Stopy płaskie – Rokowania, prognozy i postęp choroby

Stopy płaskie
Rokowania, prognozy i postęp choroby

Pes planus, charakteryzujący się utratą przyśrodkowego łuku podłużnego stopy, występuje z częstością około 26,62% w populacji. Rokowanie zależy od typu deformacji (wrodzona vs nabyta), wieku, współistniejących schorzeń oraz zastosowanego leczenia. Większość przypadków jest bezobjawowa i nie wymaga interwencji, zwłaszcza u dzieci, u których łuki stóp rozwijają się do około 10 roku życia. Jednak u pacjentów z objawowymi stopami płaskimi obserwuje się obniżoną funkcjonalność stopy (mierzoną Foot Function Index) oraz gorsze wyniki w specyficznych domenach jakości życia (Foot Health Status Questionnaire), mimo braku istotnych różnic w ogólnej jakości życia (SF-36) i niezależności funkcjonalnej (Barthel, Lawton). Czynniki ryzyka niezależnie związane z obecnością pes planus to BMI (OR=1,137), wiek (OR=1,029), rozmiar stopy (OR=1,287) oraz choroby współistniejące (OR=1,217).

Prognozy dla pacjentów ze stopami płaskimi

Rokowanie w stopach płaskich bezobjawowych
Wpływ stóp płaskich na jakość życia i funkcjonalność
Czynniki prognostyczne w stopach płaskich
Progresja i powikłania nieleczonych stóp płaskich
Sytuacje wymagające szczególnej uwagi prognostycznej

Diagnostyka i jej wpływ na rokowanie
Leczenie i jego wpływ na rokowanie

Leczenie zachowawcze
Leczenie operacyjne

Zalecenia dotyczące monitorowania i profilaktyki
Podsumowanie rokowania

Kolejne rozdziały

Prognozy dla pacjentów ze stopami płaskimi

Stopy płaskie (pes planus) to stosunkowo częsta deformacja stopy, charakteryzująca się utratą przyśrodkowego łuku podłużnego, powodującą kontakt lub prawie kontakt całej podeszwy stopy z podłożem. Według badań, częstość występowania stóp płaskich w populacji wynosi około 26,62%. Rokowanie w przypadku stóp płaskich zależy od wielu czynników, w tym typu deformacji (wrodzona lub nabyta), wieku pacjenta, współistniejących dolegliwości oraz zastosowanego leczenia.¹²

Rokowanie w stopach płaskich bezobjawowych

Większość przypadków stóp płaskich przebiega bezobjawowo i nie powoduje żadnych problemów. Pacjenci z bezobjawowymi stopami płaskimi zazwyczaj nie wymagają leczenia i mogą prowadzić normalne życie bez ograniczeń funkcjonalnych. U dzieci płaskostopie jest często zjawiskiem fizjologicznym, a łuki stóp zwykle rozwijają się do około 10 roku życia. Jednak w niektórych przypadkach łuki mogą się nie wykształcić, co z czasem może prowadzić do dyskomfortu.³⁴⁵

Wpływ stóp płaskich na jakość życia i funkcjonalność

Badania pokazują, że obecność stóp płaskich może negatywnie wpływać na jakość życia i funkcjonalność stopy. Pacjenci ze stopami płaskimi uzyskują znacząco niższe wyniki w różnych domenach jakości życia mierzonych kwestionariuszem Foot Health Status Questionnaire (FHSQ) w porównaniu z osobami bez tej deformacji. Również funkcjonalność stopy, mierzona za pomocą Foot Function Index (FFI), jest obniżona u osób ze stopami płaskimi. Efekt ten utrzymuje się po skorygowaniu wyników ze względu na wiek, płeć i choroby współistniejące.⁶⁷⁸

Interesujące jest, że kwestionariusze ogólnej jakości życia (SF-36) oraz skale oceniające niezależność funkcjonalną (Barthel i Lawton) nie wykazały istotnych różnic między osobami ze stopami płaskimi a grupą kontrolną. Sugeruje to, że wpływ stóp płaskich na ogólną jakość życia może być mniej znaczący niż ich wpływ na specyficzne aspekty zdrowia stóp.⁹¹⁰

