Health-related quality of life in flatfeet

NewsBot · Nov 8, 2014

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Health-related quality of life in children with flexible flatfeet: a cross-sectional study.
Kothari A, Stebbins J, Zavatsky AB, Theologis T.
J Child Orthop. 2014 Nov 8

PURPOSE:
The effect of paediatric flexible flatfeet (PFF) on health-related quality of life (HRQOL) has not been investigated. In this prospective cross-sectional study, the HRQOL of children with PFF was compared to those with typically developing feet (TDF) using two validated measures. We hypothesised that reduced HRQOL would be observed in children with PFF. The reliability of parents' perceptions of their child's symptoms was also investigated.
METHODS:
48 children with PFF and 47 with TDF between the ages of 8 and 15 completed The Oxford Ankle Foot Questionnaire for Children (OxAFQ-C) and Pediatric Quality of Life Inventory (PedsQL™ 4.0). Proxy questionnaires were also completed. Reliability of parent and child questionnaire scores was assessed using the intraclass correlation coefficient (ICC) and Student's t test. Differences between HRQOL between PFF and TDF were assessed using the Student's t test.
RESULTS:
ICCs overall demonstrated good reliability between parent and child questionnaire domain scores. There was a tendency for parents to overestimate the impairment of the child in the PFF group. PFF children demonstrated clinically significant decreased HRQOL than TDF children. This was most marked in the physical domain scores.
CONCLUSION:
Although parents may overestimate their child's impairment, children with PFF still have significantly impaired HRQOL when compared to TDF children. The impairment can be as severe, or worse, than published HRQOL for acutely and chronically unwell children. As such, PFF cannot be regarded as just a benign normal variant. The management of PFF should involve consideration of the symptom profile and HRQOL.
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Admin2 · Jan 8, 2015

Related Threads:
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Diagnosis of flexible flatfoot in children: a systematic clinical approach
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Is It Unethical to Prescribe Orthoses for Children with Asymptomatic Flatfoot Deformity?

NewsBot · Jan 8, 2015

THE IMPACT OF FOOT ARCH HEIGHT ON QUALITY OF LIFE IN 6-12 YEAR OLDS
Daniel López López, Mª de los Ángeles Bouza Prego, Ana Requeijo Constenla, Jesús Luis Saleta Canosa, Adolfo Bautista Casasnovas, Francisco Alonso Tajes
Colombia Medica Vol 45, No 4 (2014)

Objective: To determine whether arch height has an effect on the health-related quality of life of schoolchildren.

Methods: One hundred and thirteen schoolchildren attended an out-patient centre where self-reported data were recorded, their feet were classified into one of three groups according to their arch index (high, normal or low) and the scores obtained from the Foot Health Status Questionnaire (FHSQ - Spanish version) were compared.

Results: The groups with high, low and normal arch recorded lower scores in Section One for the general foot health and footwear domains and higher scores in foot pain and foot function. In Section Two they obtained lower scores in general health and higher scores in physical activity, social capacity and vigour.

Conclusions: Comparison of the scores obtained reveals that arch height has a negative impact on quality of life. Given the limited extent of available evidence in respect of the aetiology and treatment of foot diseases and deformities, these findings reveal the need to implement programmes to promote foot health and carry out further research into this commonly occurring disabling condition.
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NewsBot · Mar 1, 2015

The relationship between quality of life and foot function in children with flexible flatfeet
A. Kothari, P.C. Dixon, J. Stebbins, A.B. Zavatsky, T. Theologis
Gait and Posture; Article in Press

Highlights
•We undertook gait analysis of children with flat and neutral foot postures.
•Kinematic angles were correlated with quality of life.
•Children with symptomatic flatfeet walked slower with reduced stride length.
•Children with flatfeet had increased hindfoot eversion and forefoot supination.
•Forefoot supination correlated the strongest with quality of life measures.
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Flat feet in children are common, and at times symptomatic, but the relationship between function and symptoms or impairment is still unclear. We undertook a prospective, observational study comparing children with paediatric flexible flat foot (PFF) and children with neutral feet (NF) using three dimensional gait analysis (3DGA). It was hypothesised that children with PFF would demonstrate differences in both spatio-temporal parameters of gait and foot and ankle kinematics compared to the NF group and that these differences would correlate with impaired quality of life (QoL). The kinematic differences were expected to be most marked in hindfoot coronal plane motion and forefoot sagittal and transverse plane motion. Eighty-three children between the ages of 8-15 were recruited in this study: Forty-two were classified as having PFF and forty-one as NF. Each child underwent 3DGA and completed the Oxford Ankle Foot Questionnaire for Children (OxAFQ_C). Reduced OxAFQ_C physical domain scores in the PFF children were associated with slower walking speed (p = 0.014) and reduced normalized stride length (p = 0.008). PFF children also demonstrated significantly increased hindfoot eversion and forefoot supination during gait. Significant differences between groups were not observed for other foot and ankle joint motions. Increased maximum hindfoot eversion and increased forefoot supination correlated strongly with lower QoL scores in PFF children. These data further our understanding of the functional characteristics that lead to impaired QoL in PFF children. These findings will help guide the surveillance and management of children with this ubiquitous condition.
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NewsBot · Jan 1, 2017

