Evans Angela Margaret, Karimi Leila
Department of Podiatry, Lower Extremity and Gait Studies (LEGS) Research Program, La Trobe University, Bundoora, Melbourne, Australia.
School of Public Health and Human Biosciences, La Trobe University, Bundoora, Melbourne, Australia.
J Foot Ankle Res. 2015 Aug 27;8:46. doi: 10.1186/s13047-015-0101-x. eCollection 2015.
Several studies have found positive correlation between flatfeet and increased body mass in children. One study, utilizing a differing method of foot posture assessment, found the inverse. The purpose of this study was to further explore the relationship between children's foot posture and body mass, utilizing the foot posture index in a large study population, as opposed to the footprint based measures of most previous studies.
Data for both foot posture index (FPI) and body mass index (BMI) for healthy children were acquired from five previous studies. The amalgamated dataset comprised observations for both BMI and FPI-6 in 728 children aged from three to 15 years. Three FPI-6 scores levels defined the range of flatfeet detected: FPI-6 ≥ +6; FPI-6 ≥ +8; FPI-6 ≥ +10. BMI cut-points were used to define overweight for each age group.
In the study population of 728 children, flatfeet (FPI ≥ +6) were found in 290 (40 %) cases and non-flatfeet in 438 (60 %) cases. FPI ≥ +8 yielded flatfeet in 142 (20 %) cases and FPI ≥ +10 yielded flatfeet in 41 (5 %) cases. Whilst 272 (37 %) children were overweight, only 74 (10.1 %) of the overweight children had flatfeet (FPI ≥ +6), which diminished to 36 (4.9 %) at FPI ≥ +8, and 9 (1.2 %) at FPI ≥ +10. Significant and moderate correlation was found between BMI and age (r = 0.384, p < 0.01). Very weak, but significant, correlation was found between BMI and FPI (r = -0.077, p < 0.05). Significant mean differences between gender and BMI were found (t-test = 2.56, p < 0.05). There was strong correlation between FPI scores on left and right sides (r = 0.899, p < 0.01).
This study found no association between increased body mass and flatfeet in children, a finding in contrast to that repeatedly concluded by many previous studies. Whilst properties of the FPI and BMI are limiting, these findings question the concern about children's increased body mass as a specific influence on (flatter) foot posture, and also the validity of footprint versus anatomically based foot posture measures.
多项研究发现儿童扁平足与体重增加之间存在正相关。一项采用不同足部姿势评估方法的研究却得出了相反的结果。本研究的目的是在大量研究人群中利用足部姿势指数，而非大多数先前研究基于脚印的测量方法，进一步探究儿童足部姿势与体重之间的关系。
从之前的五项研究中获取了健康儿童的足部姿势指数（FPI）和体重指数（BMI）数据。合并后的数据集包含了728名3至15岁儿童的BMI和FPI-6观测值。三个FPI-6分数水平定义了所检测到的扁平足范围：FPI-6≥+6；FPI-6≥+8；FPI-6≥+10。使用BMI切点来定义每个年龄组的超重情况。
在728名儿童的研究人群中，发现290例（40%）为扁平足（FPI≥+6），438例（60%）为非扁平足。FPI≥+8时，142例（20%）为扁平足；FPI≥+10时，41例（5%）为扁平足。虽然272名（37%）儿童超重，但超重儿童中只有74名（10.1%）有扁平足（FPI≥+6），FPI≥+8时降至36名（4.9%），FPI≥+10时降至9名（1.2%）。发现BMI与年龄之间存在显著的中度相关性（r = 0.384，p < 0.01）。发现BMI与FPI之间存在非常微弱但显著的相关性（r = -0.077，p < 0.05）。发现性别与BMI之间存在显著的平均差异（t检验 = 2.56，p < 0.05）。左右两侧的FPI分数之间存在很强的相关性（r = 0.899，p < 0.01）。
本研究发现儿童体重增加与扁平足之间无关联，这一发现与许多先前研究反复得出的结论相反。虽然FPI和BMI的特性存在局限性，但这些发现质疑了将儿童体重增加视为对（更扁平）足部姿势有特定影响的担忧，以及基于脚印与基于解剖学的足部姿势测量方法的有效性。
