The Evolution of Foot Morphology in Children Between 6 and 17 Years of Age: A Cross-Sectional Study Based on Footprints in a Mediterranean Population

Footprint evaluation is a widely used method for the determination of foot morphology, but its efficacy and validity are considered controversial. Dynamic footprints were obtained from both feet of 5,866 school-aged children (6-17 years old) to detect any foot changes during growth. The interpretation of the imprint was performed using a classification scheme consisting of 6 types of footprints. In this scheme, footprint types I and II represent the typical and intermediate high-arched foot, respectively. Types III and IV represent normal foot variants, while type V corresponds to the low-arched foot and type VI to the severe flat foot, the latter often encountered in pathological conditions. There was statistically significant difference (P < .05) in footprint-type frequencies between boys and girls of ages 7, 9, 11, 14, and 15, which probably indicates the difference in growth potential of the foot between sexes. The proportion of high- and low-arched foot types decreased with increasing age in both boys and girls. Even though critical changes of the foot are believed to occur during pre-school development, this study shows that considerable changes also take place during school age and until late adolescence.