Utility Outcome Assessment of Pes Planus Deformity
Sultan Aldebeyan et at
Foot and Ankle Surgery; 30 December 2016

Highlights
•Participants were willing to sacrifice 3.6 years of life to attain perfect health.
•Participants would take a 12 percent mortality risk to correct the deformity.
•The perceived burden of flatfeet is comparable to other debilitating conditions.
•Logistic regression showed that age was inversely proportional to the TTO.
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Background
Despite being a common condition, there are no objective measures in the literature to reflect the burden of pes planus on affected individuals. Our primary objective was to evaluate this burden by recruiting a sample from the general population using validated utility outcome measures.

Methods
Participants were recruited online and filled a questionnaire to help measure the health burden of pes planus. Three recognized utility outcome scores were used to compare the health burden of monocular blindness, binocular blindness, and pes planus. These included the standard gamble (SG), time trade-off (TTO), and visual analogue score (VAS). Paired t test, independent t test, and linear regression were used for statistical analysis

Results
Ninety-two participants were included in the final analysis. The utility outcome scores (VAS, TTO, SG) for pes planus were 73 ± 17, 0.90 ± 0.08, and 0.88 ± 0.12, respectively. The linear regression analysis showed that age was inversely proportional to the time trade-off. However, race, educational level, and income were not significant predictors of utility outcome score for pes planus.

Conclusion
This study shows that the perceived burden of living with pes planus is comparable to living with some debilitating conditions. Our participants were willing to sacrifice 3.6 years of life, and have a procedure with a theoretical 12 percent mortality risk to attain perfect health.
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NewsBot · May 16, 2017

Flat Foot in a Random Population and its Impact on Quality of Life and Functionality.
PITA-FERNANDEZ, SALVADOR; GONZALEZ-MARTIN, CRISTINA; ALONSO-TAJES, FRANCISCO; SEOANE-PILLADO, TERESA; PERTEGA-DIAZ, SONIA; PEREZ-GARCIA, SERGIO; SEIJO-BESTILLEIRO, ROCIO; BALBOA-BARREIRO, VANESA
Journal of Clinical & Diagnostic Research . Apr2017, Vol. 11 Issue 4, p22-27. 6p.

Introduction: Flat foot is a common deformity in adults. It is characterized by medial rotation and plantar flexion of the talus, eversion of the calcaneus, collapsed medial arch and abduction of the forefoot. Aim: The aim of this study was to determine the prevalence of flat foot and its impact on quality of life, dependence, foot pain, disability and functional limitation among random population 40-year-old and above. Materials and Methods: A cross-sectional study in a random population sample from Cambre (A Coruña-Spain) (n=835) was performed (α =0.05; Precision=±3.4%). The diagnosis of flat foot was stablished by the study of the footprint obtained with a pedograph. Anthropometric variables were studied, Charlson's Comorbidity Index, function and state of foot (Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ)), quality of life (SF-36), and dependence for activities of daily living (Barthel and Lawton index). A logistic and lineal multiple regression analysis was performed Results: The prevalence of flat foot was 26.62%. Patients with flat foot were significantly older (65.73±11.04 vs 61.03±11.45-year-old), showed a higher comorbidity index (0.92±1.49 vs 0.50±0.98), had a greater BMI (31.45±5.55 vs 28.40±4.17) and greater foot size (25.16±1.66 vs 24.82±1.65). The presence of flat foot diminishes the quality of life, as measured by the FHSQ, and foot function, measured by the FFI. The presence of flat foot does not alter the physical and mental dimension of the SF-36 or the degree of dependence Conclusion: Flat foot was associated with age, Charlson's Comorbidity Index, BMI and foot size. The SF-36, Barthel and Lawton questionnaires remained unaltered by the presence of flat foot. The FHSQ and FFI questionnaires did prove to be sensitive to the presence of flat foot in a significant manner.
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NewsBot · Jun 3, 2017

Flat Foot in a Random Population and its Impact on Quality of Life and Functionality.
Pita-Fernandez S et al
J Clin Diagn Res. 2017 Apr;11(4):LC22-LC27. doi: 10.7860/JCDR/2017/24362.9697.