Czynniki prognostyczne w stopach płaskich

Analiza wieloczynnikowej regresji logistycznej wykazała, że następujące zmienne mają niezależny wpływ związany z obecnością stóp płaskich:¹¹

BMI (OR=1,137) – wyższy wskaźnik masy ciała wiąże się z większym ryzykiem wystąpienia stóp płaskich
Wiek (OR=1,029) – wraz z wiekiem wzrasta prawdopodobieństwo wystąpienia stóp płaskich
Średni rozmiar stopy (OR=1,287) – większy rozmiar stopy koreluje z wyższym ryzykiem płaskostopia
Choroby współistniejące (OR=1,217) – obecność chorób współistniejących zwiększa ryzyko stóp płaskich

Progresja i powikłania nieleczonych stóp płaskich

Stopy płaskie mogą ulec pogorszeniu, z utratą łuku podłużnego, prowadząc do zapadnięcia się śródstopia. W miarę postępu deformacji, elastyczna stopa może stać się sztywna i/lub bolesna, co może powodować znaczne trudności z chodzeniem. W takich przypadkach może być konieczne leczenie operacyjne.¹²

Nieleczone stopy płaskie mogą prowadzić do poważniejszych problemów, choć nie występują one u 100% pacjentów. Jeśli napięcie więzadeł, ścięgien, stawów i łuku stopy nie jest leczone, kości mogą zacząć się zapadać. Może to prowadzić do:¹³

Powstawania ostrogi piętowej
Bólu kostki i kolana
Bólu dolnej części pleców i bioder
Rozwoju zmian zwyrodnieniowych stawów

Niektórzy autorzy sugerują, że nadmierna pronacja stopy związana ze stopami płaskimi może przyczyniać się do rozwoju takich problemów jak:¹⁴

Dysfunkcja ścięgna mięśnia piszczelowego tylnego
Paluch koślawy (hallux valgus)
Metatarsalgia
Zapalenie powięzi podeszwowej
Bóle kolana

Należy jednak podkreślić, że rola stóp płaskich w rozwoju tych problemów nie została definitywnie udowodniona.¹⁵

Sytuacje wymagające szczególnej uwagi prognostycznej

Istnieją pewne stany kliniczne, w których bez leczenia istnieje wysokie prawdopodobieństwo pogorszenia stanu stóp płaskich:¹⁶

Neuropatia
Dysfunkcja mięśnia piszczelowego tylnego
Mózgowe porażenie dziecięce

W tych przypadkach wczesna interwencja terapeutyczna może zapobiec progresji deformacji i związanym z nią powikłaniom.¹⁷

Diagnostyka i jej wpływ na rokowanie

Odpowiednia diagnostyka stóp płaskich ma kluczowe znaczenie dla ustalenia właściwego rokowania. W literaturze naukowej nie istnieją jednak uniwersalne kryteria diagnostyczne płaskostopia u dzieci, a dane psychometryczne dotyczące stosowanych miar są ograniczone.¹⁸

Tylko trzy metody oceny elastycznych stóp płaskich mają opublikowane dane potwierdzające ich trafność i rzetelność w populacji pediatrycznej:¹⁹

Wskaźnik Chippaux-Smirak
Wskaźnik łuku Staheliego
Wskaźnik pozycji stopy (FPI-6)

Badania pokazują, że podografia (paedobarografia) może być czułym i specyficznym narzędziem w diagnostyce stóp płaskich. W porównaniu z grupą kontrolną, pacjenci z objawowymi elastycznymi stopami płaskimi mają znacznie wyższe ciśnienia w śródstopiu, szczególnie w przyśrodkowej części śródstopia. Podografia ma potencjał, by uczynić badanie radiologiczne zbędnym w niektórych przypadkach.²⁰

Dokładna i wiarygodna diagnostyka płaskostopia, odpowiednia dla populacji pediatrycznej, jest niezbędna, aby:²¹

Poinformować klinicystę, kiedy postawa stopy nie jest zgodna z oczekiwanym rozwojem
Umożliwić prowadzenie badań naukowych, które są odpowiednie i klinicznie zastosowalne

