Prevalence of Flatfoot and its Association with Foot Pain and Balance Performance among Secondary School Students in Owo, Nigeria

Abstract

Flatfoot is a common variation in foot posture during childhood and adolescence, yet its clinical significance remains debated. Although often considered benign, persistent flatfoot has been associated with foot pain and impaired balance in some populations. Evidence from Nigerian adolescents is limited. This study aimed to determine the prevalence of flatfoot among junior secondary school students in Owo, Nigeria, and to examine its association with foot pain and balance performance. A cross-sectional study was conducted among 369 adolescents aged 10–15 years recruited from three secondary schools in Owo, Ondo State. Flatfoot was assessed using the Navicular Drop Test. Participants reporting foot pain completed a structured questionnaire. Static and dynamic balance were assessed using the Single-Leg Stance Test and the Tandem Walk Test, respectively. Data were analyzed using chi-square tests, Mann–Whitney U tests, and binary logistic regression with significance set at p < 0.05. The prevalence of flatfoot was 8.1% (95% CI: 5.3–10.9%), with a higher prevalence in males than females. Flatfoot was not a significant predictor of foot pain after adjusting for age, gender, and body mass index (OR = 1.34, 95% CI: 0.57–3.17; p = 0.50), and no significant differences were observed in static or dynamic balance performance between groups (p > 0.05). Flatfoot was relatively uncommon among adolescents in this population and showed no significant association with foot pain or balance performance, suggesting that it may represent a benign anatomical variation in this age group.