Lee C-R, Kim M-K, Cho MS: The relationship between balance and foot pressure in fatigue of the plantar intrinsic foot muscles of adults with flexible flatfoot. J Phys Ther Sci 24: 699, 2012.
Pinney SJ, Lin SS: Current concept review: acquired adult flatfoot deformity. Foot Ankle Int 27: 66, 2006.
Lee J-E, Park G-H, Lee Y-S, et al: A comparison of muscle activities in the lower extremity between flat and normal feet during one-leg standing. J Phys Ther Sci 25: 1059, 2013.
Levinger P, Murley GS, Barton CJ, et al: A comparison of foot kinematics in people with normal-and flat-arched feet using the Oxford Foot Model. Gait Posture 32: 519, 2010.
Meehan RE, Brage M: Adult acquired flat foot deformity: clinical and radiographic examination. Foot Ankle Clin 8: 431, 2003.
Pedowitz WJ, Kovatis P: Flatfoot in the adult. J Am Acad Orthop Surg 3: 293, 1995.
Pinto RZ, Souza TR, Trede RG, et al: Bilateral and unilateral increases in calcaneal eversion affect pelvic alignment in standing position. Man Ther 13: 513, 2008.
Gurney B: Leg length discrepancy. Gait Posture 15: 195, 2002.
Khamis S, Yizhar Z: Effect of feet hyperpronation on pelvic alignment in a standing position. Gait Posture 25: 127, 2007.
Genova JM, Gross MT: Effect of foot orthotics on calcaneal eversion during standing and treadmill walking for subjects with abnormal pronation. J Orthop Sports Phys Ther 30: 664, 2000.
Poussa MS, Heliövaara MM, Seitsamo JT, et al: Development of spinal posture in a cohort of children from the age of 11 to 22 years. Eur Spine J 14: 738, 2005.
Ghasemi MS, Koohpayehzadeh J, Kadkhodaei H, et al: The effect of foot hyperpronation on spine alignment in standing position. Med J Islam Repub Iran 30: 466, 2016.
Dubousset J: Pelvic obliquity: a review. Orthopedics 14: 479, 1991.
Winter RB, Pinto WC: Pelvic obliquity: its causes and its treatment. Spine 11: 225, 1986.
Sherman RA, Karstetter KW, May H, et al: Prevention of lower limb pain in soldiers using shock-absorbing orthotic inserts. JAPMA 86: 117, 1996.
Osebold WR, Mayfield JK, Winter RB, et al: Surgical treatment of paralytic scoliosis associated with myelomeningocele. J Bone Joint Surg Am 64: 841, 1982.
Lovell WW, Winter RB, Morrissy RT, et al: Lovell and Winter's Pediatric Orthopaedics, Vol 1, Lippincott Williams & Wilkins, Philadelphia, 2006.
James J: Scoliosis, Vol 1A, Churchill Livingstone, Medford, MA, 1976.
Van Goethem J, Van Campenhout A, van den Hauwe L, et al: Scoliosis. Neuroimaging Clin N Am 17: 105, 2007.
Donzelli S, Poma S, Balzarini L, et al: State of the art of current 3-D scoliosis classifications: a systematic review from a clinical perspective. J Neuroeng Rehabil 12: 91, 2015.
Legaye J, Duval-Beaupere G, Hecquet J, et al: Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7: 99, 1998.
Abdel-Raoof N, Kamel D, Tantawy S: Influence of second-degree flatfoot on spinal and pelvic mechanics in young females. Int J Ther Rehabil 20: 428, 2013.
Eldesoky MT, Abutaleb EE: Influence of bilateral and unilateral flatfoot on pelvic alignment. World Acad Sci Eng Technol Int J Med Health Sci 9: 641, 2015.
Janssen MM, Drevelle X, Humbert L, et al: Differences in male and female spino-pelvic alignment in asymptomatic young adults: a three-dimensional analysis using upright low-dose digital biplanar X-rays. Spine 34: E826, 2009.
Duval K, Lam T, Sanderson D: The mechanical relationship between the rearfoot, pelvis and low-back. Gait Posture 32: 637, 2010.
Betsch M, Schneppendahl J, Dor L, et al: Influence of foot positions on the spine and pelvis. Arthritis Care Res (Hoboken) 63: 1758, 2011.
Levine D, Whittle M: The effects of pelvic movement on lumbar lordosis in the standing position. J Orthop Sports Phys Ther 24: 130, 1996.
Background: This cross-sectional retrospective study aimed to present the influence of unilateral and bilateral flatfoot on coronal spinopelvic alignment in asymptomatic young healthy males.
Methods: This study was performed by examining the medical reports of individuals who applied to the National Health Board to work in positions requiring physical fitness between January 1, 2018, and January 1, 2019. Plain radiographs of the feet, pelvis, and spine were analyzed. The calcaneal pitch angle for flatfoot, pelvic obliquity, and the Cobb angle for spinal asymmetry were measured. After all of the analyses were completed, participants were divided into two groups—unilateral or bilateral flatfoot, depending on the calcaneal pitch angle measurements—and compared.
Results: There was no significant difference in age between groups (P = .609). The unilateral flatfoot group showed higher values in terms of body mass index, with a significant difference (P = .01). The curve patterns were identified as single thoracic, lumbar, and double. Post-hoc analyses suggest that young males without spinal asymmetry were more likely to have unilateral flatfoot (P < .008). There were significant differences between groups in pelvic obliquity and Cobb angle (P < .05). The effect size was found to be small to medium for pelvic obliquity and medium to large for Cobb angle.
Conclusions: Young males with bilaterally increased foot pronation demonstrate more increased pelvic obliquity and spinal curvature.