Balance, Plantar Pressure Distribution and Gait in Pes Planus

The researchers will measure the distance between the navicular tuberosity and the ground with a caliper with non-weight bearing in sitting. After that, the distance between the ground and the navicular tuberosity will be measured in standing while weight-bearing. The researchers will evaluate both sides and record the value in mm. According to Navicular Drop Test, the difference between weighted and unweighted measurements is considered normal (neutral) if it is between 5 and 9 mm, pronation (pes planus) if it is 10 mm or more, and supination (pes cavus) if it is 4 mm or less. In our study, individuals with a difference of 10 mm or more in both feet will be included in the pes planus, and individuals with a difference between 5-9 mm will be included in the control group.

The index consists of six items in which the foot is evaluated observationally. In the evaluation, the individual is asked to stand in a comfortable and relaxed position. The researcher observes the medial longitudinal arch structure, the structure of the talonavicular joint region, the degree of abduction/adduction in the forefoot relative to the hindfoot in the front part of the foot. In the back foot, inversion/eversion of the calcaneus, talus head position, and curvatures above and below the lateral malleolus are evaluated. The total score is reached by scoring each criterion between -2 and +2 values. 0; neutral position, (+) values; pronation (pes planus), (-) values indicate supination (pes cavus). Individuals with +6 to +12 points from this index will be included in our study.

Static and dynamic balance and stability limit values of individuals will be evaluated with the HUR Smart Balance (SME Inc, USA) balance measurement device. The device consists of a computer and a platform on which individuals can place their feet. For static balance measurement, individuals will be asked to place their feet on the marked places on the platform. The researchers will evaluate the balance in four different situations, 30 seconds each. In the first test, individuals keep the balance on firm ground with their eyes open. The second test performed on the firm ground with eyes closed, in the third test, on the soft ground with eyes open, and in the fourth test, on the soft ground with eyes closed. For dynamic balance, individuals will be asked to extend their body weight to the front, back, and sides with their feet in 4 different directions for 8 seconds.

Plantar pressure analysis of individuals will be evaluated by measuring with the DIERS Pedoscan DICAM 3 v3.10.8 (2019) device. DIERS Pedoscan is a system integrated into the treadmill that measures the pressure distribution on the sole during stance. As a result of this evaluation, right-left and anterior-posterior weight transfer, left-right foot rotation, lateral mobility, the center of gravity movement, and swing area data will be recorded.

Gait analysis of individuals will be evaluated with the DIERS Leg Axis DICAM 3 v3.10.8 (2019) system. The system consists of a treadmill, computer, and cameras. Before the measurement, colored markers will be placed on the knee and ankle joints of the individual. For gait assessment, individuals will walk at their preferred comfortable walking speed. In the evaluation, joint angles, walking speed, step lengths are recorded. Evaluation time is approximately 5 minutes.