ◽

Jesus Montes-Alguacil ◽

Pilar Alfageme-Garcia ◽

Jose Antonio Cervera-Marin ◽

Jose Miguel Morales-Asencio ◽

...

Keyword(s):

Paediatric Population ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Foot Posture Index ◽

Posture Index ◽

Foot Posture

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Association between the Foot Posture Index and running related injuries: A case-control study

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2018.12.019 ◽

2019 ◽

Vol 61 ◽

pp. 217-221

Author(s):

Aitor Pérez-Morcillo ◽

Antonio Gómez-Bernal ◽

Vicente F. Gil-Guillen ◽

Javier Alfaro-Santafé ◽

José Víctor Alfaro-Santafé ◽

...

Keyword(s):

Case Control Study ◽

Case Control ◽

Foot Posture Index ◽

Posture Index ◽

Foot Posture ◽

Control Study

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Association between Foot Posture Index and Ankle Sprain in Indoor Football Players

Global Journal of Health Science ◽

10.5539/gjhs.v8n10p160 ◽

2016 ◽

Vol 8 (10) ◽

pp. 160 ◽

Cited By ~ 1

Author(s):

Afsaneh Safar Cherati ◽

Masoud Dousti ◽

Shima Younespour

Keyword(s):

Ankle Sprain ◽

Football Players ◽

Male And Female ◽

Positive History ◽

Foot Posture Index ◽

Posture Index ◽

Foot Posture ◽

History Of ◽

The Relationship

Objective: This study investigated the relationship between foot type and ankle sprain incidence.Method: In a prospective cohort study using the FPI, 68 adult male and female indoor football (Futsal) players were measured and their feet were classified according to foot posture index (FPI) as neutral, supinated and pronated. They were followed over 6 month as a one competition season and at the end, any injuries at the ankle during this period were detected.Result: There was no significant association between FPI score (considering the total FPI score and its six components) and occurrence of ankle sprain. Also, no association was existed between gender, age, height, weight, BMI, duration of professional exercise, dominant foot and occurrence of ankle sprain. In this study, the history of previous ankle sprain was the only significant predictor of the occurrence of ankle sprain in the follow-up period. Participants with the positive history of previous ankle sprain were at higher risk of developing new ankle sprain (OR=6.02, 95% CI: (1.93, 18.84), p=0.002).Conclusion: There was no significant association between FPI score and occurrence of ankle sprain.Limitation: there was scarce of supinated foot in the study so evaluation of relationship between supinated feet and ankle sprain was not applicable.

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