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The arch myth: investigating the impact of flat foot on vertical jump height: a systematic review and meta-analysis

BMC Sports Science, Medicine and Rehabilitation volume 16, Article number: 236 (2024) Cite this article

Abstract

Objective

The necessity to exclude flat foot when selecting athletes is a controversial issue. This study aimed to investigate whether flat foot affects vertical jump.

Methods

The quality of the literature was assessed using the observational study quality assessment tool provided by the Joanna Briggs Institute (JBI) Centre for Evidence-Based Health Care in Australia. Meta-analysis, heterogeneity testing, sensitivity analysis, subgroup analysis, and forest plot were conducted using Review Manager 5.4.

Results

In the end, 9 articles met the meta-analysis criteria. Due to the heterogeneity of the studies, only vertical jump height was used as an indicator for meta-analysis. Meta-analysis results showed low heterogeneity among studies (I2 = 6%, P = 0.39), and the combined effect size showed no significant difference in jumping height between flat foot and normal foot (P = 0.73, ES = 0.13, 95%CI [-0.58, 0.83]). Subgroup analyses showed no significant differences in jump heights between flat and normal foot in either the adolescent subgroup (ES = 0.07, 95% CI [-1.04, 1.18]) or the adult subgroup (ES = 0.16, 95% CI [-0.76, 1.08]). Subgroups were divided according to training background, and jump height was unaffected by flat foot in both athletes (ES = -0.08, 95%CI [-1.07, 0.90]) and amateur (ES = 0.34, 95%CI [-0.67, 1.35]).

Conclusion

Overall, flat foot do not affect vertical jump height, although flat foot have different vertical jump biomechanics. This study breaks the bias that flat foot have poorer athletic performance. The meta-analysis has been registered with PROSPERO under registration number CRD42023481326.

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Introduction

The foot is a critical component of walking, running, and jumping, providing support and transmitting force to complete movement [1]. It is vital in maintaining balance and adapting to different surfaces, contributing significantly to overall physical performance. The foot arch is an essential part of the foot, comprising the Medial Longitudinal Arch (MLA), Lateral Longitudinal Arch (LLA), and Transverse Arch (TA) [2, 3]. The MLA, in particular, enhances movement efficiency by storing and releasing elastic potential energy [4]. Based on the height of the MLA, the foot can be classified into the flat foot, normal foot, and high arch foot [5]. Flat foot is a condition characterized by a collapse of the MLA, often accompanied by forefoot abduction, talar depression, and ligamentous laxity [6, 7]. Flat foot can be further categorized as flexible versus rigid. Flexible flat foot [8] differs from rigid flat foot in that flexible only shows arch collapse when the patient is weight-bearing and can show a normal medial longitudinal arch in the non-weight-bearing state (e.g., sitting position). However, in rigid flatfoot [9], the arch collapses in both weight-bearing and non-weight-bearing situations.

Flat foot may result in significant changes in lower extremity biomechanics, which may affect physical performance. Flat foot may lead to significant changes in the biomechanics of the lower limbs, including kinematics and plantar pressures [10,11,12]. This can affect physical performance. Živković et al.(2014) [13] conducted a study involving 114 elementary school students aged 11 to 12 years, categorizing them based on their foot type and assessing their explosive power through various tests. The results revealed that children with normal arches outperformed their flat foot peers significantly in explosive power tests. Similarly, Kojić et al.(2021) [14] found that foot condition had a significant impact on motor test results in preschool children, with those having high arches performing the best, followed by those with normal arches. In another study, Kararti et al.(2018) [15] recruited 64 healthy young adults aged between 18 and 25, evaluating flat foot using the Navicular Drop Test (NDT) and assessing physical performance through the side-step test and shuttle run test. Their findings indicated that increased severity of flat foot was associated with poorer performance in both tests. El-Shamy et al.(2014) [16] highlighted the impact of flat foot on dynamic balance, noting decreased balance parameters in adolescent females with flexible flat foot at various levels of the Biodex Balance System.

