Table 1 Characteristics of included articles

1

Houck et al., 2008 [39]

21 participants (14 pronators, 7 control)

USA

3/18

Goniometrically, Navicular drop test

Kinematics: Calcaneus eversion, Calcaneus dorsiflexion

Motion Analysis

System, force plate

Cross sectional study

Increased rearfoot eversion during early stance

2

Levinger et al., 2010 [42]

20 participants aged 18 years or more (10 flatfoot, 10 normal)

Australia

13/7

radiographic measurements

obtained from weight bearing X-rays

Kinematics: Hindfoot relative to tibia; Dorsiflexion, Plantarflexion, Eversion, Inversion, Internal rotation, External rotation

Motion analysis system, force plates

Cross-sectional study

Increased rearfoot internal rotation. increased rearfoot eversion

3

Shih et al., 2012 [29]

30 children aged 7–10 years (20 flexible flatfoot, 10 normal)

Taiwan

Both

Navicular drop test (Feiss line)

Kinematics: maximum and minimum angles calcaneal and knee and hip

LIBERTY electromagnetic

Tracking system

A case-control

No significant differences

4

Twomey & mcintosh, 2012 [27]

24 children aged 11–12 years (12 low arch, 12 normal)

Australia

Both

Static (foot print index and arch index), dynamic (navicular drop test)

Tempo-spatial Parameters: cadence, stride time, step time, stride length, step length.

Kinematics: Hip; flexion, rotation, abduction. Knee flexion, varus, valgus. Ankle; flexion

Motion Analysis System

Cross-sectional study

Increased external hip rotation throughout the stance phase and in terminal swing. There was also a significant difference between the two groups in the left knee varus/valgus angle.

5

Hösl et al., 2014 [36]

46 children and adolescents aged 7 years or more (ASFF: n = 21, SFF: n = 14, TDF: n = 11)

Germany

27/19

Oxford Foot Model

Tempo-spatial Parameters: Velocity, Step length, Step width

Kinematics: Hindfoot relative to tibia; Dorsiflexion, Plantarflexion, Eversion, Inversion, Internal rotation, External rotation

A Vicon Nexus system and force plate

Cross sectional study

SFF walked significantly slower than TDF and decreased their step length to a similar extent.

Concerning ROM values, both ASFF and SFF showed significant restrictions in dorsiflexion, as well as less plantarflexion during push-off.

6

Buldt et al., 2015 [26]

97 participants aged 18–47 years (30 pes-planus, 30 pes-cavus, 37 normal foot)

Australia

46/51

Foot Posture Index, Arch Index, normalized

Navicular height

Tempo-spatial Parameters: Velocity

Kinematics: Knee; flexion, extension, adduction, abduction, external rotation, internal rotation

Motion analysis system, force plates

Cross sectional study

Planus group increased external rotation angle at heel contact compared to

both normal and cavus groups.

7

Prachgosin et al., 2015 [40]

28 participants aged 18–50 years (13 flatfoot, 15 normal)

Thailand

4/24

Footprint (arch index), foot radiographs

Tempo-spatial Parameters: Velocity, Stride length, Cadence

Kinematics: Hindfoot relative to tibia; Dorsiflexion, Plantarflexion, Eversion, Inversion, Internal rotation, External rotation

Motion analysis

System, force plates

Cross-sectional study

Increased peak eversion MLA moment and a smaller peak MLA deformation angle during specific subphases. The increased peak of hindfoot plantarflexion and internal rotation and the peak of forefoot abduction in the specific subphases.

8

Zhang et al., 2017 [24]

26 participants (17 over-pronated foot, 9 normal)

Belgium

15/11

Foot Posture Index

Kinematics: Hindfoot relative to Tibia; Dorsiflexion, Plantarflexion, Eversion, Inversion, Internal rotation, External rotation

Three-dimensional motion analysis system, force plate, An ultrasound system

Cross-sectional study

Increased rearfoot peak eversion and forefoot peak supination during walking.

9

Kerr et al., 2018 [17]

106 participants aged 5–18 years (53 asymptomatic neutral foot, 27 asymptomatic mild flatfoot, 17 asymptomatic flatfoot, 19 symptomatic flatfoot)

UK

51/65

Oxford Foot Model

Kinematics: Hindfoot relative to Tibia; inversion. Knee; flexion, varus. Hip; flexion

Vicon Motion Systems, Force-plates

Cross sectional study

The SF group also had slightly more (4º) hindfoot-tibia eversion than the AN group.

