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Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic flatfeet using
Matthias Hösl1, Harald Böhm, Christel Multerer
1Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229 Aschau i. Chiemgau, Germany.
Gait & Posture
|June 26, 2013
Summary
Flexible flatfeet, whether symptomatic (SFF) or asymptomatic (ASFF), show similar foot kinematic alterations. However, ASFF may face increased risk of anterior shank muscle fatigue due to altered ankle joint kinetics during gait.
Area of Science:
- Orthopaedics
- Biomechanics
- Podiatry
Background:
- Flexible flatfeet are common in paediatric and juvenile populations.
- The functional implications of asymptomatic flexible flatfeet (ASFF) compared to symptomatic flexible flatfeet (SFF) remain debated.
Purpose of the Study:
- To compare foot function during walking in children with symptomatic flexible flatfeet (SFF) and asymptomatic flexible flatfeet (ASFF).
- To identify kinematic and kinetic differences between SFF, ASFF, and typically developing feet (TDF).
Main Methods:
- 3D multi-segment foot kinematics and ankle joint kinetics were captured during barefoot gait analysis.
- Participants included 14 SFF, 21 ASFF, and 11 TDF.
- Clinical examination assessed passive dorsiflexion restrictions.
Main Results:
- Both SFF and ASFF exhibited pronounced foot kinematic alterations compared to TDF, including reduced hindfoot dorsiflexion and increased forefoot supination/abduction.
- No significant kinematic differences were observed between SFF and ASFF.
- SFF showed impaired propulsion (lack of positive ankle joint energy), while ASFF absorbed more negative ankle joint energy during loading response.
Conclusions:
- Despite lacking symptoms, ASFF demonstrates altered foot function during gait.
- Symptom development in flexible flatfeet may relate to tissue wear and individual pain thresholds rather than kinematic severity.
- ASFF may be at higher risk for anterior shank muscle fatigue and overuse syndromes.
