Flat Foot and Coronal Spinopelvic Alignment

Study Overview
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Brief Summary
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This study aimed to present the influence of unilateral and bilateral flat foot on coronal spinopelvic alignment in asymptomatic young healthy males. It will be carried out by examining the medical reports of individuals who apply to the National Health Board to work in positions requiring physical fitness between January 2018 and January 2019. Plain radiographies of the feet, pelvis, and spine will be analyzed. Calcaneal pitch angle (CPA) for flat foot, pelvic obliquity (PO), and Cobb angle (CA) for spinal asymmetry will be measured. After all analyzes were completed, participants will be divided into 2 groups as unilateral (UniFF) or bilateral (BiFF) flat foot, depending on the CPA measurements and will be compared.

Official Title
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The Influence of Bilateral and Unilateral Flat Foot on Coronal Spinopelvic Alignment in Asymptomatic Young Healthy Males

Conditions
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Flat Foot [Pes Planus] (Acquired), Left Foot, Flat Foot [Pes Planus] (Acquired), Right Foot, Flat Foot Acquired Bilateral (Pes Planus), Pelvic Obliquity, Spinal Curvatures

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Body mass index (BMI) ranging between 18.5-24.9 kg/m2 (accepted as normal weight by World Health Organisation (WHO)) Age ranging between 18-25 years Male gender Exclusion Criteria: Being older than 25 years BMI out of normal weight according to WHO Being female History of spinal trauma/ surgery Having/had spinal disorders like spondylolisthesis, spondylodiscitis, etc. Having/had chronic inflammatory arthritis especially spodiloarthrosis (i.e., ankylosing spondylitis, psoriatic arthritis, etc.) Having/had a vertebral fracture Having/had aseptic necrosis of the vertebra Radiographs with inappropriate image qualities.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Unilateral Flat Foot (UniFF)<br>Participants with flat foot unilaterally (Only one foot's Calcaneal pitch angle ≤ 20 degree) | |
| Bilateral Flat Foot (BiFF)<br>Participants with flat foot bilaterally (Both feet's Calcaneal pitch angle ≤ 20 degree) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Calcaneal pitch angle (CPA) | Calcaneal pitch angle (CPA) is defined as an angle between a line drawn from the inferior of the calcaneocuboid joint to the inferior border of the calcaneus and a second line drawn from the inferior aspect of the sesamoid bones to the inferior border (13). CPA for both (right and left) foot was evaluated from all plain radiographs in this study and the angles equal to or less than 20 degrees were accepted as a flat foot. | Baseline | 
| Pelvic obliquity (PO) | Pelvic obliquity (PO) was measured by horizontal pelvic obliquity according to Osebold et al. from a posteroanterior radiograph. The angle between the line drawn between the most proximal points on the iliac crest and the line drawn parallel to the lower end of the radiograph was recorded. | Baseline | 
| The Cobb angle (CA | The Cobb angle (CA) is a gold standard measurement for identifying the magnitude of spinal curves (14). Spinal curvature was measured from the standing full-length posteroanterior radiograph. The angle of the curve is measured as an angle between the perpendiculars of the lines parallel to the upper border of the upper vertebral body and parallel to the lower border of the lowest vertebral body of the curve (16). Straight or symmetrical spines in the coronal plane were accepted as a normal spine, and curves<10 degrees accepted as spinal asymmetry, and the curves ≥ 10 degrees accepted as scoliosis (15). Spinal curve patterns in coronal planes were classified according to the Scoliosis Research Society classification. The curve was classified as single in terms of one curve exists in the thoracal or lumbal spine; as double in terms of one curve exist the through thoracal and lumbal spine; and as triple that exists through upper thoracal, middle thoracal and lumbal spine (17). | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Flat foot, pelvic obliquity, spinal asymmetry, Cobb angle, calcaneal pitch angle