Leczenie i jego wpływ na rokowanie

Leczenie stóp płaskich jest zazwyczaj konieczne tylko wtedy, gdy stan jest nowy, bolesny lub postępujący, lub gdy występuje stała deformacja lub inny powiązany problem.²²

Leczenie zachowawcze

Większość przypadków stóp płaskich nie wymaga leczenia, jeśli nie powodują bólu. Nieinwazyjne metody leczenia mogą być zalecane przez lekarza, jeśli płaskostopie powoduje ból stopy lub inne problemy.²³²⁴

Leczenie operacyjne

Operacja może być opcją dla pacjentów, u których ból nadal ogranicza aktywność pomimo zastosowania leczenia zachowawczego. Zabieg operacyjny może naprawić problemy z kośćmi i ścięgnami, które powodują ból. Niektóre schorzenia, takie jak koalicja stępu, mogą wymagać operacji w celu skorygowania deformacji, aby stopa pozostała elastyczna.²⁵²⁶

Operacja często poprawia ból i funkcję stopy u osób, które jej potrzebują, co przekłada się na lepsze rokowanie długoterminowe.²⁷

Zalecenia dotyczące monitorowania i profilaktyki

Ważne jest, aby poważnie traktować objawy związane ze stopami płaskimi. Niektóre typy i przyczyny płaskostopia są poważniejsze i mogą powodować dalsze problemy, jeśli nie zostaną leczone. Zaleca się konsultację z ortopedą lub podiatrą w przypadku wystąpienia objawów.²⁸

Stopy płaskie nie mogą same ustąpić, dlatego ignorowanie tego stanu nie jest zalecane. Nawet jeśli jest to schorzenie, które nie jest poważne, może być kontrolowane dzięki odpowiedniemu leczeniu. Jeśli pacjenci zaczynają odczuwać ból w kończynach dolnych i identyfikują się z wymienionymi objawami, zaleca się kontakt ze specjalistą w celu omówienia najlepszych opcji leczenia.²⁹

Podsumowanie rokowania

Rokowanie w przypadku stóp płaskich jest zazwyczaj dobre, szczególnie w przypadkach bezobjawowych. Liczne badania wskazują jednak, że obecność stóp płaskich może wpływać na jakość życia związaną ze zdrowiem stóp oraz funkcjonalność. Czynniki takie jak BMI, wiek, rozmiar stopy i choroby współistniejące mogą wpływać na rokowanie.³⁰³¹

W przypadkach objawowych stóp płaskich, odpowiednie leczenie – zarówno zachowawcze, jak i operacyjne – może znacząco poprawić jakość życia pacjentów. Szczególną uwagę należy zwrócić na pacjentów z neuropatią, dysfunkcją mięśnia piszczelowego tylnego i mózgowym porażeniem dziecięcym, u których rokowanie bez leczenia może być gorsze.³²³³

Podsumowując, stopy płaskie, mimo że często bezobjawowe, mogą wpływać na jakość życia i funkcjonowanie pacjentów. Wczesna diagnostyka, właściwe monitorowanie i odpowiednie leczenie są kluczowe dla zapewnienia optymalnego rokowania.³⁴³⁵

