Assessment of Planter Arch Index and Prevalence of Flat Feet Among Students of Gregory University Uturu
CHAPTER ONE
OBJECTIVE OF THE STUDY
- To find out what people know about the arches of the foot.
- To determine the prevalence of pes planus among students of Gregory university Uturu.
- To determine the prevalence of pes cavus among students of Gregory university Uturu.
- To know the lower limb disorders that affect pes planus.
CHAPTER TWO
RELATED LITERATURE
Pes planus or flat feet is a postural deformity relating to the collapse or flattening of the medial longitudinal arch. It can also be referred to as hyperpronation or overpronation. Pes planus results in the midfoot region pronating towards the ground, and in some cases touching the ground completely. Although there are varying degrees of collapse, people are still able to live completely pain-free with flat feet.Flat feet progress slowly as the feet’s exposure to weight-bearing activities increases. The two most common progressions from flat feet are foot deformities and bony stress injuries.
Flat Feet leads to conditions such as:
Tibialis Posterior Tendinopathy
Medial Tibial Stress Syndrome
Achilles Tendinopathy
Patellofemoral Pain Syndrome
Causes of flat feet
This condition can be congenital (e.g. from birth) or acquired (e.g. adults, increased exposure to weight-bearing).
Congenital flatfeet occurs when a child is born with or predisposed to having a more flexible midfoot region resulting in pronation or collapsing of the arch.
Acquired flatfeet is caused by a loss of active (e.g. intrinsic foot and ankle stabilizers) or passive support (ligamentous laxity, hypermobile joints) during dynamic weight-bearing activities. Muscular insufficiency in the ankle and arch stabilizers are the most common etiological factor for flat feet. Research suggests the tibialis posterior muscle is the most integral in stabilizing the medial longitudinal arch, via its insertion into the bony roof of the arch. When the arch stabilizers are performing sub-optimally, when weight and force are applied down through the foot, the arch slowly pronates and flattens towards the ground.
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
In this chapter, we would describe how the study was carried out.
Research design
Research design is a detailed outline of how an investigation took place. It entails how data is collected, the data collection tools used and the mode of analyzing data collected (Cooper & Schindler (2006). This study used a descriptive research design. Gill and Johnson (2002) state that a descriptive design looks at particular characteristics of a specific population of subjects, at a particular point in time or at different times for comparative purposes. The choice of a survey design for this study was deemed appropriate as Mugenda and Mugenda (2003) attest that it enables the researcher to determine the nature of prevailing conditions without manipulating the subjects.
Further, the survey method was useful in describing the characteristics of a large population and no other method of observation can provide this general capability. On the other hand, since the time duration to complete the research project was limited, the survey method was a cost effective way to gather information from a large group of people within a short time. The survey design made feasible very large samples and thus making the results statistically significant even when analyzing multiple variables. It allowed for many questions to be asked about a given topic giving considerable flexibility to the analysis. Usually, high reliability is easy to obtain by presenting all subjects with a standardized stimulus; observer subjectivity is greatly eliminated. Cooper and Schindler (2006) assert that the results of a survey can be easily generalized to the entire population.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
Results
Table 1 reveals the descriptive result of male and female students with left and right normal feet. The male was as follows; width of central foot (right= 4.677 ± 0.61cm, left = 4.759 ± 0.672cm), width of rear foot (right= 5.569 ± 0.62, left = 5.576 ± 0.529) and planter arch index as (right, 0.846 ± 0.11cm, left, 0.857 ± 0.123) and the female presented
thus; The right and left feet are 4.707 ± 0.74cm and 4.870 ± 0.730cm respectively; and the right and left rear feet measure 5.598 ± 0.67cm and 5.606 ± 0.654cm respectively. The planter arch index of the right and left feet are recorded as 0.839 ± 0.91cm and 0.845 ± 0.144cm respectively
CHAPTER FIVE
DISCUSSION OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS
Discussions Of Findings
The medial longitudinal arch and the bony configurations of the foot indeed constitute the floppy shape of the foot, which play a role in shock absorption, support, and transmission of body weight in stance and dynamic positions. Absence of the medial longitudinal arch leads to flat foot, and could be due to a variety of factors which may be physiological or pathological(Krupa et al., 2015).
