Biomechanical and functional performance differences in individuals with and without pes planus: A systematic review and modified GRADE evidence synthesis protocol.
Background
Pes planus (flat foot) is characterized by a reduction of the medial longitudinal arch and alterations in foot biomechanics that may influence gait, balance, and functional performance. However, existing evidence regarding its biomechanical and functional consequences remains inconsistent. This systematic review aims to examine differences in biomechanics and functional performance among individuals with pes planus and those with normal arches.
Methods
This review will include individuals of any age, sex, diagnosed with pes planus using validated criteria, compared with individuals with normal foot arches. Observational and experimental studies reporting biomechanical or functional outcomes will be included. Primary outcomes will comprise biomechanical measures, including kinematic, kinetic, spatiotemporal, plantar pressure, and muscle activity measures. Secondary outcomes will include, but not be limited to, functional performance measures such as balance and agility. A systematic search will be conducted across PubMed, Scopus, Web of Science, SPORTDiscus, EMBASE, and CINAHL, supplemented by grey literature searches in ProQuest, OpenGrey, and Google Scholar. Two independent reviewers will perform study selection, data extraction, and quality assessment using the Downs and Black index. Effect sizes will be reported as standardized mean differences or odds ratios with 95% confidence intervals, and the certainty of evidence will be evaluated using a modified GRADE approach.
Systematic review registration number
CRD420261331845.
Keywords
Flatfoot, Foot biomechanics, Functional performance, Gait analysis, Pes planus, Plantar pressure
Conflict of interest statement
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.