Vol.9(16), pp.

551-554, 23 August, 2014

DOI: 10.5897/ERR2014.1790
Article Number: CC66EB846637
ISSN 1990-3839
Copyright 2014
Author(s) retain the copyright of this article
http://www.academicjournals.org/ERR

Educational Research and Reviews

Full Length Research Paper

The relationship with balance, foot posture, and foot

size in school of Physical Education and Sports
Students
Gonul Babayigit Irez
Mugla Sitki Kocman University, School of Physical Education, Turkey.
Received 21 March, 2014; Accepted 11 July, 2014

The aim of this study is to investigate the relationship of foot posture and foot size with balance. A
hundred and thirteen healthy volunteers were recruited from undergraduate students (Male = 74,
Female = 37, age range 1822). The Foot Posture Index (FPI-6), anthropometric measurements, dynamic
balance and static balance measurements were done to investigate the relationships between all the
variables. Pearson products moment correlation coefficient test was used for statistical analyses. As a
result, it was found that there was a weak, negative correlation between the static balance and foot
posture variables, r = -.22, n = 113, P < .005. Moreover, there was a weak positive correlation between
static balance and heel breadth, r = -.19, n = 113, P < .005; and it was found that there was another small
negative correlation between dynamic balance and foot length, r = -.13, n = 113, P < .005. Deficiency in
foot posture may lead to some injuries by affecting on balance. This can be very important to both
athletes and elderly people.
Key words: Foot posture, foot size, university students, balance.
INTRODUCTION
Variations in foot posture can affect the function of the
foot and this may lead to injuries (Redmond et al., 2008;
Nigg et al., 1993). There are different methods for
identifying foot posture. The FPI is an observational
scoring system (the Foot Posture Index); it consists of
six validated, criterion-based observations of the back
foot and the forefoot when standing in a relaxed position
(Redmond et al., 2001; Redmond et al., 2008). Screening
of athletes by using the FPI to identify risk of injury is
important to prevent future serious injuries (Cain, 2007).
Both pronated and supinated foot is a risk factor for
sports injuries (Cain, 2007). Balance is defined as the

process of maintaining the center of gravity within the

bodys base of support and it has been used as a
measure of lower extremity function (Cote et al., 2005).
Factors that may influence balance ability should be
considered in examining balance as an outcome measurement as a risk factor for injury in sports (Rosychuk
et al., 2005; Emery, 2003). In some research, supinated
or pronated foot types are addressed for reason of
balance deficiency (Cote et al., 2005; Hertel et al., 2002;
Olmsted and Hertel, 2004).
In literature, the relationship of foot posture and injury
risk was studied by some researchers (Cain, 2007;

E-mail: [email protected].
Author agree that this article remain permanently open access under the terms of the Creative Commons
Attribution License 4.0 International License

552

Educ. Res. Rev.

Table 1. Descriptive Statistics of Participants.

Age (year)
Height (cm)
Weight(kg)
Static Balance (time)
Dynamic balance(sec)

Mean
21.3
1.74
66.6
1.69
10.68

Std. Deviation
1.63
8.02
9.52
1.86
4.17

N
113
113
113
113
113

MacManus et al., 2004) with very limited research (Cote

et al., 2005) to identify if there was any relationship
between dynamic or static balance, foot posture and foot
size. The aim of this study was to investigate the
relationship of foot posture, foot size and balance. Poor
foot posture may be controlled by well-designed
appropriate footwear or orthoses. After identifying and
solving foot posture problem, balance deficiency may be
decrease in sports school students for success in their
sports performance. Moreover, if the problems are identified early, and with suitable treatment it may minimize
elderly from the risk of falling.
METHOD
Participants
One hundred and thirteen healthy volunteers were recruited from
the undergraduate students of the Mugla Sitki Kocman University,
School of Physical Education (Male = 74, Female = 37, age range
1822). Subjects were included in the study who had not sustained
any injury in their both lower leg/foot over the past 12 months, had
no pain, symptoms or previous surgery in their feet. Health report
document signed by a medical doctor was demanded from all
participants and informed consent was signed by participants after
giving them short information about the study. Each subjects age,
height, weights, foot size (foot length, foot width and heel breadth)
were documented (Table 1).

