No group without hindlimb suspension was included, it remains unclear whether the observed reduction

The gap

Evidence profile

Sourced from the recommendations and limitations of the source papers, classified as general, drawn from work published between 2025 and 2026, spanning 3 journals. Those papers have been cited 1 times in total.

Supporting evidence — 3 representative gaps

• Frequency of Pes Planus in Its Association with Ankle Pain and Risk of Fall Reported in School Students. Cross-Sectional Study (2026) · American Journal of Physical Education and Health Science · doi

  • Introduce early screening programs in schools to identify students with pes planus and related ankle or balance problems. • Provide awareness sessions and simple exercise programs to strengthen the foot, improve balance, and reduce fall risk among schoolchildren. • Conduct longitudinal studies with larger and more diverse student populations to confirm these findings and evaluate long-term outcome. 5 6 https://journals.e-palli.com/home/index.php/ajpehs Page Am. J. Phys. Educ. Health Sci. 4(1) 57-67, 2026REFERENCES Açak, M. (2020). The effects of individually designed insoles on pes planus treatment. Scientific Reports, 10(1), 19715. Aenumulapalli, A., Kulkarni, M. M., & Gandotra, A. R. (2017). Prevalence of flexible flat foot in adults: a cross-sectional study. Journal of clinical and diagnostic research: JCDR, 11(6), AC17. Alahmri, F., Alsaadi, S., Ahsan, M., & Almousa, S. (2022). The effect of isokinetic hip muscle strength on normal medial longitudinal arch feet and pes planus. Journal of medicine and life, 15(9), 1164. Ateeque, A., Shabbir, S., Nadeem, T., Zubair, H., & Khizar, Z. (2024). Prevalence of Flatfoot in School-Going Children, Lahore. Journal of Health and Rehabilitation Research, 4(2), 745-749. Ayu, I. A. A. S. I., Suadnyana, A., Kadek, N. K. Y. F. N., Fridayani, Y., Made, I. M. D. P. I., & Prianthara, D. (2023). Association of foot posture and static balance among senior high school students in Bali, Indonesia as predictor of injury: A cross-sectional study. The Southeast Asian Journal of Tropical Medicine and Public Health, 54(Suppl. 2), 272–286. Babu, D., & Bordoni, B. (2020). Anatomy, bony pelvis and lower limb, medial longitudinal arch of the foot. In StatPearls. StatPearls Publishing. Bakırhan, S., Elibol, N., Özkeskin, M., & Özden, F. (2021). The relationship between knee-ankle muscle strength and performance tests in young female adults with flexible pes planus. Bulletin of Faculty of Physical Therapy, 26(1), 4. Barutcu, E., Paksoy, B., Selçuk, M., Karaca, O., & Yılmaz, K. (2024). Effects Of Pes Planus On Foot Pain, Low Back Pain And Balance İn Young Adult Individuals. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 15(3), 240- 246. Birhanu, A., Nagarchi, K., Getahun, F., Gebremichael, M. A., & Wondmagegn, H. (2023). Magnitude of flat foot and its associated factors among school-aged children in Southern Ethiopia: an institution-based cross-sectional study. BMC Musculoskeletal Disorders, 24(1), 966. Chou, M.-C., Huang, J.-Y., Hung, Y.-M., Perng, W.-T., Chang, R., & Wei, J. C.-C. (2021). Flat foot and spinal degeneration: Evidence from nationwide population- based cohort study. Journal of the Formosan Medical Association, 120(10), 1897-1906. Demircioglu, G., & Genc,

  generalrecommendations
  Keywords: foot planus journal balance among longitudinal health flat cross sectional school programs students ankle effects
• Joint Contracture Resulting From a Two-Hour Daily Joint Immobility: An Experimental Study in Rats (2026) · Cureus · doi

  In addition, because no group without hindlimb suspension was included, it remains unclear whether the observed reduction in ankle dorsiflexion range of motion was specifically attributable to the two hour daily immobilization period alone. Additionally, the development of contracture may vary depending on the interaction between immobilization duration and experimental period, which should be explored in subsequent investigations. Fifth, the histological assessment in this study was limited to the measurement of soleus muscle fiber cross-sectional area. Eighth, the immobilization period was fixed at two hours per day; however, it remains uncertain whether this duration represents the minimum threshold for inducing contracture.