Kolejne rozdziały

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Materiały źródłowe

#1 Pes Planus (Flat Foot) | Causes, Symptoms and Treatment
https://patient.info/doctor/pes-planus-flat-feet
Pes planus (commonly referred to as 'flat feet’) is a relatively common foot deformity and is defined by the loss of the medial longitudinal arch of the foot where it contacts or nearly contacts the ground. […] Pes planus may be lifelong, or acquired through time, inflammation or other musculoskeletal problems. […] Pes planus treatment is generally only needed if the condition is new, painful or progressing, or when there is a fixed deformity or other associated problem. […] Pes planus can deteriorate, with loss of the longitudinal arch, leading to collapse of the midfoot. […] With deterioration, a flexible foot can become rigid and/or painful. This can cause significant difficulties with walking and may require surgery. […] It is generally accepted that physiological pes planus is unlikely to cause significant foot problems.
#2 Quality of Life and Functionality in Patients with Flatfoot | IntechOpen
https://www.intechopen.com/chapters/60494
The prevalence of flat feet was 26.62%. […] Having flat feet decreases the quality of life and function of the foot. […] The presence of flat foot has also been associated with the presence of different states of health, the presence of pain, and the fatigue in women. […] This study shows that the quality of life and functionality in patients with flatfoot is lower than in those who do not, and that this effect is maintained after adjusting for age, sex and comorbidity using the FHSQ and FFI questionnaires. […] The questionnaires SF-36, Barthel and Lawton were not altered with the presence of flat feet, while the questionnaires FHSQ and FFI were sensitive to the presence of flat feet.
#3 Flat Feet (Pes Planus): Types, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/flat-feet-pes-planus
Can you live normally with flat feet? Yes. Many people with flat feet dont have noticeable symptoms or need treatment. Your healthcare provider may recommend nonsurgical treatments if pes planus causes foot pain or other problems. […] Flat feet are common and often no cause for concern. Children with flat feet usually develop arches by about age 10. But sometimes they dont, and their flat feet may start to cause them discomfort in time. […] It’s important to take your symptoms seriously. Some types and causes of flat feet are more severe, and they can cause further problems if left untreated. Consult an orthopedist or podiatrist if you have symptoms.
#4 Flat feet Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/flat-feet
Most cases of flat feet are painless and do not cause any problems. They will not need treatment. […] Some causes of painful flat feet can be treated without surgery. If other treatments do not work, surgery may be needed to relieve pain in some cases. Some conditions such as tarsal coalition may need surgery to correct the deformity so the foot stays flexible. […] Surgery often improves pain and foot function for people who need it.
#5 Flatfeet – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/flatfeet/diagnosis-treatment/drc-20372609
No treatment is necessary for flatfeet if it doesn’t cause pain. […] Surgery may be an option when patients have pain that still limits their activities after they have tried nonsurgical treatments. Surgery can repair the bone and tendon problems that are causing the pain.
#6 Flat Foot in a Random Population and its Impact on Quality of Life and Functionality
https://pmc.ncbi.nlm.nih.gov/articles/PMC5449819/
The prevalence of flat foot was 26.62%. […] The presence of flat foot diminishes the quality of life, as measured by the FHSQ, and foot function, measured by the FFI. […] Flat foot was associated with age, Charlsons 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. […] After conducting a multivariate logistic regression analysis, the following variables were observed to have an independent effect associated with the presence of flat foot: BMI (OR=1.137), age (OR=1.029), mean foot size (OR=1.287) and comorbidity (OR=1.217). […] The scores for the different questionnaires used to measure foot function; quality of life and dependence, according to the presence or absence of flat foot in the entire sample were studied, and stratified by sex.
#7 Flat Foot in a Random Population and its Impact on Quality of Life and Functionality
https://pmc.ncbi.nlm.nih.gov/articles/PMC5449819/
Patients suffering from flat foot have significantly lower scores in the different quality of life domains in the FHSQ than non-sufferers. […] The presence of flat foot is in turn close to being significant and has a positive regression coefficient, which would seem to imply that the presence of flat foot increases the score in the FFI and hence it reduces functionality. […] This study shows that quality of life and foot function in patients with flat foot is lower that in those who do not suffer from the disorder, and that said effect remains after adjusting for age, sex and comorbidity using the FHSQ and FFI questionnaires.