Measurements
The Foot Posture Index (FPI-6): This item consists of a series of
criterion-based observations of the six constituent measures
required to assess overall foot posture (Talar head palpation,
Curves above and below the lateral malleoli, Inversion/eversion of
the calcaneus, Bulge in the region of the talonavicular joint,
Congruence of the medial longitudinal arch, Abduction/adduction
of the forefoot on the Rear foot). For the measurements,
participants stood in their comfortable angles with their arms by
their sides and looking straight ahead to assess the FPI-6. A 5point Likert-type scale where lower scores represent a more
supinated foot position and higher scores a more pronated position
scoring system was used. Ordinal FPI data were converted to
Rasch transformed scores allowing the data to be analyzed as
interval data (Keenan et al., 2007).

Anthropometric measurements of foot (foot size)

Foot size (mm) was measured by using anthropometric set including heel breadth, foot breadth, and length of foot measurements

Figure 1. Measurement of foot size

(Figure 1). Subjects foot placed on a flat surface in a standing

position and both feet are measured by anthropometric set. All
measurement was done by the same researcher.

Dynamic and Static Balance

Dynamic Balance was assessed using a Lafayette Instruments
Stabilometer (model number 16030-Lafayette, IN). Each subject
was given one trial to understand how the apparatus worked and
to experiment with foot and body position. From that point, each
subject was given a 30 s trial with rest periods between each trial.
The best score of the three trials was recorded (Wolkodoff et al.,
2008). Static Balance was assessed by using flamingo balance
test. The participants were asked to stand on their dominant leg.
The free leg was flexed at the knee and foot of this leg hold close
to the buttocks. After one trial was given the stopwatch was
started and counted the number of falls in 60 s (Oja and Tuxworth,
1995).
Statistical analyses
SPSS 17.0 Statistical package was used for analyzing data.
Pearson products moment correlation coefficient test was used to
analyze correlation between variables (p<0.05). Demographic data
were summarized by arithmetic mean and standard deviation
values. The difference assumed significance when the `p` value
was lower than 0.05.

RESULTS
The relationship between Balance, Foot Posture, and
Foot Size was investigated using Pearson products
moment correlation coefficient.
Preliminary analyses were performed to ensure no
violation of the assumptions of normality, linearity and
homoscedasticity. There was a weak, negative correlation between the static balance and foot posture
variables, r = -.22, n = 113, P < .005. Moreover, there
was a weak positive correlation between static balance
and heel breadth, r = -.19, n = 113, P < .005 and it was
found that there was another small negative correlation
between dynamic balance and foot length, r = -.13, n =
113, P < .005 (Table 2).

Irez

553

Table 2. Pearson product~moment correlations between measures of balance,

foot posture, and foot size.

Scale
1.Foot posture
2.Dynamic balance
3.Static balance
4. Foot length
5. Heel breadth
6. Foot breadth

1
-

2
.005
-

3
-.222*
-.183*
-

4
.010
-.125*
-.079
-

5
-.064
.006
0.187*
.382*
-

6
.045
-.073
.053
.418
.779*
-

*p < .005.

DISCUSSION AND CONCLUSION

Our primary findings revealed that foot posture and foot
size types were affected in static and dynamic measures.
The ability to sense motion in the foot and make postural
alterations in response is essential in preventing injury.
Our findings suggest that some aspects of postural
stability are affected by foot type and posture.
Cote et al. (2005) determine if supinated and pronated
foot types influence measures of static and dynamic
balance. They found no difference in center of balance
or postural sway as a function of foot type. Moreover,
their results suggested that postural stability is affected
by foot type under both static and dynamic conditions. In
our study, we found that dynamic balance and foot
posture were associated with each other although static
balance was minimally affected by foot type.
Habib and Westcott (1999) found that increased foot
length was associated with greater balance ability in
children. The age of their subjects differed considerably
from that of the subjects in our study; in this study it was
found that there was a weak relationship with static
balance and heel breadth.
Menz et al. (2005) found that foot and ankle characteristics are significant independent predictors of balance
and functional ability in older people. One hundred
seventy-six people recruited to their study; they measured foot posture and effects of on balance and it
explained up to 59% of the variance in these test scores.
In this present study, it was found that there was a
relationship between balance and foot posture; it may
have similar findings, but their subjects age group was
older.
Cowley and Marsden (2013) studied the changes in
foot posture after a half marathon. They found that foot
posture towards a more pronated position may have
implications for foot function, and therefore risk of injury.
This study group included school of physical education
students and it was assumed that they were active in
different sports; so it is important result to find relationship with foot posture. This may lead to sports injuries,
because foot posture problems can cause balance
deficiency whether they are in sports activity or not.
Some researchers (Dong-chul et al., 2014) suggested

