Assessment of flat foot using plantar arch index in young adults


  • Amith Ramos KSHEMA
  • Shannon Fernandes
  • . Pooja
  • Pooja J. Panicker
  • Pooja Krishnan



BMI, Plantar arch index, Flat foot, Staheli’s method


Introduction and Aim: Flat foot or pes planus results from collapse of the arches of the foot. Etiology, however varies in different age groups. As anthropometric measurements are age dependent, their correlation with different foot postures should be age specific. Our study aimed at using Plantar arch Index (PAI) to identify prevalence of flat foot in a young student population and find any association of obesity with flat foot.


Methods: A prospective study was conducted on 150 medical students of a medical college. Staheli’s method was used to calculate PAI after collecting the footprints of students by ink method.


Results: Prevalence of type III flat foot deformity was 6%, with a male preponderance. The PAI values ranged from 0 to 1.818. No association was found between obesity and PAI.


Conclusion: Obesity was not associated with flat foot in the age group 18-25 years probably indicating different etiology for acquired flat foot in this age group. Our study also suggests that simple ink print method is a simpler method to diagnose flat feet deformity clinically using PAI.

Author Biographies

Amith Ramos, KSHEMA

Department of Anatomy, KS Hegde Medical Academy, Mangalore Karnataka, India

Shannon Fernandes

Assistant Professor

Department of OBG

Father Muller Medical College

Mangalore, Karnataka, India

. Pooja

Intern, KS Hegde Medical Academy, Mangalore Karnataka, India

Pooja J. Panicker

Intern, KS Hegde Medical Academy, Mangalore Karnataka, India

Pooja Krishnan

Intern, KS Hegde Medical Academy, Mangalore Karnataka, India


Saltzman, C. L., Nawoczenski, D. A., Talbot, K. D. Measurement of the medial longitudinal arch. Arch Phys Med Rehabil. 1995 Jan; 76(1): 45-49.

Standring, S. Gray’s Anatomy.40th ed. Elsevier publications (UK); 2008. Pp. 1450.

Low, S. Shoes, Sitting, and Lower Body Dysfunctions Published: November 22, 2009.

Burns, J., Crosbie, J., Hunt, A., Ouvrier, R. The effect of pes cavus on foot pain and plantar pressure. Clin Biomech (Bristol, Avon). 2005; 20: 877-882.

López, D., Gracia-Mira, R., Alonso, F., López, L. Analogy of the pediatric prevention. A study through the Internet. Rev Int of Hundred Pedol. 2012; 6: 63-72.

Williams, D. S., Mc Clay, I. S. Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity. Physical Therapy. 2009; 80(9): 864-871.

Halabachi, F., Mazaheri, R., Mirshahi, M., Abbasian, L. Pediatric flexible flat foot; clinical aspects and algorithmic approach. Iran J Pediatr. 2013; 23(3): 247-260.

Mickle, M. J., Steele, J. R., Munro, B. J. The feet of overweight and obese young children: are they flat or fat? Obesity. 2006; 14(11): 1949-1953.

Pfeiffer, M., Kotz, R., Ledl, T., Hauser, G., Shega, M. Prevalence of flat foot in preschool aged children. Pediatric. 2006; 118(2): 634-639.

Levinger, P., Lenz, H. B., Fotoohabaddi, R., Feller, J. A., Bartlett, J. R., Bergman, N. R. Foot posture in people with medial compartment knee osteoarthritis. Journal of Foot and Ankle Research. 2010; 3(29): 1-8.

Evans, A. M., Nicholson, H., Zakarias, N. The paediatric flat foot proforma (p-FFP): improved and abridged following a reproducibility study. Journal of Foot and Ankle Research. 2009; 2(25): 1-8.

Tudor, A., Ruzia, L., Sestan, B., Sirola, L., Prpc, T. Flat footedness is not a disadvantage for athletic performance in children aged 11-15 yrs. Pediatrics. 2009; 123(286): 386-392.

Engel, G. M., Staheli, L. T. The natural history of torsion and other factors influencing gait in childhood. A study of the angle of gait, tibial torsion, knee angle, hip rotation, and development of the arch in normal children. Clin OrthopRelat Res 1974; 99: 12-17.

Hernandez, A. J., Kimura, L. K., Laraya, M. H. F., Favaro, E. Calculation of Staheli’s plantar arch index and prevalence of flat feet: a study with 100 children aged 5-9 years. Acta Ortop Bras. 2007; 15(2): 68-71.

Riccio, I., Gimigliano, F., Gimigliano, R., Porpora G., Iolascon, G. Rehabilitative treatment in flexible flatfoot: a perspective cohort study. MusculoskeletSurg. 2009; 93: 101.

Ganapathy, A., Sadeesh, T., Raghuram, K. Effect of Height, Weight and BMI on Foot Postures of Young Adult Individuals. Journal of Clinical and Diagnostic Research. 2018 Sep, Vol-12(9): AC06-AC08.

Vijayakumar, K., Senthil Kumar, S., Subramanian, R. A Study on the relationship between BMI and prevalence of flat foot among the adults using foot print parameters. Int. J. of Adv. Res. 2016; 4 (May): 1428-1431.

Rithanya, P., Babu, Y., Mohanraj, K. G. Assessment of flat foot by plantar arch index using footprint in aged population. Drug Invention Today. 2018; 10; 11.

Pita-Fernández, S., González-Martín, C., Seoane-Pillado, T., López-Calviño, B., Pértega-Díaz, S., Gil-Guillén V, et al., 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: 148-154.

Dunn, J. E., Link, C. L., Felson, D. T., Crincoli, M. G., Keysor, J. J., McKinlay, J. B., et al., Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol. 2004; 159: 491-498.

Nguyen, U. S., Hillstrom, H. J., Li, W., Dufour, A. B., Kiel, D. P., Procter-Gray, E., et al., Factors associated with hallux valgus in a population-based study of older women and men: The MOBILIZE Boston study. Osteoarthritis Cartilage 2010; 18: 41-46.

Redmond, A. C., Crane, Y. Z., Menz, H. B. Normative values for the foot posture index. Journal of Foot and Ankle Research. 2008; 1(6): 1-9.

Deshmandi, H., Rahnema, N., Mehdizadeh, R. Relationship between obesity and flatfoot in high school boys and girls. International Journal of Sports Science and Engineering. 2009; 3(1): 43-49.

Fuhrmann, R. A., Trommer, T., Venbrocks, R. A. The acquired buckling-flatfoot. A foot deformity due to obesity?. Orthopade. 2005; 34: 682-689.




How to Cite

Ramos A, Fernandes S, Pooja ., Panicker PJ, Krishnan P. Assessment of flat foot using plantar arch index in young adults. Biomedicine [Internet]. 2021 Oct. 29 [cited 2023 Jun. 10];41(3):535-8. Available from:



Original Research Articles

Plum Analytics 

Most read articles by the same author(s)