Risks of postural disorders in schoolchildren with flat feet

Introduction. The state of posture and foot are basic characteristics of the health and well-being in children and adolescents. Forming a single biomechanical system of human support, movement and balance, they are in a certain relationship. It is of scientific and practical interest to study the effects of foot deformity in the form of flat feet on the formation of postural disorders, as this allows scientifically substantiating measures to prevent postural disorders by preventing foot deformities. The purpose of the work: to establish and assess the risks of flat feet affecting postural disorders in students from 5^th to 11^th grade using evidence-based medicine methodology.

Materials and methods. An online survey was conducted of sixteen thousand six hundred seventy one student in grades 5^th –11^th with a diagnosis of foot deformity in the form of flat feet and 42,663 students in the same classes who were not diagnosed with such a diagnosis. The distribution by class was approximately equal and amounted to 15–18%. The respondents answered the questions: “Did the doctors notice that you have flat feet?” and “Did the doctors notice a violation of your posture?”. The answers included the following options: “No”, “I don’t know”, “Yes”. The survey was voluntary and anonymous. The number of children with postural disorders, having a normal arch of the foot and flat feet was estimated. To assess the causation of postural disorders by flat feet, the relative risk (RR) and etiological proportion (EF) were calculated.

Results. Children with flat feet, compared with children with a normal arch of the foot, the incidence of postural disorders was found to be higher during the entire period of secondary and high school education. In the 5^th grade students with a normal arch of the foot, the incidence of posture disorders was 14.6% (95% CI 13.9–15.4), with flat feet — 41.5% (95% CI 39.6–43.5) (p < 0.05). In the 11^th grade students, posture disorders were more common in both normal arch of the foot and flat feet, respectively, in 31.4 (95% CI 29.6–33.2) and 58.8% (95% CI 56.2–61.3) students (p < 0.05). The values of RR = 2.928 (95% CI 2.739–3.131) and EF = 65.9% in the 5^th grade students indicate a high degree of conditioning of posture disorders by the influence of flat feet. In the 11^th grade students, RR = 1.840 (95% CI 1.719–1.969) and EF = 45.7% indicate the average degree of conditioning.

Conclusion. The data obtained can be used in the development of preventive programs for the prevention of postural disorders and flat feet in students in educational institutions.

Contribution:
Khramtsov P.I., Berezina N.O. — concept and design of the study;
Razova E.V., Antonova E.V. — collection and processing of material;
Khramtsov P.I. — statistical processing and writing the text;
Komarova O.V. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: October 22, 2025
Accepted: November 27, 2025
Published: December 25, 2025

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