title: Flatfoot in school-age children: prevalence and associated factors.
abstract: BACKGROUND
  Flatfoot has been shown to cause abnormal stresses on the foot and lower extremity. The altered mechanical stresses on these structures can aggravate the foot deformity. Screening of the flatfoot and its associated factors helps detect underlying risks influencing the stresses on the foot. The purpose of this study was to analyze the structure of the medial foot arch and investigate its associated factors in students, aged 7 to 14 years.
  
  
  METHODS
  Multistage cluster sampling was used and each cluster included 2 other random sampling levels. A total of 667 Iranian school children were recruited and their feet were bilaterally evaluated using a static footprint while standing in a fully weightbearing position. The footprint, an observational measurement, and a questionnaire were used for the foot assessment.
  
  
  RESULTS
  The prevalence of flatfoot was 17.1% in the population studied. There was no gender difference but the prevalence of flatfoot did decrease with age. The significant differences were observed in the prevalence of flatfoot between normal-weight, overweight, and obese groups (P < .01); more overweight participants had flatter feet.
  
  
  CONCLUSIONS
  This study demonstrated that development of the longitudinal plantar arch in school-age children is influenced by age and weight. Age and weight were the primary predictive factors of flatfoot.
  
  
  METHODS
  Prognostic, Level IV: Case series.
authors.affiliation: Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (ESD, FJ);School of Health Sciences, University of Salford, Salford, UK (JMAM)Orthotics and Prosthetics Department, Isfahan University of Medical Sciences, Isfahan, Iran (FA, FS, MJ) sadeghi@rehab.mui.ac.ir.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Sadeghi-Demneh
authors.affiliation: Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (ESD, FJ);School of Health Sciences, University of Salford, Salford, UK (JMAM)Orthotics and Prosthetics Department, Isfahan University of Medical Sciences, Isfahan, Iran (FA, FS, MJ).
authors.forename: Fahimehsadat
authors.initials: F
authors.lastname: Jafarian
authors.affiliation: Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (ESD, FJ);School of Health Sciences, University of Salford, Salford, UK (JMAM)Orthotics and Prosthetics Department, Isfahan University of Medical Sciences, Isfahan, Iran (FA, FS, MJ).
authors.forename: Jonathan M A
authors.initials: JM
authors.lastname: Melvin
authors.affiliation: Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (ESD, FJ);School of Health Sciences, University of Salford, Salford, UK (JMAM)Orthotics and Prosthetics Department, Isfahan University of Medical Sciences, Isfahan, Iran (FA, FS, MJ).
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Azadinia
authors.affiliation: Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (ESD, FJ);School of Health Sciences, University of Salford, Salford, UK (JMAM)Orthotics and Prosthetics Department, Isfahan University of Medical Sciences, Isfahan, Iran (FA, FS, MJ).
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Shamsi
authors.affiliation: Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (ESD, FJ);School of Health Sciences, University of Salford, Salford, UK (JMAM)Orthotics and Prosthetics Department, Isfahan University of Medical Sciences, Isfahan, Iran (FA, FS, MJ).
authors.forename: Mohamad
authors.initials: M
authors.lastname: Jafarpishe
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D005260:Female; D005413:Flatfoot / Q000453:epidemiology*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012737:Sex Factors
keywords: flatfoot; footprint; school-age children