#8 Quality of Life and Functionality in Patients with Flatfoot | IntechOpen
https://www.intechopen.com/chapters/60494
The prevalence of flat feet was 26.62%. […] Having flat feet decreases the quality of life and function of the foot. […] The presence of flat foot has also been associated with the presence of different states of health, the presence of pain, and the fatigue in women. […] This study shows that the quality of life and functionality in patients with flatfoot is lower than in those who do not, and that this effect is maintained after adjusting for age, sex and comorbidity using the FHSQ and FFI questionnaires. […] The questionnaires SF-36, Barthel and Lawton were not altered with the presence of flat feet, while the questionnaires FHSQ and FFI were sensitive to the presence of flat feet.
#9 Flat Foot in a Random Population and its Impact on Quality of Life and Functionality
https://pmc.ncbi.nlm.nih.gov/articles/PMC5449819/
The prevalence of flat foot was 26.62%. […] The presence of flat foot diminishes the quality of life, as measured by the FHSQ, and foot function, measured by the FFI. […] Flat foot was associated with age, Charlsons 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. […] After conducting a multivariate logistic regression analysis, the following variables were observed to have an independent effect associated with the presence of flat foot: BMI (OR=1.137), age (OR=1.029), mean foot size (OR=1.287) and comorbidity (OR=1.217). […] The scores for the different questionnaires used to measure foot function; quality of life and dependence, according to the presence or absence of flat foot in the entire sample were studied, and stratified by sex.
#10 Quality of Life and Functionality in Patients with Flatfoot | IntechOpen
https://www.intechopen.com/chapters/60494
The prevalence of flat feet was 26.62%. […] Having flat feet decreases the quality of life and function of the foot. […] The presence of flat foot has also been associated with the presence of different states of health, the presence of pain, and the fatigue in women. […] This study shows that the quality of life and functionality in patients with flatfoot is lower than in those who do not, and that this effect is maintained after adjusting for age, sex and comorbidity using the FHSQ and FFI questionnaires. […] The questionnaires SF-36, Barthel and Lawton were not altered with the presence of flat feet, while the questionnaires FHSQ and FFI were sensitive to the presence of flat feet.
#11 Flat Foot in a Random Population and its Impact on Quality of Life and Functionality
https://pmc.ncbi.nlm.nih.gov/articles/PMC5449819/
The prevalence of flat foot was 26.62%. […] The presence of flat foot diminishes the quality of life, as measured by the FHSQ, and foot function, measured by the FFI. […] Flat foot was associated with age, Charlsons 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. […] After conducting a multivariate logistic regression analysis, the following variables were observed to have an independent effect associated with the presence of flat foot: BMI (OR=1.137), age (OR=1.029), mean foot size (OR=1.287) and comorbidity (OR=1.217). […] The scores for the different questionnaires used to measure foot function; quality of life and dependence, according to the presence or absence of flat foot in the entire sample were studied, and stratified by sex.
#12 Pes Planus (Flat Foot) | Causes, Symptoms and Treatment
https://patient.info/doctor/pes-planus-flat-feet
Pes planus (commonly referred to as 'flat feet’) is a relatively common foot deformity and is defined by the loss of the medial longitudinal arch of the foot where it contacts or nearly contacts the ground. […] Pes planus may be lifelong, or acquired through time, inflammation or other musculoskeletal problems. […] Pes planus treatment is generally only needed if the condition is new, painful or progressing, or when there is a fixed deformity or other associated problem. […] Pes planus can deteriorate, with loss of the longitudinal arch, leading to collapse of the midfoot. […] With deterioration, a flexible foot can become rigid and/or painful. This can cause significant difficulties with walking and may require surgery. […] It is generally accepted that physiological pes planus is unlikely to cause significant foot problems.
#13 Flat Feet: Are your patients at risk for more health problems?
https://www.linkedin.com/pulse/flat-feet-your-patients-risk-more-health-problems-abraham-dpm/
Flat feet can lead to more serious problems, but it is not 100% it will occur to every patient. Ignoring flat feet is also something I recommend not doing. This condition cannot go away on its own. […] If the strain on the ligaments, tendons, joints, and arch of your foot are not treated then the bones start to collapse. This leads to heel spurs, ankle and knee pain, lower back and hip pain, and can possibly develop arthritis. […] Having flat feet is not a serious condition and can be maintained with treatment. If your patients start to experience pain in the lower extremities and identifies with the symptoms above then contact Suzanne Abraham to discuss the best treatment options and work together to get your patients the best outcome!