some foot exercises for people having foot posture

problems to increase their balance ability. This study
results show the importance of identifying foot posture
problems which is to balance deficiency.
As a conclusion, problems in foot posture may lead to
some injuries by affecting balance or result in falls. This
can be very important both to athletes and in the future
for elderly people. This study suggest that if foot posture
problems are diagnosed earlier, it may decrease falls
which can cause injuries in both daily and sports
activities.

Conflict of Interests
The author have not declared any conflict of interests.
REFERENCES
Cote KP, Michael EB, Bruce MG, Sandra JS (2005). Effects of
Pronated and Supinated Foot Postures on Static and Dynamic
Postural Stability. J. Athl. Train. 40(1):41-46.
Cowley E, Marsden J (2013). The effects of prolonged running on foot
posture: a repeated measures study of half marathon runners using
the foot posture index and navicular height. J. Foot Ankl. Res. 6:20.
http://link.springer.com/article/10.1186%2F1757-1146-6-20
Dong-chul M, Kyoung K, Su-kyoung L (2014).Immediate Effect of
Short-foot Exercise on Dynamic Balance of Subjects with
Excessively Pronated Feet. J. Phys. Ther. Sci. 26(1):117-119.
Emery CA (2003). Is there a clinical standing balance measurement
appropriate for use in sports medicine? A review of the literature. J.
Sci. Med. Sport. 6:492-504.
Habib Z, Westcott S (1998).Assessment of anthropometric factors on
balance tests in children. Pediatr. Physic. Therap. 10:101-109.
Hertel J, Gay MR, Denegar CR (2002). Differences in postural control
during single-leg stance among healthy individuals with different foot
types. J. Athl. Train. 37:129-132.
Keenan AM, Redmond AC, Horton M, Conaghan PG, Tennant A
(2007). The Foot Posture Index: Rasch analysis of a novel, footspecific outcome measure. Arch. Phys. Med. Rehabil. 88:88-93.
MacManus A, Stevenson M, Finch CF, Elliott B, Hamer P, Lower A,
Bulsara M (2004). Incidence and risk factors for injury in non-elite
Australian
football.
J.
Sci.
Med.
Sport.
7:384-391.
http://researchonline.nd.edu.au/era_health_article/14/
Menz HB, Morris ME, Lord SR (2005). Foot and Ankle Characteristics
Associated With Impaired Balance and Functional Ability in Older
People. J. Gerontol. Biol. Sci. Med. Sci. 60(12):1546-1552.
doi: 10.1093/gerona/60.12.1546
Nigg BM, Cole GK, Nachbauer W (1993). Effects of arch height of the
foot on angular motion of the lower extremities in running. J.

554

Educ. Res. Rev.

Biomech. 26:909-916.
Oja P, Tuxworth B (1995). Eurofit for Adults: Assessment of HealthRelated Fitness. Finland: Council of Europe Publishing pp.1-13.
Olmsted LC, Hertel JN (2004). Influence of foot type and orthotics on
static and dynamic postural control. J. Sport Rehabil. 13:54-66.
Redmond AC, Crosbie J, Ouvrier RA (2001). Development and
validation of a novel rating system for scoring foot posture: the Foot
Posture Index. Clin. Biomech. 21(1):89-98.
Redmond AC, Yvonne ZC, Hylton BM (2008).Normative values for the
Foot
Posture
Index.
J.
Foot
Ankle
Res.
1:6
http://link.springer.com/article/10.1186%2F1757-1146-1-6

Rosychuk RJ, Brian HR, Carolyn AE, David C, Terry PK (2005).

Development of a Clinical Static and Dynamic Standing Balance
Measurement Tool Appropriate for Use in Adolescents. Phys. Ther.
85:502-514.
Wolkodoff N, Peterson S, Miller J (2008). The fitness effects of a
combined aerobic and pilates program: An eight-week study using
the
Stamina
AeroPilates
Pro
XP555.
Retrieved
from
http://www.lighterliving.com/uploads/documents/PilatesResearchPa
per2.pdf.