AF group had increased forefoot-hindfoot abduction (3°) compared to AN. AF group had less forefoot-hindfoot adduction (4°) than AN.

10

Shin et al., 2019 [43]

78 participants (16 severe flat foot, 20 moderate flat foot:52–80 years, 42 non-flatfoots:60–69 years)

Republic of Korea

0/78

Navicular drop test

Tempo-spatial Parameters: Cadence, Speed, Stride length, Step width, Step time

Kinematics: Hindfoot relative to Tibia; Dorsiflexion, Plantarflexion, Eversion, Inversion, Internal rotation, External rotation

Optical motion capture system

Cross sectional study

Decreased cadence, speed, stride length, and step width, Decreased ROM of sagittal and transverse plane of the hindfoot.

11

Dodelin et al., 2020 [25]

154 participants aged 20–50 years (63 pronated foot, 91 neutral foot)

France

154/0

Foot Posture Index, dynamic Center of

Pressure Excursion Index

Tempo-spatial Parameters: Velocity, Step length, Cadence.

Kinematics: Hindfoot relative to Tibia; Dorsiflexion, Plantarflexion, Eversion, Inversion, Internal rotation, External rotation

A 3-dimensional motion analysis system, pressure distribution platforms

Cross-sectional

Increased Anterior-posterior pelvic tilt ROM, peak knee internal rotation, forefoot dorsiflexion ROM, peak forefoot abduction, and rearfoot eversion. Increased Hallux contact time and time to peak force under the medial forefoot.

12

Alahmri et al., 2021 [28]

40 participants aged mean 21.45 years (20 asymptomatic pronated foot, 20 non-pronated foot)

Saudi Arabia

40/0

Navicular drop and rearfoot

Angle tests

Kinematic: Hip; flexion, extension, adduction, abduction, external rotation, internal rotation

MVN Xsens system

Cross sectional study

no significant differences in hip joint kinematics during gait

13

Marouvo et al., 2021 [20]

31 participants aged18-40 years (15 flatfoot, 16 normal foot)

Portugal

18/13

Navicular Drop Test, Resting Calcaneal Stance Position test

Kinematics: Ankle; Dorsiflexion, Plantarflexion, Abduction, Adduction, Internal rotation, External rotation.

Knee; Flexion, Extension, Abduction, Adduction, Internal rotation, External rotation.

Hip; Flexion, Extension, Abduction, Adduction, Internal rotation, External rotation

3d motion capture system

Cross sectional study

Decreased ankle peak dorsiflexion, abduction, and internal and external rotation, knee and hip peak extension, external rotation, and knee abduction.

14

Kim et al., 2021 [38]

47 participants aged 18–35 years (11 normal weight with normal arch heights, 10 normal weights with lower arch heights, 8 obesity with normal arch heights, 18 obesity with lower arch heights)

USA

22/25

Arch height index, Navicular drop test

Tempo-spatial Parameters: Step length, Step width, Velocity.

Kinematics: Ankle; Dorsiflexion, Plantarflexion, Abduction, Adduction, Internal rotation, External rotation.

Knee; Flexion, Extension, Abduction, Adduction, Internal rotation, External rotation.

Pressure-sensitive gait carpet, motion capture system, force plates

Cross-sectional study

Step length decreased in individuals with obesity than individuals with normal weight, Step width and double-limb support time increased in individuals with obesity than individuals with normal weight.

15

Son et al., 2023 [41]

20 participants aged 20–40 years (10 flexible flatfoot, 10 normal foot)

Republic of Korea

20/0

AP and lateral foot radiographs

Kinematics: Tibiotalar joint; Dorsiflexion, Plantarflexion, Abduction, Adduction, Internal rotation, External rotation.

Motion capture cameras, force plate

Cross sectional study

Increased lateral contact force and posteriorly located center of pressure in the tibiotalar joint

16

Vijittrakarnrung et al., 2024 [43]

22 participants aged 18–23 (11 symptomatic flexible flatfoot, 11 control)

Thailand

12/10

Radiographic/ Oxford Foot Model

Tempo-spatial Parameters: Cadence, Cycle time, Velocity, Stride length, Step width

Kinematics: Hindfoot relative to Tibia; Dorsiflexion, Plantarflexion, Eversion, Inversion, Internal rotation, External rotation

motion analysis system, force plates

Case-control

For hindfoot relative to tibia, the hindfoot internal rotation consistently demonstrated a higher value within the flexible flatfoot group vs. control group throughout the gait cycle.