The present study is an Assessment of planter arch index and prevalence of flat feet among students of Gregory university uturu, Abia State, Nigeria. The mean values of normal Planter Arch Indexes (PAI) recorded among the male students were 0.85 ± 0.11 and 0.80 ± 0.10 for the right and left feet respectively while the female students was 0.84 ± 0.90 and 0.85 ± 0.10 for the right and left feet respectively. On the , the male right and left mean PAI were 0.84 ± 0.90 and 0.84 ± 0.08 respectively; while on the female farmers, the mean PAI was 0.80 ±0.14 on the right and 0.84 ± 0.11 on the left. These values are similar to those reported by Krupa et al. (2015), who reported the range of normal planter arch index as 0.72 to 0.73. This is also in line with the report of Pranati et al. (2017) who recorded the average normal PAI value of right foot among teens of age 14 to 17 years as 0.711 and that of the left foot as 0.74.
The mean of the right and left flat foot occurring among the male students were 1.36 ± 0.23 and 1.29 ± 0.12 respectively whereas in females, it was 1.29 ± 0.01 on the right, with all the measured left feet appearing normal. On the farmers, the mean of the right flat foot was 1.22 ± 0.03, with none occurring in the left. On the females the average of the right and left feet measured 1.17 ± 0.21 and 1.31 ± 0.14 respectively, with the differences not appearing statistically significant. There was no bilateral flat foot recorded and the occurrence of unilateral flat could be due to the type of footwear used especially during the period of development of the medial longitudinal arch.
The prevalence of flat foot in the present study was on 6.22%. This agrees with the result of Senadheera et al. (2016) where the prevalence among 722 participants in Sri Lanka was 5.95%. In buttressing this point, Abdel-Fattah et al. (2006) reported that the prevalence of flat foot among adult Saudi Arabian Army recruits of ages 18-21 years was 5.0%, although their value was lower, but still in the range of our result. However, it disagrees with the findings reported by Staheliet al. (1987) whose study was done on subjects of ages between 1 to 80 years with the percentage prevalence of 20%. Salvador et al. (2017) have it that 26.62% prevalence was recorded in their study with individuals between 40 years and above. A prevalence of 26.5% was reported in a study carried out by Otsuka et al., (2003) on a population sample of 242 women and 98 men in Japan. The differences in these values could be due to the ages used in the studies.
In this study, the overall prevalence of flat foot in the male’s was (3.7%) and (2.5%) in the female’s which shows that prevalence of flat foot is higher in the males than in the females. However, this difference was not significant enough. This agrees with the reports of some findings such as Yashika et al. (2016) who recorded 21.8% prevalence among males and 17.9% in females in the age group of 18-24 years. Many other studies in the body of literature reported a higher prevalence of flat foot in males than in females such as the studies conducted by Pfeiffer et al. (2006); Murley et al. (2009); Chen et al. (2011); and Chang et al. (2010). This higher incidence of flat foot among males may be due to the use of wrongly designed footwear, inadequate exercise or overweight.
The prevalence of right flat foot was 4.15% while that of the left foot was 2.5%. Thus, our study recorded a higher prevalence of flat foot on the right than the left. This is in the same direction with the study of Senadheera et al. (2016) where the right and left unilateral flat feet were respectively 7.76% and 2.35% prevalent.
In relation to the occupations chosen in this study, the prevalence of flat foot among farmers was 2.90% and that among students was 3.3%. This difference, however, was not statistically significant which implies that occupation does not affect the planter arch index of an adult. This point was further supported with the work done by Sachithanadam and Joseph (1995) whose findings suggested that the length of time (prolonged weight bearing) spent depending on occupation type is unlikely to cause flat foot. This as well explains the low prevalence of flat foot in adults after skeletal maturity, with most of them occurring as acquired flat (Yashika et al., 2016) foot due to injury (such as joint laxity or peroneal tendonitis) directed to the particular foot bearing it.
CONCLUSIONS
The present study empirically assessed the planter arch indexes and prevalence of flat foot among adults between the ages 18 and above,among students of Gregory university uturu. The study was carried out on a population of 241 students in the area of the present study.
The normal planter arch indexes recorded in this study showed variations according to the variables chosen (occupation, gender, side of foot). However, these differences were not significant enough. The prevalence of flat foot was higher among students than in farmers, and the prevalence of flat foot was higher in the male than in female. A higher prevalence was also recorded in the right feet compared to the left. However, the variations among the variables did not make up a significant statistical difference at 0.05 significant levels. This therefore implies that occupation does not affect the planter arch index of a matured adult.
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