The Prevalence and Associated Factors of Pes Planus Among Albanian Secondary School Students: A Cross-Sectional Study

Pes planus (flat feet) is a common postural condition among children and adolescents, characterised by a collapsed medial longitudinal arch. Its aetiology is multifactorial, and persistence beyond childhood may lead to long-term musculoskeletal complications.

This study aimed to determine the prevalence of pes planus among secondary school students in Tirana, Albania, and assess possible associations with gender, age, body mass index (BMI), height, weight, and spinal deformities such as scoliosis.

A cross-sectional study was conducted between January and May 2024 in nine public schools in Tirana. A total of 2020 students aged 10-15 years participated. Assessment tools included the Navicular Drop Test, longitudinal ankle angle, Trendelenburg test, Adams test, and measurements with a scoliometer for scoliosis. BMI percentiles were classified according to the World Health Organization growth charts for individuals aged 5-19 years. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20 (Released 2015; IBM Corp., Armonk, New York, United States), with significance set at p < 0.05.

Pes planus was identified in 474 students (204 female students and 270 male students), representing 23.46% of the participants. Male students showed a significantly higher prevalence at 26.16% (n = 270) compared to female students, who had a prevalence of 20.65% (n = 204) (χ²(1) = 8.544, DF = 1, φ = 0.065, p = 0.0035). Male students also had greater odds of having pes planus compared to female students (OR: 1.36, 95% CI: 1.01-1.68, p = 0.003). No statistically significant association was found between pes planus and BMI, body height, scoliosis, or participation in physical activity. The prevalence of pes planus was higher in older age groups, reaching a peak at 13 years, with 26.78% (n = 109), and at 14-15 years, with 25.58% (n = 76).

Pes planus is prevalent among Albanian adolescents, particularly in the male population. Early screening during school years is advisable to prevent potential long-term complications. No significant correlations were found between pes planus and weight, height, or the presence of scoliosis.