Self-perceived foot function and pain in children and adolescents with flexible flatfeet – Relationship between dynamic pedobarography and the foot function index

•Dynamic pedobarography and the FFI were evaluated in a clinical sample of pediatric flatfeet.•Pedobarography was correlated the disability and pain domain of the FFI.•More associations could be found with respect to perceived disability than for pain.•Peak pressures and forces are more important than area related measurements. There is considerable debate as to which parameters to include in the assessment of paediatric flatfeet. Dynamic pedobarography is an objective, dynamic method to measure foot function. Information about its associations to patient-reported measures may help to focus on the most relevant parameters. What is the association between the Foot Function Index and pedobarographic assessments in flatfeet of children and adolescents? A consecutive clinical case series of 51 participants with idiopathic flexible flatfeet aged 7–17 years underwent barefooted pedobarography during gait and completed the Foot Function Index Questionnaire. Pedobarographic data categorized into values related to area, peak pressure and force with respect to the hind-, mid- and forefoot were extracted. To test the associations between the Foot Function Index and pedobarographic assessments, bivariate partial correlations were tested and contact times served as co-variate. Several significant associations between peak pressure or forces beneath the hindfoot, midfoot and hallux to self-perceived function were found (|rho| = 0.28–.46, P < 0.05). In particular, reduced peak forces and pressures underneath the hindfoot and hallux, a lateral shift (smaller medio-lateral ratios) of hindfoot pressure and force and a medial shift (larger medio-lateral ratios) of midfoot pressure seem to be negatively associated with foot-related disability. Overall, less evidence was noted for associations to pain scores. Area related outcomes (including the arch index) contained no information for function while a larger BMI was the strongest thread for disability (rho = 0.42, P = 0.002) and pain (rho = 0.31, P = 0.027). When using pedobarography for the assessment of flexible flatfeet of children and adolescents, less attention should be paid to area related measurements which do not provide information about self-perceived function or disability. Instead, peak pressures or forces in the hind- or midfoot or beneath the hallux may be focussed. Weight reductions are potentially an effective strategy to reduce or prevent symptoms.