  generallimitations
  Keywords: immobilization period remains whether contracture duration addition group without hindlimb suspension included unclear observed reduction
• Plantar pressure distribution during gait cycle after subtalar arthroereisis in adolescent flexible flatfoot (2025) · Frontiers in Pediatrics · cited 1× · doi

  sensors and J Electromyogr Kinesiol. (2000) 10(5):361–74. doi: 10.1016/S1050-6411(00)00027-4 for SEMG 33. Hagen M, Schwiertz G, Landorf KB, Menz HB, Murley GS. Selective activation of lower leg muscles during maximum voluntary isometric contractions. Hum Mov Sci. (2016) 50:30–7. doi: 10.1016/j.humov.2016.10.002 34. Schmidt H, Sauer LD, Lee SY, Saliba S, Hertel J. Increased in-shoe lateral (2011) instability. Foot Ankle Int. plantar pressures with chronic ankle 32(11):1075–80. doi: 10.3113/FAI.2011.1075 35. Carr JB, Yang S, Lather LA. Pediatric pes planus: a state-of-the-art review. Pediatrics. (2016) 137(3):e20151230. doi: 10.1542/peds.2015-1230 36. Bresnahan PJ, Juanto MA. Pediatric flatfeet—a disease entity that demands greater attention and treatment. Front Pediatr. (2020) 8:19. doi: 10.3389/fped.2020.00019 37. Li B, He W, Yu G, Zhou H, Xia J, Zhao Y, et al. Treatment for flexible flatfoot in children with subtalar arthroereisis and soft tissue procedures. Front Pediatr. (2021) 9:656178. doi: 10.3389/fped.2021.656178 38. Dars S, Uden H, Banwell HA, Kumar S. The effectiveness of non-surgical intervention (foot orthoses) for paediatric flexible pes planus: a systematic review: update. PLoS One. (2018) 13(2):e0193060. doi: 10.1371/journal.pone.0193060 39. Bernasconi A, Lintz F, Sadile F. The role of arthroereisis of the subtalar joint for flatfoot in children and adults. EFORT Open Rev. (2017) 2(11):438–46. doi: 10.1302/ 2058-5241.2.170009 40. Chang TJ, Lee J. Subtalar joint arthroereisis in adult-acquired flatfoot and posterior tibial tendon dysfunction. Clin Podiatr Med Surg. (2007) 24(4):687–97. doi: 10.1016/j.cpm.2007.07.008 41. Fernández De Retana P, Álvarez F, Bacca G. Is there a role for subtalar arthroereisis in the management of adult acquired flatfoot? Foot Ankle Clin. (2012) 17(2):271–81. doi: 10.1016/j.fcl.2012.03.006 42. Choi JY, Lee DJ, Kim SJ, Suh JS. Does the long-term use of medial arch support insole induce the radiographic structural changes for pediatric flexible flat foot?—a prospective comparative study. Foot Ankle Surg. (2020) 26(4):449–56. doi: 10.1016/ j.fas.2019.05.017 43. Chatwin KE, Abbott CA, Boulton AJM, Bowling FL, Reeves ND. The role of foot pressure measurement in the prediction and prevention of diabetic foot ulceration—a comprehensive review. Diabetes Metab Res Rev. (2020) 36(4):e3258. doi: 10.1002/dmrr.3258 44. Ohuchi H, Chavez JS, Alvarez CAD. Changes in calcaneal pitch and heel fat pad thickness in static weight bearing radiographs while wearing shoes with arch support and heel cup orthotics. Asia Pac J Sports Med Arthrosc Rehabil Technol. (2019) 17:21–4. doi: 10.1016/j.asmart.2019.07.001 45. Yurt Y, Şener G, Yakut Y. The effect of different foot orthoses on pain and health related quality of life in painful flexible flat foot: a randomized controlled trial. Eur J Phys Rehabil Med. (2019) 55(1):95–102. doi: 10.23736/S1973-9087.18. 05108-0 46. Reeves J, Jones R, Liu A, Bent L, Plater E, Nester C. A systematic review of the effect of footwear, foot orthoses and taping on lower limb muscle activity during walking and running. Prosthet Orthot Int. (2019) 43(6):576–96. doi: 10.1177/ 0309364619870666 47. Gutierrez PR, Lara MH. Giannini prosthesis for flatfoot. Foot Ankle Int. (2005) 26(11):918–26. doi: 10.1177/107110070502601104

  generalrecommendations
  Keywords: foot ankle flatfoot review flexible subtalar arthroereisis pediatric orthoses role lower planus treatment front pediatr

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