Occurrence of adult acquired flat foot among diabetic patients in Rawalpindi and Islamabad: a cross-sectional descriptive study
Year 2023,
, 266 - 271, 30.12.2023
Ateeqa Younis
,
Madiha Ashfaq
Faiza Waheed
Onaisa Farooq
Aliya Ashraf
Laiba Ghayour
Haniya Iqbal
Annam Saba
Abstract
Human foot is a biological masterpiece, which is strong enough to support the body weight and flexible enough to adjust to various surfaces. Foot postural deviation can alter the alignment of the entire body. The collapse of the medial longitudinal arch of the foot causes one of the most prevalent deformities i.e. flat foot. Diabetic patients are more prone to have flat foot due to degeneration of posterior tibial tendon over the course of their disease. The aim of this study was to determine the occurrence of adult acquired flat foot and assess the disability of flat foot among diabetic population in Rawalpindi and Islamabad, Pakistan. In this cross-sectional descriptive study, 384 diabetic patients aged 35-60 year were enrolled after obtaining informed consent. Non-probability convenience sampling technique was employed. The data was gathered by performing navicular drop test to determine the presence of flat foot, assessment of posterior tibial tendon dysfunction through single heel rise test and by using foot function index questionnaire to assess pain, disability and activity limitation. Based on results of the study, posterior tibial tendon dysfunction was observed to cause the appearance of low navicular height leading to flat foot in 58.33% of the population. Moreover, there is a moderate tendency of occurrence of flat foot among diabetic population in the absence of other risk factors such as hypertension, obesity, steroids use and previous foot trauma etc. With regard to the functionality measured by foot function index, it was implied that the functional status of the patient was reduced because of the pain, disability and activity restriction in the presence of flat foot.
Ethical Statement
The manuscript has not been published and is not under consideration for publication in any other journal. Instructions to the author were read. We accept all conditions and publication rights. All authors have approved the manuscript and its submission to the journal. We have no conflict to declare. We have no funding resources to declare.
Project Number
FUCP/932-9/DPTF1809
References
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- Ozdinc, S. A., & Turan, F. N. (2016). Effects of ballet training of children in Turkey on foot anthropometric measurements and medial longitudinal arc development. J Pak Med Assoc, 66(7), 869-874.
- Pita-Fernandez, S., Gonzalez-Martin, C., Alonso-Tajes, F., Seoane-Pillado, T., Pertega-Diaz, S., Perez-Garcia, S., Seijo-Bestilleiro, R., & Balboa-Barreiro, V. (2017). Flat foot in a random population and its impact on quality of life and functionality. J Clin Diagn Res, 11(4), LC22-LC27.
- Rungprai, C., & Maneeprasopchoke, P. (2021). A Clinical Approach to Diagnose Flatfoot Deformity. J Foot Ankle Surg, 8, 48-54.
- Sierevelt, I., Zwiers, R., Schats, W., Haverkamp, D., Terwee, C., Nolte, P., & Kerkhoffs, G. (2018). Measurement properties of the most commonly used Foot-and Ankle-Specific Questionnaires: the FFI, FAOS and FAAM. a systematic review. Knee Surg Sports Traumatol Arthrosc, 26, 2059-2073.
- Sung, P. S. (2018). The Sensitivity of Thresholds by Ground Reaction Force and Postural Stability in Subjects With and Without Navicular Drop. J Foot Ankle Surg, 57(4), 742-746.
- Taddei, U. T., Matias, A. B., Ribeiro, F. I., Inoue, R. S., Bus, S. A., & Sacco, I. C. (2018). Effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: Feasibility study for a randomized controlled trial. Phys Ther Sport, 34, 216-226.
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- Watanabe, K., Kitaoka, H. B., Fujii, T., Crevoisier, X., Berglund, L. J., Zhao, K. D., Kaufman, K. R., & An, K.-N. (2013). Posterior tibial tendon dysfunction and flatfoot: analysis with simulated walking. Gait Posture, 37(2), 264-268.
Year 2023,
, 266 - 271, 30.12.2023
Ateeqa Younis
,
Madiha Ashfaq
Faiza Waheed
Onaisa Farooq
Aliya Ashraf
Laiba Ghayour
Haniya Iqbal
Annam Saba
Project Number
FUCP/932-9/DPTF1809
References
- Adeniyi, A., Aiyegbusi, O., Ogwumike, O., Adejumo, P., & Fasanmade, A. (2015). Habitual physical activity, peripheral neuropathy, foot deformities and lower limb function: characterising prevalence and interlinks in patients with type 2 diabetes mellitus. Journal of Endocrinology, Metabolism and Diabetes in South Africa, 20(2), 101-107.