INTRODUCTION:
Flat foot is a common deformity in adults. It is characterized by medial rotation and plantar flexion of the talus, eversion of the calcaneus, collapsed medial arch and abduction of the forefoot.
AIM:
The aim of this study was to determine the prevalence of flat foot and its impact on quality of life, dependence, foot pain, disability and functional limitation among random population of 40-year-old and above.
MATERIALS AND METHODS:
A cross-sectional study in a random population sample from Cambre (A Coruña-Spain) (n=835) was performed (α =0.05; Precision=±3.4%). The diagnosis of flat foot was stablished by the study of the footprint obtained with a pedograph. Anthropometric variables were studied, Charlson's Comorbidity Index, function and state of foot (Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ)), quality of life (SF-36), and dependence for activities of daily living (Barthel and Lawton index). A logistic and linear multiple regression analysis was performed.
RESULTS:
The prevalence of flat foot was 26.62%. Patients with flat foot were significantly older (65.73±11.04 vs 61.03±11.45-year-old), showed a higher comorbidity index (0.92±1.49 vs 0.50±0.98), had a greater BMI (31.45±5.55 vs 28.40±4.17) and greater foot size (25.16±1.66 vs 24.82±1.65). The presence of flat foot diminishes the quality of life, as measured by the FHSQ, and foot function, measured by the FFI. The presence of flat foot does not alter the physical and mental dimension of the SF-36 or the degree of dependence.
CONCLUSION:
Flat foot was associated with age, Charlson's Comorbidity Index, BMI and foot size. The SF-36, Barthel and Lawton questionnaires remained unaltered by the presence of flat foot. The FHSQ and FFI questionnaires did prove to be sensitive to the presence of flat foot in a significant manner.
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NewsBot · Jul 27, 2018

Foot Arch Height and Quality of Life in Adults: A Strobe Observational Study.
López-López D et al
Int J Environ Res Public Health. 2018 Jul 23;15(7)

BACKGROUND:
Variations in the foot structure related with the high or low arch are identified common lower limb conditions, and it is supposed to be the effect on the quality of life (QoL) associated to foot health in adults. Here we aimed to determine the relationships between relatively high and low feet arches and QoL.

METHODS:
A cross-sectional study was carried out. Among 138 adults enrolled in the study, 66 had a high arch, 21 had a low arch, and 51 were within the normal range. Changes related to the foot structure were analyzed using Area Calc version 2.6 software, and data obtained using the Foot-Health-Status-Questionnaire (FHSQ), whose domains were compared between foot arch groups by means of the one-way analysis of variance (ANOVA).

RESULTS:
The results of the FHSQ comparison between the three groups within the sample population did not show any statistically significant difference (p > 0.05) for any domains of specific foot (pain, function, general health and footwear) and general (general health, physical activity, social function and vigor) health-related QoL.

CONCLUSIONS:
Specific foot and general health-related QoL did not seem to be influenced by the foot arch height between high, normal and low feet arches heights. Nevertheless, further studies with higher sample sizes and matched-paired groups should be carried out.
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NewsBot · Feb 23, 2020

Quality of Life in Adult Population with Flat Feet
Twinkle Dabholkar et al
International Journal of Health Sciences and Research Vol.10; Issue: 2; February 2020