#14 Pes Planus (Flat Foot) | Causes, Symptoms and Treatment
https://patient.info/doctor/pes-planus-flat-feet
However, some authors suggest that excessive foot pronation may contribute to the development of foot pain and foot problems such as tibialis posterior dysfunction, hallux valgus, metatarsalgia, plantar fasciitis, and knee pain. […] The role of pes planus in these problems has not been proved. […] Situations where deterioration is likely without treatment include neuropathy, tibialis posterior dysfunction, and cerebral palsy.
#15 Pes Planus (Flat Foot) | Causes, Symptoms and Treatment
https://patient.info/doctor/pes-planus-flat-feet
However, some authors suggest that excessive foot pronation may contribute to the development of foot pain and foot problems such as tibialis posterior dysfunction, hallux valgus, metatarsalgia, plantar fasciitis, and knee pain. […] The role of pes planus in these problems has not been proved. […] Situations where deterioration is likely without treatment include neuropathy, tibialis posterior dysfunction, and cerebral palsy.
#16 Pes Planus (Flat Foot) | Causes, Symptoms and Treatment
https://patient.info/doctor/pes-planus-flat-feet
However, some authors suggest that excessive foot pronation may contribute to the development of foot pain and foot problems such as tibialis posterior dysfunction, hallux valgus, metatarsalgia, plantar fasciitis, and knee pain. […] The role of pes planus in these problems has not been proved. […] Situations where deterioration is likely without treatment include neuropathy, tibialis posterior dysfunction, and cerebral palsy.
#17 Pes Planus (Flat Foot) | Causes, Symptoms and Treatment
https://patient.info/doctor/pes-planus-flat-feet
However, some authors suggest that excessive foot pronation may contribute to the development of foot pain and foot problems such as tibialis posterior dysfunction, hallux valgus, metatarsalgia, plantar fasciitis, and knee pain. […] The role of pes planus in these problems has not been proved. […] Situations where deterioration is likely without treatment include neuropathy, tibialis posterior dysfunction, and cerebral palsy.
#18 Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC5975578/
Flexible flat foot is a normal observation in typically developing children, however, some children with flat feet present with pain and impaired lower limb function. […] The outcomes of this review indicate that the FPI 6, Staheli arch index or Chippaux-Smirak index should be the preferred method of paediatric foot posture measurement in future research. […] No universally accepted criteria for diagnosing paediatric flat foot was found within existing literature, and psychometric data for foot posture measures and definitions used was limited. […] Within the limits of this review, only three measures of flexible flat foot had any published data to support validity and reliability of the measure within a paediatric population (Chippaux-Smirak index, Staheli arch index and FPI-6), each with their own limitations.
#19 Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC5975578/
Flexible flat foot is a normal observation in typically developing children, however, some children with flat feet present with pain and impaired lower limb function. […] The outcomes of this review indicate that the FPI 6, Staheli arch index or Chippaux-Smirak index should be the preferred method of paediatric foot posture measurement in future research. […] No universally accepted criteria for diagnosing paediatric flat foot was found within existing literature, and psychometric data for foot posture measures and definitions used was limited. […] Within the limits of this review, only three measures of flexible flat foot had any published data to support validity and reliability of the measure within a paediatric population (Chippaux-Smirak index, Staheli arch index and FPI-6), each with their own limitations.
#20
https://journals.lww.com/international-journal-of-surgery/fulltext/2012/10000/outcome_measures_in_flat_foot__analysis_of.282.aspx
Aim: To compare the paedobarographic findings of normal feet to flat feet and investigate if there are sensitive paedobarographic markers that can be used in diagnosing flat feet. […] The flat feet group had significantly higher MMF, LMF, TMF and MMFR (P 0.001 Mann-Whitney). LMF had the highest sensitivity and NPV (94%) whereas MMF, TMF and MMFR had the highest specificity and PPV (100%). […] Compared to our control group, patients with symptomatic flexible flat feet had significantly higher pressures in the midfoot, in particular in the medial midfoot. Paedobarography appears to be a sensitive and specific tool in diagnosing flat feet and has the potential to make radiological examination unnecessary.
#21 Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC5975578/