The vertical jump is a fundamental movement in many sports. In basketball, each player needs to complete approximately 50 jumps per game [17], including single-leg and double-leg jumps [18]. The vertical jump can be used to assess lower limb explosiveness [19]. The countermovement jump (CMJ) and the squat jump (SJ) are two common vertical jump tests [20]. The CMJ allows the subject to perform a self-selected countermovement before jumping. SJ, on the other hand, does not have a reverse motion. Subjects must maintain a static isometric squat position before takeoff. The core of vertical jumping, whether SJ or CMJ, involves flexion and extension of the hips, knees, and ankles. Previous research has shown [21] that increasing the ankle dorsiflexion angle before a vertical jump can enhance jump height. This may be since the fact that ankle dorsiflexion lengthens the calf triceps (gastrocnemius and piriformis), which generates higher torque and enhances jumping power [22]. On the other hand, studies [23] have shown that individuals with flat foot have relatively little ankle dorsiflexion mobility. This means that they have a restricted ankle dorsiflexion angle before jumping and may not be able to elongate the calf triceps as effectively as normal foot, which in turn limits the ability to generate higher torque. This difference of flat foot in ankle mobility may therefore have a negative impact on vertical jump. From a muscular perspective, however, the primary source of strength in the vertical jump is the coordinated firing of the hip extensors, knee extensors, ankle plantar flexors and toe flexors [24]. Numerous studies [25,26,27] have shown that individuals with flat foot have greater toe flexion strength(TFS) than normal foot. Given that TFS is a crucial component for enhancing jumping height [28], it raises the possibility that flat foot may improve vertical jump height. It is not clear whether the effect of flat foot on vertical jumping is positive or negative. This complex relationship suggests that interactions between multiple variables need to be considered when assessing the effect of flat foot on vertical jump.

Jumping height, as a result of the vertical jump, has integrated a variety of factors such as lower limb muscle strength, joint range of motion, and body coordination, making it a simpler and more representative indicator [29, 30]. However, the effect of flat foot on vertical jump height remains a critical topic [31,32,33,34]. For instance, Lin et al.(2001) [31] reported that individuals with flat foot exhibited inferior height in vertical jump compared to those with normal foot. Conversely, Sajedi et al.(2018) [33] found no significant difference in the CMJ height between flat foot and normal foot individuals.

This study aimed to systematically evaluate the effects of flat foot on vertical jump height as well as biomechanics. By understanding the effect of flat foot on jump height, sports teams or clubs can develop more scientific athlete selection criteria that take into account the role of athletes’ foot structure in vertical jumping, and thus make more rational judgements during the selection process.

Methods

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Appendix 1) [35]. The meta-analysis was registered with PROSPERO under the registration number CRD42023481326. Data extraction and methodological quality assessment were independently conducted by two researchers (Hb. Y and Wj. W). In instances of disagreement, a third researcher (Wh. T) was consulted to resolve the discrepancies.

Data source

Three reviewers (Hb. Y, Wj. W, and Wh. T) collectively decided on the search terms. After determining the search terms, retrieval and screening were done independently by two reviewers (Hb. Y and Wj. W) respectively and the consistency of the screening results was checked by Kappa. Any ambiguity in the screening process was discussed and decided jointly with the third reviewer(Wh. T). Relevant research papers were identified through comprehensive searches of the EBSCOhost, Web of Science, and PubMed databases. Additionally, grey literature was explored via ResearchGate and Google Scholar. The most recent search was conducted on May 16, 2024. Initially, the search strategy was formulated according to the PICO principle. However, due to too many restrictions, there was little literatures, so we finally decided to adjust the search strategy. Finally, P (participant) and O (Outcome) were retained as part of the PICO principle. Flat Foot and Pes Planus are Medical Subject Headings (MeSH) in the search terms. MeSH may be more precise, but sometimes it overlooks keywords that are not systematically marked in some studies. Therefore, read the literature and extract keywords for search. A combination of keywords was used. The patients’ search terms included “foot posture,” “flat foot,” “flat feet,” “arch index,” “arch height index,” “arch height,” “Clark’s angle,” “medial longitudinal arch,” “low arch,” “foot varus,” and “navicular drop.” The outcome search terms included “physical performance,” “vertical jump,” “jump performance,” “athletic performance,” and “jump.” Boolean logic operators facilitated the search strategy. Appendix 2 provides a detailed list of the search terms used for each database and the number of records retrieved from each source.

Selection criteria

All retrieved studies were imported into EndNote 20 (Thomson Reuters, New York, NY, USA) for organization and management. Only articles published in peer-reviewed journals were included in the analysis. Conference papers, non-English articles, and articles where data extraction was not feasible were excluded. The inclusion criteria are detailed in Table 1. Studies that did not meet these criteria were excluded from the analysis. The CMJ and SJ are commonly used jumps to evaluate vertical jumping. Their execution methods and biomechanical characteristics are similar. Therefore, in order to maintain the comparability and consistency of the research results, only studies that included CMJ and SJ were included to avoid the confounding effect caused by different jump types.