Introduction: Flat foot is a common, yet neglected postural deformity. It is necessary to assess
implications of flat feet on quality of life in the physically active age group of 20- 40 years.
Aim: To determine the impact of flat foot on foot-related health and Quality of Life (QOL), among a
population of 20-40 year-old individuals with bilateral flexible flat feet.
Methodology: A cross-sectional study in a population sample of 100 individuals (43 males and 57
females), having bilateral flexible flat feet was performed. Subjects with an FPI score of +6 to +12
and a Navicular Drop Test result of 10mm or more were included. Participants completed the Revised
Foot Function Questionnaire (FFI-R) to quantify foot-related health and quality of life across 4
domains (pain and stiffness, difficulty, activity limitation, social issues). Statistical analysis dispersion
was then performed.
Results: This study reveals that mean total disability percentage (+/-SD) of 100 individuals suffering
from bilateral flexible flat feet and having mean (+/-SD) FPI score of 7.78 (+/-1.2) (right foot) and
7.79 (+/-1.2) (left foot), as measured by FFI-R scores, was 34% (+/-8.2). The total disability
percentage ranged from 21-65%. The pain and stiffness, activity limitation and social domains were
most affected with mean score percentages being 34%, 37% and 37% respectively.
Conclusion: The present study shows that quality of life as measured on the FFI-R is affected in
individuals with flat feet in the age group 20-40 years. The most reported affected domains were pain,
activity limitation and social domain. Participants with flat feet complained of foot pain, difficulty
walking on uneven ground, walking fast, running, maintaining balance, concern at the appearance of
their feet and difficulty in finding suitable footwear. Hence, these factors demand appropriate
intervention.
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NewsBot · Jan 29, 2021

Quality of Life in Young Adults after Flatfoot Surgery: A Case-Control Study
Nicolò Martinelli et al
J Clin Med. 2021 Jan 24;10(3):451

The true impact of surgery for flatfoot deformities on patient's quality of life and health status remains poorly defined. The aim of this study is to evaluate the quality of life and the return to daily tasks and sports or physical activities in young adults after surgical correction of flatfoot deformity. Patients treated for bilateral symptomatic flat foot deformity were retrospectively studied. The healthy control group comprised a matched reference population with no history of foot surgery or trauma that was voluntary recruited from the hospital community. All subjects were asked to fill out questionnaires centered on the assessment of the health-related quality of life (Short-form 36; SF-36) and physical activity (International Physical Activity Questionnaire; IPAQ). Most study group SF-36 subscales were lower when compared to the control group. Among the study group, post-operatively, 36.6% of patients managed to resume low levels of sports activity, 40% were sufficiently active and were able to perform moderate sports activity (an activity that requires moderate physical effort and which forces the patient to breathe with a frequency only moderately higher than normal), while 23.3% of them were active or very active and were able to perform intense physical activity. Most IPAQ scores were statistically different from the control group. The present study suggests that patients treated with medializing calcaneal osteotomy and navicular-cuneiform arthrodesis for symptomatic flafoot had lower levels of quality of life and physical activity when compared to healthy subjects. After surgery, patients showed a significant improvement in the clinical scores.
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NewsBot · Feb 2, 2023

Health related quality of life of children with flexible flatfoot
Žukauskas, Saidas;Čekanauskas, Emilis;Barauskas, Vidmantas
Source

Introduction Pediatric flexible flatfoot usually is described as a foot posture with deficiency or insufficiency of the longitudinal arch in the midfoot. The debate between treatment and observation of asymptomatic flexible flat feet is still on top. Aims and Objectives The aim of this study was to investigate the child and parent perceptions of health-related quality of life associated with flexible flatfeet. Materials and methods In the study 176 boys and 175 girls were enrolled in the study with pediatric flexible flatfeet and normal feet between the pre-school and school age completed the Pediatric Quality of Life Inventory (PedsQLTM 4.0). Proxy questionnaires were also completed. Objective parameters were also included and compared with life quality. Results Parents' assessment of the quality of life of children with asymptomatic mobile flatfoot is more higher than children. Reliability between patient and proxy questionnaires was assessed using the absolute agreement intraclass correlation coefficient and comparing mean absolute differences with a paired two-tailed t test as per recommendations. Questionnaire domain scores were compared between subject groups using an unpaired two-tailed Student’s t test. Pearson’s R was used to assess the correlation between PedsQLTM 4.0 domain scores. Alpha was set at 0.05 to define significance. Conclusions This suggests that a non-symptomatic mobile flatfoot is not always a reflection of a normal foot and that the child's health-related quality of life complaints should be considered more closely in the identification and development of a treatment
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NewsBot · Feb 3, 2023

Quality of life in flexible painful flatfoot treated by anterograde calcaneo-stop procedure: The patient's and family's perspective
Daniela Dibello et al
PLoS One. 2023 Feb 2;18(2):e0263763

Purpose: This study aimed to evaluate the quality of life and satisfaction about the surgical treatment in patients with symptomatic flexible flatfoot.

