{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:56:43Z","timestamp":1787032603003,"version":"build-2736575974"},"reference-count":62,"publisher":"MDPI AG","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,11,1]]},"abstract":"\n \n Background<\/jats:title>\n Flatfoot, or pes planus, is one of the most common foot posture problems in children that may lead to lower-extremity pain owing to a potential increase in plantar pressure. First, we compared plantar pressure distribution between children with and without flatfoot. Second, we examined the reliability and accuracy of a simple metric for characterization of foot posture: the Clarke angle. Third, we proposed a mathematical model to predict plantar pressure magnitude under the medial arch using body mass and the Clarke angle.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Sixty children with flatfoot and 33 aged-matched controls were recruited. Measurements included in-shoe plantar pressure distribution, ground reaction force, Clarke angle, and radiography assessment. The measured Clarke angle was compared with radiographic measurements, and its test-retest reliability was determined. A mathematical model was fitted to predict plantar pressure distribution under the medial arch using easy-to-measure variables (body mass and the Clarke angle).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A high correlation was observed between the Clarke angle and radiography measurements (r &gt; 0.9; P &lt; 10\u22126). Excellent between- and within-day test-retest reliability for Clarke angle measurement (intraclass correlation coefficient, &gt;0.9) was observed. Results also suggest that pressure magnitude under the medial arch can be estimated using the Clarke angle and body mass (R2 = 0.95; error, &lt;0.04 N\/cm2 [2%]).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study suggests that the Clarke angle is a practical, reliable, and sensitive metric for quantification of medial arch height in children and could be recommended for research and clinical applications. It can also be used to estimate plantar pressure under the medial arch, which, in turn, may assist in the timely intervention and prognosis of prospective problems associated with flatfoot posture.<\/jats:p>\n <\/jats:sec>","DOI":"10.7547\/8750-7315-104.6.622","type":"journal-article","created":{"date-parts":[[2014,12,16]],"date-time":"2014-12-16T17:30:08Z","timestamp":1418751008000},"page":"622-632","source":"Crossref","is-referenced-by-count":36,"title":["Assessing Plantar Pressure Distribution in Children with Flatfoot Arch"],"prefix":"10.3390","volume":"104","author":[{"given":"Jolanta","family":"Pauk","sequence":"first","affiliation":[{"name":"Mechanical Engineering Faculty, Automatics and Robotics Department, Bialystok University of Technology, Bialystok, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail","family":"Ihnatouski","sequence":"first","affiliation":[{"name":"Research Center of Resource Saving, Belarusian Academy of Science, Minsk, Belarus."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijan","family":"Najafi","sequence":"first","affiliation":[{"name":"Interdisciplinary Consortium on Advanced Motion Performance, Southern Arizona Limb Salvage Alliance, Department of Surgery, and Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Arizona."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"ref411","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/0021-9290(87)90255-7","article-title":"The arch index: a useful measure from footprints","volume":"20","author":"Cavanagh","year":"1987","journal-title":"J Biomech"},{"key":"ref211","first-page":"4","article-title":"Comparative analysis of distribution on the sole surface of arched feet and flat feet","volume":"65","author":"Szczygiel","year":"2008","journal-title":"Przegl Lek"},{"key":"ref601","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/107110079401500107","article-title":"Plantar pressure distribution patterns of young school children in comparison to adults","volume":"15","author":"Hennig","year":"1994","journal-title":"Foot Ankle Int"},{"key":"ref191","first-page":"46","article-title":"\u201cRegression Analysis with Standardized Variables,\u201d","author":"Allen","year":"1997","journal-title":"Understanding Regression Analysis"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.clinbiomech.2003.09.007","article-title":"The influence of walking speed and footwear on plantar pressures in older adults","volume":"19","author":"Burnfield","year":"2004","journal-title":"Clin Biomech (Bristol, Avon)"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1038\/sj.ijo.0801192","article-title":"Does obesity influence foot structure in prepubescent children?","volume":"24","author":"Riddiford-Harland","year":"2000","journal-title":"Int J Obes Relat Metab Disord"},{"key":"ref91","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/0021-9290(87)90255-7","article-title":"The arch index: a useful measure from footprints","volume":"20","author":"Cavanagh","year":"1987","journal-title":"J Biomech"},{"key":"ref541","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.gaitpost.2008.01.012","article-title":"The effect of foot