The definitions of flat foot for the Chippaux-Smirak index within this review did decrease linearly with age: 62.7% in 3 to 6 year olds, to 40% in 9 to 16 year olds. […] However, the definitions of flat foot for the Staheli arch index did not decrease as expected (e.g. 1.07 in 3 to 6 year olds and 1.28 in 6 to 9 year olds). […] It is essential this is addressed in future research. Valid and reliable diagnoses of flat foot appropriate to the paediatric population is required to i) inform the clinician when the foot posture is not in keeping with expected development, and ii) allow research to be appropriate and clinically applicable.
#22 Pes Planus (Flat Foot) | Causes, Symptoms and Treatment
https://patient.info/doctor/pes-planus-flat-feet
Pes planus (commonly referred to as 'flat feet’) is a relatively common foot deformity and is defined by the loss of the medial longitudinal arch of the foot where it contacts or nearly contacts the ground. […] Pes planus may be lifelong, or acquired through time, inflammation or other musculoskeletal problems. […] Pes planus treatment is generally only needed if the condition is new, painful or progressing, or when there is a fixed deformity or other associated problem. […] Pes planus can deteriorate, with loss of the longitudinal arch, leading to collapse of the midfoot. […] With deterioration, a flexible foot can become rigid and/or painful. This can cause significant difficulties with walking and may require surgery. […] It is generally accepted that physiological pes planus is unlikely to cause significant foot problems.
#23 Flat Feet (Pes Planus): Types, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/flat-feet-pes-planus
Can you live normally with flat feet? Yes. Many people with flat feet dont have noticeable symptoms or need treatment. Your healthcare provider may recommend nonsurgical treatments if pes planus causes foot pain or other problems. […] Flat feet are common and often no cause for concern. Children with flat feet usually develop arches by about age 10. But sometimes they dont, and their flat feet may start to cause them discomfort in time. […] It’s important to take your symptoms seriously. Some types and causes of flat feet are more severe, and they can cause further problems if left untreated. Consult an orthopedist or podiatrist if you have symptoms.
#24 Flatfeet – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/flatfeet/diagnosis-treatment/drc-20372609
No treatment is necessary for flatfeet if it doesn’t cause pain. […] Surgery may be an option when patients have pain that still limits their activities after they have tried nonsurgical treatments. Surgery can repair the bone and tendon problems that are causing the pain.
#25 Flatfeet – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/flatfeet/diagnosis-treatment/drc-20372609
No treatment is necessary for flatfeet if it doesn’t cause pain. […] Surgery may be an option when patients have pain that still limits their activities after they have tried nonsurgical treatments. Surgery can repair the bone and tendon problems that are causing the pain.
#26 Flat feet Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/flat-feet
Most cases of flat feet are painless and do not cause any problems. They will not need treatment. […] Some causes of painful flat feet can be treated without surgery. If other treatments do not work, surgery may be needed to relieve pain in some cases. Some conditions such as tarsal coalition may need surgery to correct the deformity so the foot stays flexible. […] Surgery often improves pain and foot function for people who need it.
#27 Flat feet Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/flat-feet
Most cases of flat feet are painless and do not cause any problems. They will not need treatment. […] Some causes of painful flat feet can be treated without surgery. If other treatments do not work, surgery may be needed to relieve pain in some cases. Some conditions such as tarsal coalition may need surgery to correct the deformity so the foot stays flexible. […] Surgery often improves pain and foot function for people who need it.
#28 Flat Feet (Pes Planus): Types, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/flat-feet-pes-planus
Can you live normally with flat feet? Yes. Many people with flat feet dont have noticeable symptoms or need treatment. Your healthcare provider may recommend nonsurgical treatments if pes planus causes foot pain or other problems. […] Flat feet are common and often no cause for concern. Children with flat feet usually develop arches by about age 10. But sometimes they dont, and their flat feet may start to cause them discomfort in time. […] It’s important to take your symptoms seriously. Some types and causes of flat feet are more severe, and they can cause further problems if left untreated. Consult an orthopedist or podiatrist if you have symptoms.
#29 Flat Feet: Are your patients at risk for more health problems?
https://www.linkedin.com/pulse/flat-feet-your-patients-risk-more-health-problems-abraham-dpm/
