Comparison of travel distance of center of pressure using the footscan system in individuals with and without flatfoot.

Abstract

Background: Diagnosis and treatment of flatfoot are often overlooked. Current diagnostic methods, such as lateral foot radiography and physical examination, primarily assess simple static foot conditions. The Footscan test can be employed to evaluate the static and dynamic balance of patients with flatfoot; however, the precise reference value for various Footscan test results remains undetermined.

Objective: This study aimed to contribute to the body of knowledge regarding flatfoot diagnosis by identifying objective differences between patients with and without flatfoot.

Methods: This study focused on individuals aged 19-50 years without ankle injuries or surgeries that could affect balance. The Footscan system was used to evaluate static balance using the total travel distance (TD) of the center of pressure in the standing position for 10 s. For dynamic balance indices, the sole was divided into forefoot, midfoot, and hindfoot zones by the system, and the contact distribution of each zone was quantified as a percentage during a 1-min walking period. Statistical analysis was performed to compare the normal and flatfoot groups, leading to the determination of cutoff values for clinically significant indices.

Results: The study included 116 feet of 58 healthy individuals and 56 feet of 28 patients with flatfoot. Significant differences were found between the two groups for all static and dynamic balance variables. Logistic regression analysis identified TD (p = 0.001) and midfoot contact distribution (p < 0.001) as significant risk factors of flatfoot. Receiver operating characteristic analysis determined the cut-off values with the highest sum of sensitivity and specificity for diagnosis: TD ≥ 20.5 mm and midfoot contact distribution ≥ 18.95%.

Conclusions: The Footscan test indices showed significant differences in static and dynamic balance between patients with flatfoot and normal individuals. TD and midfoot contact distribution emerged as meaningful indicators of diagnostic potential.