Meta Analysis the Effect of Body Mass Index on the Flat Foot Incidence

Philipus Prihantiko Kurniagung, Dono Indarto, Setyo Sri Rahardjo


Background: Musculoskeletal disorders in the form of flat foot, back pain and knee pain are often found in people who are obese. Flat foot is a musculoletal disorder characterized by a decrease or decrease in the height of the medial arch as a parameter, especially those that can be observed and measured in height. This study aims to estimate the average size of the effect of BMI on the risk of flat foot.

Subjects and Method: Meta-analysis study and systematic reviews were applied to this study using the electronic database Pubmed, Science Direct, Google Scholar and Springer Link. Keywords to search for articles are as follows: "flat foot", "adult flat foot", "Flexible Flat Foot", "Body Mass Index", "Pediatric flat foot", "pes planus", "obesity", "overweight", "Ado­lescent flat foot". Articles were collected using PRISMA diagrams, and analyzed using the Review Manager 5.3 application.

Results: Meta-analysis of 4 cross-sectional articles of obese individuals (aOR= 3.10; 95% CI= 1.80 to 5.32 p= 0.001); Meta-analysis of 2 case-control articles, obese individuals (aOR= 5.49; 95% CI= 1.33 to 22.61; p= 0.07). Meta-analysis of 3 cohort articles of obese individuals (aOR= 1.64; 95% CI= 1.34 to 2.02; p<0.001); Obesity is a risk factor that can increase the incidence of flat foot.

Conclusion: Obesity is a risk factor that can increase the incidence of flat foot.

Keywords: Obesity, flat foot, risk factors

Correspondence: Philipus Prihantiko Kurniagung. Masters Pro­gram in Public Health. Universitas Sebe­las Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: pri­hantiko­ Mobile:089688103450.

Journal of Epidemiology and Public Health (2020), 05(03): 329-338


Full Text:



Abdel-Fattah MM, Hassanin MM, Felem-bane FA, Nassaane MT (2006). Flat foot among Saudi Arabian army re-cruits: prevalence and risk factors. East Mediterr Health J. 12(1-2):211-7.

Abich Y, Mihiret T, Yihunie Akalu, Gashaw M, Janakiraman B (2020). Flatfoot and associated factors among Ethio-pian school children aged 11 to 15 years: A school-based study. PLOS ONE, 15(8), doi: 10.1371/journal.po-ne.0238001.

Alghadir AH, Gabr SA, Rizk AA (2019). Plasmatic adipocyte biomarkers and foot pain associated with flatfoot in schoolchildren with obesity. Rev Assoc Med Bras, 65(8): 1061–1066. doi:10.1590/1806-9282.65.8.1061.

Asencio JMM, Medina-Alcántara MF, Or-tega-Avila AB, Jimenez-Cebrian AM, Moguer JP, Cervera-Marin JA, Gijon-Nogueron G (2019). Anthropometric and psychomotor development factors linked to foot valgus in children aged 6 to 9 years. J Am Podiatr Med

Assoc. 109(1): 30–35. doi:10.7547/16-108.

Butterworth PA, Landorf KB, Smith SE, Menz HB (2012). The association between bodymassindex and mus-culoskeletal foot disorders: a syste-matic review. Obes Rev. 13(7): 630–642.doi:10.1111/j.1467.

Brunnstrom’s clinical kinesiology. 6th Neu-mannDA. (2016). Kinesiology of the musculoskeletal system: foundations for rehabilitation. 3rd ed. St. Louis (MO): Mosby.

Chang Y, Hung W, Wu H, Chiu Y, Hsu H (2010). Measurements of foot arch in standing, level walking, vertical jump and sprint start. Int Journal of Sport and Exercise Science, (2)2, 31-38.

Chen KC, Yeh CJ, Tung L, Yang JF, Yang SF, Wang CH (2010). Relevant factors influencing flatfoot in preschool-aged children. Eur. J Pediatr. 170(7): 931–936. doi:10.1007/s00431-010-1380-7

Dare DM, Dodwell ER (2014). Pediatric flatfoot. Curr Opin Pediatr, 26(1): 93–100. doi: 10.1097/mop.0000000000-000039.

EzemaCI, AbaraoguUO, Okafor GO (2014). Flat foot and associated factors among primary school children: A cross-sectional study. Hong Kong Physiother J, 32(1), 13–20. doi:10.10-16/j.hkpj.2013.05.001.

Fernandez SP, Martin CG, Tajes FA, Pilla-do, TS, Diaz SP, Garcia SP, Bestilleiro RS, Barreiro VB (2017). Flat foot in a random population and its impact on quality of life and functionality.J clin diagn res. 11(4): doi:10.7860/jcdr/20-17/24362.9697.

Houglum PA, Bertoti DB (2012). Brun-nstrom’s clinical kinesiology. 6th ed. Philadelphia (PA): The F.A Davis Co

Machluf Y, Fink D, Farkash R, Rotkopf R, Pirogovsky A, Tal O, Chaiter Y (2016). Adolescent BMI at Northern Israel. Medicine. 95(12). doi:10.1097/md.00-00000000003022.

Maggio AB, Martin XE, Saunders Gasser C, Gal-Duding C, Beghetti M, Farpour-Lambert NJ, Chamay-Weber C (2014). Medical and non-medical complications among children and adolescents with excessive body weight. BMC Pediatrics, 14(1). doi:10.-1186/1471-2431-14-232.

Park SY, Bang HS, Park DJ (2018). Poten-tial for foot dysfunction and plantar fasciitis according to the shape of the foot arch in young adults. J Exerc Rehabil, 14(3), 497–502. doi:10.1296-5/jer.1836172.086.

Park SY, Park DJ (2019). Comparison of foot structure, function, plantar pres-sure and balance ability according to the body mass index of young adults. Osong Public Health Res Perspect, 10(2): 102–107. doi: 10.24171/j.phrp.-2019.10.2.09

Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M (2006). Prevalence of Flat Foot in Preschool-Aged Children. Pediatrics, 118(2): 634–639.doi:10.1542/peds.-2005-2126.

Pourghasem M, Kamali N, Farsi M, Soltan-pour N (2016). Prevalence of flat foot among school students and its rela-tionship with BMI. Acta Orthop Trau-matol Turc, 50(5): 554–557. doi:10.-1016/j.aott.2016. 03.002

Sadeghi-Demneh E, Melvin JMA, Mickle K (2018). Prevalence of pathological flatfoot in school-age children. JFoot. (37), 38–44.doi:10.1016/j.foot.2018.-05.002.

Shibuya N, Kitterman RT, LaFontaine J, Jupiter DC (2014). Demographic, physical, and radiographic factors associated with functional flatfoot deformity. J Foot Ankle Surg. 53(2): 168–72.

Shree S, Revathi S, Thiyagarajan A, Kumar D (2018). Does Obesity Cause Flat Foot?. Obes Ther 2(1).

Tenenbaum S, Hershkovich O,Gordon B, Bruck N, Thein R, Derazne E, Afek A (2013). Flexible pes planus in adoles-cents. Foot Ankle Int, 34(6): 811–817. doi:10.1177/1071100712472327.

Vergara AE, Serrano SRF, Correa PJR, Molano AC, Guevara OA (2012). Pre-valence of flatfoot in school between 3 and 10 years. Study of two different populations geographically and so-cially. Colomb Med. 141–146. doi:10-.25100/cm.v43i2.785.

Witari NPD, Cahyawati PN, Lestarini A, (2018). Prevalence flatfoot in primary school, IOP Conf Ser Mater Scieng. doi:10.1088/1757899x/434/1/434.


  • There are currently no refbacks.