Flat feet can lead to more serious problems, but it is not 100% it will occur to every patient. Ignoring flat feet is also something I recommend not doing. This condition cannot go away on its own. […] If the strain on the ligaments, tendons, joints, and arch of your foot are not treated then the bones start to collapse. This leads to heel spurs, ankle and knee pain, lower back and hip pain, and can possibly develop arthritis. […] Having flat feet is not a serious condition and can be maintained with treatment. If your patients start to experience pain in the lower extremities and identifies with the symptoms above then contact Suzanne Abraham to discuss the best treatment options and work together to get your patients the best outcome!
#30 Flat Foot in a Random Population and its Impact on Quality of Life and Functionality
https://pmc.ncbi.nlm.nih.gov/articles/PMC5449819/
The prevalence of flat foot was 26.62%. […] The presence of flat foot diminishes the quality of life, as measured by the FHSQ, and foot function, measured by the FFI. […] Flat foot was associated with age, Charlsons 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. […] After conducting a multivariate logistic regression analysis, the following variables were observed to have an independent effect associated with the presence of flat foot: BMI (OR=1.137), age (OR=1.029), mean foot size (OR=1.287) and comorbidity (OR=1.217). […] The scores for the different questionnaires used to measure foot function; quality of life and dependence, according to the presence or absence of flat foot in the entire sample were studied, and stratified by sex.
#31 Quality of Life and Functionality in Patients with Flatfoot | IntechOpen
https://www.intechopen.com/chapters/60494
The prevalence of flat feet was 26.62%. […] Having flat feet decreases the quality of life and function of the foot. […] The presence of flat foot has also been associated with the presence of different states of health, the presence of pain, and the fatigue in women. […] This study shows that the quality of life and functionality in patients with flatfoot is lower than in those who do not, and that this effect is maintained after adjusting for age, sex and comorbidity using the FHSQ and FFI questionnaires. […] The questionnaires SF-36, Barthel and Lawton were not altered with the presence of flat feet, while the questionnaires FHSQ and FFI were sensitive to the presence of flat feet.
#32 Pes Planus (Flat Foot) | Causes, Symptoms and Treatment
https://patient.info/doctor/pes-planus-flat-feet
However, some authors suggest that excessive foot pronation may contribute to the development of foot pain and foot problems such as tibialis posterior dysfunction, hallux valgus, metatarsalgia, plantar fasciitis, and knee pain. […] The role of pes planus in these problems has not been proved. […] Situations where deterioration is likely without treatment include neuropathy, tibialis posterior dysfunction, and cerebral palsy.
#33 Flat feet Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/flat-feet
Most cases of flat feet are painless and do not cause any problems. They will not need treatment. […] Some causes of painful flat feet can be treated without surgery. If other treatments do not work, surgery may be needed to relieve pain in some cases. Some conditions such as tarsal coalition may need surgery to correct the deformity so the foot stays flexible. […] Surgery often improves pain and foot function for people who need it.
#34 Flat Foot in a Random Population and its Impact on Quality of Life and Functionality
https://pmc.ncbi.nlm.nih.gov/articles/PMC5449819/
Patients suffering from flat foot have significantly lower scores in the different quality of life domains in the FHSQ than non-sufferers. […] The presence of flat foot is in turn close to being significant and has a positive regression coefficient, which would seem to imply that the presence of flat foot increases the score in the FFI and hence it reduces functionality. […] This study shows that quality of life and foot function in patients with flat foot is lower that in those who do not suffer from the disorder, and that said effect remains after adjusting for age, sex and comorbidity using the FHSQ and FFI questionnaires.
#35 Quality of Life and Functionality in Patients with Flatfoot | IntechOpen
https://www.intechopen.com/chapters/60494
The prevalence of flat feet was 26.62%. […] Having flat feet decreases the quality of life and function of the foot. […] The presence of flat foot has also been associated with the presence of different states of health, the presence of pain, and the fatigue in women. […] This study shows that the quality of life and functionality in patients with flatfoot is lower than in those who do not, and that this effect is maintained after adjusting for age, sex and comorbidity using the FHSQ and FFI questionnaires. […] The questionnaires SF-36, Barthel and Lawton were not altered with the presence of flat feet, while the questionnaires FHSQ and FFI were sensitive to the presence of flat feet.