Foot arch asymmetry and its correlations with physical fitness level and body mass index among school-aged children

Purpose: To assess potential differences in foot arch structure between the left and right feet and how this is connected to physical fitness and BMI in school-age children. Methods: 437 children (6-16 years) participated and were divided into group 1 (n = 188, aged 6-9 yrs), and group 2 (n = 249, aged 10-16 yrs). Bilateral foot arches' absolute values were obtained using a digital pressure platform, and arches' types based on the Chippaux-Smirak-Index (CSI) (high, normal, flat arches) were identified. Physical fitness levels using the modified Zuchora test's total score and categorization level, and the BMI were determined for all children. Results: Abnormal foot arches were more common in the non-dominant left foot compared to the dominant right foot, with a higher occurrence of high arches than flat feet in both groups. The foot arch CSI-mean values were significantly asymmetrical, with the left foot showing higher values (0.23 +/- 0.17) than the right foot (0.22 +/- 0.16) (p = 0.004). Group 2 showed a notable direct relationship between children's BMI and the CSI-absolute values of both left (p = 0.009) and right (p = 0.030) foot arches. While group 1 showed a strong link between children's BMI and left-foot CSI-absolute values (p = 0.028), there was no such correlation with right-foot CSI-absolute values (p = 0.055). Nonetheless, there was no significant correlation found between the left/right foot arches CSI-absolute values and either the children's gender or their overall physical fitness scores in both groups. Conclusion: It is recommended to pay closer attention to the health impacts associated with the non-dominant foot and high arches as the left foot is more susceptible to abnormal arches, with high arches being more prevalent than flat arches.