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Gait Alterations in Flatfoot Compared to Healthy Controls: A Systematic Review and Meta-Analysis
Yoon-Chung Sophie Kim1,2, Albert T Anastasio1,3, Grayson M Talaski1
1Department of Orthopaedic Surgery, Duke University, Durham, NC 27710, USA.
Journal of Clinical Medicine
|May 13, 2026
Summary
Flatfoot deformity alters gait, leading to longer stance duration and shorter stride length in individuals compared to healthy controls. These changes highlight potential markers for impaired biomechanics.
Area of Science:
- Biomechanics
- Orthopedics
- Gait Analysis
Background:
- Flatfoot deformity is linked to abnormal lower extremity biomechanics and functional limitations during walking.
- Existing research on spatio-temporal gait alterations in flatfoot is inconsistent.
- A comprehensive synthesis of gait changes in flatfoot is needed.
Purpose of the Study:
- To systematically review and synthesize spatio-temporal gait alterations in individuals with flatfoot.
- To quantitatively evaluate key gait parameters in flatfoot populations.
Main Methods:
- Systematic review following PRISMA guidelines.
- Searched MEDLINE (PubMed) and Scopus databases.
- Included studies comparing flatfoot and healthy controls on spatio-temporal gait parameters.
- Performed random-effects meta-analyses on gait velocity, stance duration, stride length, and cadence.
Main Results:
- Fifteen studies were included; five contributed to meta-analysis.
- Individuals with flatfoot exhibited significantly longer stance duration and shorter stride length compared to controls.
- No significant differences were found in gait velocity or cadence.
- High heterogeneity (I² > 80%) was observed across outcomes.
Conclusions:
- Flatfoot is associated with consistent spatio-temporal gait adaptations, including increased stance duration and decreased stride length.
- These gait changes may indicate altered mechanics and functional impairment.
- Standardized protocols are necessary for future gait analysis research in flatfoot.
