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Objective <p>This study investigated the prevalence of flat feet in South Indian school children and association of flat foot with age,&#xa0;gender and BMI&#xa0; and also&#xa0;compared three diagnostic methods: Staheli's plantar arch index, Chippaux-Smirak index, and Denis footprint grade&#xa0;for percentage agreement. </p> Materials and Methods <p> A total of 853 South Indian school children (378 males, 475 females) were studied to assess flat foot prevalence. Participants were divided into age groups: 5–8, 9–12, and 13–15 years. Flatfoot was evaluated using Staheli’s plantar arch index, Chippaux-Smirak index, and Denis footprint grade. BMI was calculated as weight divided by height squared. The study analyzed the association of flatfoot with age, gender, and BMI, and also examined the variability among the three diagnostic methods in identifying flat foot.</p> Results <p>The prevalence of flat foott varied by method: 9% (Staheli's&#xa0;arch index), 12.7% (Dennis&#xa0;foot print grade), and 18.8% (Chippaux-Smirak&#xa0;index). A significant relationship was found between flat foot and age (<i>p</i> &lt; 0.001), with higher prevalence in younger children. BMI was positively associated with flat foot (<i>p</i> &lt; 0.001), with overweight and obese children showing the highest prevalence. No significant gender-based differences were observed. Method concordance varied: Staheli's index showed 91% agreement with Dennis footprint grade and 98.7% with Chippaux-Smirak. Dennis&#xa0;foot print grade agreed 65% with Staheli's&#xa0;arch index and 100% with Chippaux-Smirak&#xa0;index. Chippaux-Smirak index had 47.5% concordance with Staheli's&#xa0;arch index and 67.5% with Dennis&#xa0;foot print grade.</p> Conclusion <p>The study concluded that flat feet prevalence in the&#xa0;school going&#xa0; population is at least 9%&#xa0;in South India. While there was variability in detection rates among the three methods, they consistently showed associations with age and BMI. The researchers recommend the Chippaux-Smirak index as the best screening tool among the three, despite its potential for over-diagnosis.</p> <p>Level of evidence :&#xa0;Cross sectional study level 4.</p>

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Prevalence of Flat Foot in South Indian School Going Children and Concordance between Stahelis Plantar Arch Index, Chippaux Smirak Index and Denis Foot Print Grade in Diagnosing Flat Foot

  • 期刊论文

  • 发表日期：

    2025年7月21日

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  • M. Lokesh,
  • P. Gopinath Menon,
  • TR. Ashok

摘要

Objective

This study investigated the prevalence of flat feet in South Indian school children and association of flat foot with age, gender and BMI  and also compared three diagnostic methods: Staheli's plantar arch index, Chippaux-Smirak index, and Denis footprint grade for percentage agreement.

Materials and Methods

A total of 853 South Indian school children (378 males, 475 females) were studied to assess flat foot prevalence. Participants were divided into age groups: 5–8, 9–12, and 13–15 years. Flatfoot was evaluated using Staheli’s plantar arch index, Chippaux-Smirak index, and Denis footprint grade. BMI was calculated as weight divided by height squared. The study analyzed the association of flatfoot with age, gender, and BMI, and also examined the variability among the three diagnostic methods in identifying flat foot.

Results

The prevalence of flat foott varied by method: 9% (Staheli's arch index), 12.7% (Dennis foot print grade), and 18.8% (Chippaux-Smirak index). A significant relationship was found between flat foot and age (p < 0.001), with higher prevalence in younger children. BMI was positively associated with flat foot (p < 0.001), with overweight and obese children showing the highest prevalence. No significant gender-based differences were observed. Method concordance varied: Staheli's index showed 91% agreement with Dennis footprint grade and 98.7% with Chippaux-Smirak. Dennis foot print grade agreed 65% with Staheli's arch index and 100% with Chippaux-Smirak index. Chippaux-Smirak index had 47.5% concordance with Staheli's arch index and 67.5% with Dennis foot print grade.

Conclusion

The study concluded that flat feet prevalence in the school going  population is at least 9% in South India. While there was variability in detection rates among the three methods, they consistently showed associations with age and BMI. The researchers recommend the Chippaux-Smirak index as the best screening tool among the three, despite its potential for over-diagnosis.

Level of evidence : Cross sectional study level 4.