Objectives The foot posture index (FPI) is an observational tool designed to measure the position of the foot. The objective of this study was to establish international reference data for foot posture across childhood, and influence of body mass index (BMI) on paediatric foot posture. Design Cross-sectional study. Setting and participants The dataset comprised 3217 healthy children, aged from 3 to 15 years. Contributing data were acquired from Spain, UK and Australia. Interventions Foot posture was described by means and z-score of the FPI and the height and weight of each subject was measured and the BMI was calculated. Results The foot posture of 3217 children were reviewed. A pronated (FPI ≥+6) foot posture was found in 960 (29.8%) children, a normal (FPI 0 to +6) foot posture in 1776 (55.2%) and a highly pronated (FPI +10) foot posture was found in 127 children (3.9%) (range −4 to +12 FPI). Less than 11% were found to have a supinated foot type (n=354). Approximately 20% of children were overweight/obese, but correlation between BMI and FPI was weak and inverse (r=−0.066, p<0.01), refuting the relationship between increased body mass and flatfeet. Conclusions This study confirms that the ‘flat’ or pronated foot is the common foot posture of childhood, with FPI score of +4 (3) the average finding. Trend indicated a less flatfoot with age, although non-linear. A wide normal range of foot posture across childhood is confirmed.

Background: The Foot Posture Index (FPI) is an observational tool designed to measure the position of the foot. Its reliability is well established, and it provides normative reference values for the general population. However, this is not so for the paediatric population. The aim of this study is to determine FPI reference values in childhood, taking into account age and gender.Methods: This cross‐sectional study included 1,762 school children (863 boys and 899 girls) aged 6–11 years, from Málaga, Granada and Plasencia (Spain). In every case, FPI measurements were obtained for both feet by two experienced podiatrists. A descriptive analysis was then conducted and the percentiles of the variables determined, with a significance level of P < 0.05.Results: The consolidated FPI results for the sample population produced mean values of 3.74 (SD 2.93) points for the right foot and 3.83 (SD 2.92) for the left. The 50th percentile was 4 points for both genders and for both feet, except for the right foot among the girls, which was slightly lower, at 3 points. The 85th percentile, which is considered to represent the boundary between the normal and the pronated foot among children, was 6 points, uniformly among the subjects.Conclusions: As a normative FPI value for the paediatric population, we recommend the 50th percentile, i.e. 4 points, for children, of both genders, aged 6 years. This value progressively falls with age, to 3 FPI points for children aged 11 years. The 85th percentile for the pronated foot and the 4th percentile for the supinated foot can be considered the pathological boundary.

The aim was to identify conservative treatments available for acute ankle sprain and to evaluate their effectiveness with respect to pain relief and short-term recovery of functional capacity. A systematic review of the relevant literature was conducted via a data search of the PROSPERO, PubMed, Scopus, CINAHL, PyscINFO and SPORTDiscus databases, from inception until December 2019, focusing on randomised control trial studies. Two of the authors independently assessed the quality of each study located and extracted the relevant data. The quality of each paper was assessed using the Cochrane risk of bias tool included in RevMan 5. In all, 20 studies met the inclusion criteria. In terms of absence of bias, only nine papers were classed as “high quality”. Studies (75%) were of low quality in terms of the blinding of participants and personnel and uncertainty in blinding of outcome assessment and all presented one or more other forms of bias. Despite the generally low quality of the studies considered, it can be concluded that conservative treatment for acute ankle sprain normally achieves pain relief and rapidly improved functionality. Research based on higher-quality study designs and procedures would enable more definitive conclusions to be drawn.