Methods: The Oxford Ankle Foot Questionnaire for children (one to fill in before the surgical correction and another 6-12 months after the screw's removal), the PedsQLTM Healthcare Satisfaction Generic Module and the PedsQLTM General Well-Being Scale were administered to all patients who underwent the anterograde calcaneo-stop procedure for flexible painful flatfoot between January 2012 and December 2015.

Results: One hundred forty patients were sent the questionnaires and 74 (40 male and 34 female) of them responded. The surgical correction was performed at a medium age of 11,84±1,65 years. When the Oxford Ankle Foot Questionnaire for children scores before surgical correction and after the screw removal were compared, the latter scored significantly higher for all domains. Healthcare satisfaction was good in all families. Most of the patients scored medium-high on the PedQLTM General Well-Being both when asked about themselves (mean 86,50±7,44) and in general about their health (76,06±12,32).

Conclusion: Our results confirmed that flexible painful flatfoot is significantly affecting the quality of life of children and that the anterograde calcaneo-stop procedure is a valuable technique, which improves their quality of life and the family wellbeing.
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NewsBot · May 15, 2023

Really Asymptomatic? Health-Related Quality of Life and Objective Clinical Foot Characteristics among 5–10-Year-Old Children with a Flexible FlatFoot
Saidas Žukauskas,Vidmantas Barauskas,Ramunė Degliūtė-Muller andEmilis Čekanauskas
J. Clin. Med. 2023, 12(9), 3331; https://doi.org/10.3390/jcm12093331

The potential effects of asymptomatic flexible flatfoot (FF) on children’s health-related quality of life (QoL) and objective clinical foot characteristics have been poorly investigated in the literature. Therefore, this study aimed to analyse these indicators, comparing the children with asymptomatic FF and a control group. Methods: In total, 351 children were enrolled in this cross-sectional study—160 children with asymptomatic FF and 191 controls (children with normal feet). The children and their parents completed the Paediatric Quality of Life Inventory (PedsQLTM 4.0). The objective foot characteristics included clinical foot posture measures, footprints, general hyperlaxity, and X-ray measurements. Results: Children with asymptomatic FF had a significantly lower QoL (overall and all four dimensions). The parents’ assessment of the QoL of their children with asymptomatic FF in most cases was lower compared to their children’s self-reported QoL. Moreover, almost all clinical foot measures also had significantly worse profiles among asymptomatic FF cases compared to the controls. This was observed with the Foot Posture Index-6 (FPI-6), the navicular drop (ND) test, the Chippaux–Smirak Index (CSI), Staheli’s Index (SI), the Beighton scale, and radiological angles (except the talo-first metatarsal angle). Conclusion: The findings suggest that asymptomatic FF not always reflects a normal foot development. This condition is related to decreased health-related quality of life, so the 5–10-year-old children’s and their parents’ complaints should be considered more closely in identification, treatment, and monitoring plans.
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NewsBot · Feb 16, 2024

Assessment of foot arch shape and health status of adult population from Eastern Slovakia
Jana Gaľová et al
Cent Eur J Public Health. 2023 Dec;31(Suppl 1):S26-S30

Background: The purpose of this study was to determine the foot arch shape and the associated health status in a selected sample of individuals belonging to the adult majority population of eastern Slovakia and to evaluate which of the observed factors are involved in the occurrence and development of foot arch abnormalities.

Methods: The weight and height of probands were measured according to standard anthropometric methods using a personal scale and an anthropometer. The BMI index was calculated for each proband from the measured data. A Pod4Foot Classic podoscope was used to obtain the plantograms. The Chippaux-Smirak index method was used to evaluate the plantograms. The study includes a questionnaire containing questions about factors affecting the foot arch shape.

Results: The arch of the right foot was supported by the effect of wearing shoes at home (p = 0.013). There was an association between wearing high-heeled shoes and foot arch disorder, both on the right (p = 0.011) and left (p = 0.045) foot. There was no significant relationship between the prevalence of overweight or obesity, between wearing orthopaedic insoles in shoes without a prescription, wearing orthopaedic footwear at home, between sport or static and active work and foot arch disorder in our study.

Conclusions: Most of the probands had a bilaterally normal arched foot, which is a positive result. Nowadays, there are a large number of orthopaedic devices on the market that help to shape the arch of the foot properly, but it is not correct to use these devices arbitrarily, without a doctor's prescription and a diagnosis of foot arch deviation.
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