Prevalence of Flatfoot in School-Going Children, Lahore

Abstract

Background: Flatfoot is characterized by a reduced medial longitudinal arch height and can be flexible or fixed, congenital, or acquired. It can influence physical activity and mood in children, and its prevalence varies widely among different populations. Objective: To determine the prevalence of flatfoot among school-going children aged 7-15 years in Lahore, Pakistan, and to assess its distribution across different age groups and genders. Methods: A cross-sectional study was conducted over six months at Dar-e-Arqam School, Westwood campus, Lahore. The sample size of 106 was calculated using the formula { n = Z^2 P(1-P) / d^2 } with a 16% expected prevalence, 7% precision, and Z value of 1.96. Non-probability sampling was used. Inclusion criteria were children aged 7-15 years of both genders, excluding those with fractures, congenital deformities, or a history of ankle sprain. Footprints were obtained using ink-impregnated pads, and the Chippaux-Smirak index (CSI) was used to diagnose and grade flatfoot. Data were analyzed using SPSS version 25, with descriptive statistics presented as frequencies and percentages. Results: The prevalence of flatfoot among the children was 40.6%, with 4 cases of unilateral flatfoot (3.8%) and 39 cases of bilateral flatfoot (36.7%). Normal arches were found in 62 children (58.5%), and 1 child (0.9%) had a high arch. Among those with flatfoot, 17 had grade 1 flatfoot (16.0%), 12 had grade 2 flatfoot (11.3%), and 14 had grade 3 flatfoot (13.2%). The highest prevalence of flatfoot was observed in the 7-9 years age group (23 cases), while the 13-15 years group had the highest number of normal arches (29 cases). There was no significant difference in the prevalence of flatfoot between genders. Conclusion: Flatfoot is relatively common among children in Lahore, with a prevalence of 40.6%. The condition's prevalence decreases with age, and no significant gender differences were observed. Further research should include a larger sample size, random sampling, and assessment of symptomatic aspects to enhance understanding.