type on in-shoe plantar pressure during walking and running","volume":"28","author":"Chuckpaiwong","year":"2008","journal-title":"Gait Posture"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1093\/ptj\/67.5.688","article-title":"Pes cavus and pes planus: analyses and treatment","volume":"67","author":"Franco","year":"1987","journal-title":"Phys 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examination variables predict high plantar pressures in the diabetic foot?","volume":"93","author":"Wrobel","year":"2003","journal-title":"JAPMA"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/0141-5425(85)90040-8","article-title":"Foot pressure patterns during gait","volume":"7","author":"Soames","year":"1985","journal-title":"J Biomed Eng"},{"key":"ref381","first-page":"261","article-title":"Flexible flatfoot in children: a controversial subject [in Polish]","volume":"68","author":"Walczak","year":"2003","journal-title":"Chir Narzadow Ruchu Ortop Pol"},{"key":"ref401","article-title":"Lashkovsky V: \u201cBiomechanical Aspects of Modern Pediatrics Development","author":"Sviridenok","year":"2008","journal-title":"Biomechanics of Human Foot, international conference proceedings"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.2337\/diacare.18.11.1460","article-title":"Increased foot pressures after great toe amputation in diabetes","volume":"18","author":"Lavery","year":"1995","journal-title":"Diabetes Care"},{"key":"ref21","first-page":"892","article-title":"\u201cPes Planus,\u201d","author":"Rose","year":"1991","journal-title":"Disorder of the Foot and Ankle"},{"key":"ref471","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/0958-2592(91)90036-B","article-title":"A study of plantar pressures in a diabetic clinic population","volume":"2","author":"Veves","year":"1991","journal-title":"The Foot"},{"key":"ref61","first-page":"261","article-title":"Flexible flatfoot in children: a controversial subject [in Polish]","volume":"68","author":"Walczak","year":"2003","journal-title":"Chir Narzadow Ruchu Ortop Pol"},{"key":"ref271","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1016\/j.jbiomech.2012.03.006","article-title":"Dynamic plantar loading index: understanding the benefit of custom foot orthoses for painful pes cavus","volume":"45","author":"Najafi","year":"2012","journal-title":"J Biomech"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.clinbiomech.2009.11.007","article-title":"Effects of foot orthoses on gait patterns of flat feet patients","volume":"25","author":"Chen","year":"2010","journal-title":"Clin Biomech (Bristol, Avon)"},{"key":"ref621","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00003086-198007000-00038","article-title":"Normal foot-ground pressure pattern in children","volume":"150","author":"Aharonson","year":"1980","journal-title":"Clin Orthop Relat Res"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1177\/107110070402500811","article-title":"The arch index: a measure of flat or fat feet?","volume":"25","author":"Wearing","year":"2004","journal-title":"Foot Ankle Int"},{"key":"ref81","article-title":"Lashkovsky V: \u201cBiomechanical Aspects of Modern Pediatrics 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and in healthy subjects","volume":"17","author":"Sarnow","year":"1994","journal-title":"Diabetes Care"},{"key":"ref341","first-page":"892","article-title":"\u201cPes Planus,\u201d","author":"Rose","year":"1991","journal-title":"Disorder of the Foot and Ankle"},{"key":"ref71","first-page":"4","article-title":"The variability of plantar pressure pattern distribution in healthy children and its relation to flexible flatfoot","volume":"5","author":"Walczak","year":"2007","journal-title":"J Orthop Trauma Surg Relat Res"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.2337\/diacare.17.9.1002","article-title":"In-shoe foot pressure measurements in diabetic patients with at-risk feet and in healthy subjects","volume":"17","author":"Sarnow","year":"1994","journal-title":"Diabetes Care"},{"key":"ref511","first-page":"46","article-title":"\u201cRegression Analysis with Standardized Variables,\u201d","author":"Allen","year":"1997","journal-title":"Understanding 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Analysis"},{"key":"ref531","first-page":"4","article-title":"Comparative analysis of distribution on the sole surface of arched feet and flat feet","volume":"65","author":"Szczygiel","year":"2008","journal-title":"Przegl Lek"},{"key":"ref171","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/S0966-6362(01)00151-5","article-title":"Foot type classification: a critical review of current methods","volume":"15","author":"Razeghi","year":"2002","journal-title":"Gait Posture"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/0141-5425(85)90040-8","article-title":"Foot pressure patterns during gait","volume":"7","author":"Soames","year":"1985","journal-title":"J Biomed Eng"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0966-6362(01)00165-5","article-title":"The distributed plantar vertical force of neutrally aligned and pes planus feet","volume":"15","author":"Ledoux","year":"2002","journal-title":"Gait 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