- Adhikari, U., Arulsingh, W., Pai, G., & Raj, J. O. (2014). Normative values of navicular drop test and the effect of demographic parameters-A cross sectional study. Annals of Biological Research, 5(7), 40-48.
- Aenumulapalli, A., Kulkarni, M. M., & Gandotra, A. R. (2017). Prevalence of flexible flat foot in adults: a cross-sectional study. J Clin Diagn Res, 11(6), AC17–AC20.
- Akhtar, S., Nasir, J. A., Abbas, T., & Sarwar, A. (2019). Diabetes in Pakistan: A systematic review and meta-analysis. Pak J Med Sci, 35(4), 1173.
- Durrant, B., Chockalingam, N., Richards, P. J., & Morriss-Roberts, C. (2015). Posterior Tibial Tendon Dysfunction: What does the single heel raise test mean in assessment? Foot Ankle Int, 8(2), 6.
- Erol, K., Karahan, A. Y., Kerimoğlu, Ü., Ordahan, B., Tekin, L., Şahin, M., & Kaydok, E. (2015). An important cause of pes planus: the posterior tibial tendon dysfunction. Clinics and Practice, 5(1), 699.
- Flores, D. V., Mejía Gómez, C., Fernández Hernando, M., Davis, M. A., & Pathria, M. N. (2019). Adult acquired flatfoot deformity: anatomy, biomechanics, staging, and imaging findings. Radiographics, 39(5), 1437-1460.
- Godoy-Santos, A. L., Schmidt, E. L., & Chaparro, F. (2021). What are the updates on epidemiology of progressive collapsing foot deformity? Foot Ankle Clin 26(3), 407-415.
- Gonzalez-Martin, C., Pertega-Diaz, S., Seoane-Pillado, T., Balboa-Barreiro, V., Soto-Gonzalez, A., & Veiga-Seijo, R. (2019). Structural, dermal and ungual characteristics of the foot in patients with type II diabetes. Medicina, 55(10), 639.
- Herchenröder, M., Wilfling, D., & Steinhäuser, J. (2021). Evidence for foot orthoses for adults with flatfoot: a systematic review. J Foot Ankle Surg, 14, 1-11.
- Knapp, P. W., & Constant, D. (2022). Posterior Tibial Tendon Dysfunction. StatPearls Publishing, Treasure Island (FL).
- Ozdinc, S. A., & Turan, F. N. (2016). Effects of ballet training of children in Turkey on foot anthropometric measurements and medial longitudinal arc development. J Pak Med Assoc, 66(7), 869-874.
- Pita-Fernandez, S., Gonzalez-Martin, C., Alonso-Tajes, F., Seoane-Pillado, T., Pertega-Diaz, S., Perez-Garcia, S., Seijo-Bestilleiro, R., & Balboa-Barreiro, V. (2017). Flat foot in a random population and its impact on quality of life and functionality. J Clin Diagn Res, 11(4), LC22-LC27.
- Rungprai, C., & Maneeprasopchoke, P. (2021). A Clinical Approach to Diagnose Flatfoot Deformity. J Foot Ankle Surg, 8, 48-54.
- Sierevelt, I., Zwiers, R., Schats, W., Haverkamp, D., Terwee, C., Nolte, P., & Kerkhoffs, G. (2018). Measurement properties of the most commonly used Foot-and Ankle-Specific Questionnaires: the FFI, FAOS and FAAM. a systematic review. Knee Surg Sports Traumatol Arthrosc, 26, 2059-2073.
- Sung, P. S. (2018). The Sensitivity of Thresholds by Ground Reaction Force and Postural Stability in Subjects With and Without Navicular Drop. J Foot Ankle Surg, 57(4), 742-746.
- Taddei, U. T., Matias, A. B., Ribeiro, F. I., Inoue, R. S., Bus, S. A., & Sacco, I. C. (2018). Effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: Feasibility study for a randomized controlled trial. Phys Ther Sport, 34, 216-226.
- Toullec, E. (2015). Adult flatfoot. Orthop Traumatol: Surg Res, 101(1), S11-S17.
- Watanabe, K., Kitaoka, H. B., Fujii, T., Crevoisier, X., Berglund, L. J., Zhao, K. D., Kaufman, K. R., & An, K.-N. (2013). Posterior tibial tendon dysfunction and flatfoot: analysis with simulated walking. Gait Posture, 37(2), 264-268.