Table 1 Selection criteria
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Date extraction

The extracted data included (i) basic information (author’s name, year of publication); (ii) subject characteristics(age, sex, height, weight, body mass index); (iii) sample size; (iv) foot arch measurements; (v) Height of CMJ and SJ; (vi) Any biomechanical parameter of vertical jump.

Methodological quality assessment

The quality of the included studies was assessed using the observational study quality assessment tool provided by the Joanna Briggs Institute (JBI) Centre for Evidence-Based Health Care in Australia [36]. The JBI scale consists of eight questions: Q1: Were the sample inclusion criteria clearly defined? Q2: Was the study population and setting described in detail? Q3: Was exposure measured in a valid and reliable manner? Q4: Was the measurement of objective standards used? Q5: Were confounders identified? Q6: Was there a strategy to deal with the confounders? Q7: Was the outcome measured in a valid and reliable manner? Q8: Were appropriate statistical analyses used? Each criterion was scored with 1 point for a “yes” result and 0 points for a “no” or “unclear” result. To ensure the reliability of the meta-analysis results, only studies with a total score of ≥ 5 were included in the analysis [37].

Statistical analysis

Meta-analysis, heterogeneity testing, sensitivity analysis, publication bias, subgroup analysis, and forest plot were conducted using Review Manager 5.4 (Copenhagen: The Cochrane Collaboration, 2020). The primary quantitative synthetic indicator in this study was jump height. If the unit of measurement for jump height was inconsistent across studies, it was converted to centimetres uniformly. Once the units were harmonised, the mean difference and 95% confidence interval (CI) were used as effect scales for combining effect sizes(ES). The results of the Meta-analysis are presented as a forest plot. Less than 0.2 is a trivial difference, 0.2–0.5 is a small difference, 0.5–0.8 is a medium difference, and 0.8 and above is a large difference [38]. The I²statistic was employed to assess heterogeneity among studies. The random effects model was applied if I²> 50, indicating high heterogeneity. Conversely, the fixed effect model was utilized if I²≤50, suggesting low heterogeneity [39]. And, indicators that could not be quantitatively synthesised were analysed using qualitative synthesis.

Results

Search result

A total of 2260 articles were retrieved through systematic database searches, following which 596 duplicate records were identified and removed. Following the initial screening of abstracts and titles, 59 articles were selected for full-text review. Subsequently, after a comprehensive assessment of the full-text articles, 47 studies were excluded based on predefined criteria. These exclusions comprised 2 non-English articles, 4 conference papers, 26 articles failed to provide the required data, and 15 articles deemed irrelevant to the topic under investigation. Following methodological quality assessment using the Joanna Briggs Institute scale, an additional 3 articles were excluded due to a methodological quality score below the predetermined threshold of 5 points, resulting in their exclusion from further analysis. Consequently, a final set of 9 articles met the inclusion criteria for the meta-analysis. The reasons for the exclusion of articles are detailed in Appendix 3. Notably, the agreement between the two reviewers during the initial screening and full-text review stages was substantial, as evidenced by high kappa values of 0.930 and 0.863, respectively. The literature screening process is depicted in Fig. 1.

Fig. 1
figure 1

PRISMA flow chart

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Study characteristics

The included studies involved five methods for measuring flat foot, each with different standards. The specific measurement methods are described in Table 2.

Table 2 Foot measurement
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The total sample size included in the meta-analysis was 815, including 410 normal foot and 405 flatfoot. All studies reported ages, ranging from 10.01 ± 0.59 to 25.24 ± 3.31 years. Six studies [38, 39, 41, 43, 45, 46] reported height, ranging from 139.8 ± 7.86 to 173.25 ± 2.22 cm. Six studies [38, 39, 41, 43, 45, 46] reported weight, ranging from 36.74 ± 7.07 to 65.13 ± 4.66 kg. Three studies [38, 41, 46] used SJ and six studies [39, 40, 42,43,44,45] used CMJ. One study [38] did not report whether arms were swung during jumping. Of the remaining eight reports, four studies [40, 43,44,45] reported swinging and four studies [39, 41, 42, 46] reported jumping without arm swinging. Three studies [38, 41, 45] reported barefoot jumping, one [39] reported jumping with shoes, and the remaining five studies [40, 42,43,44, 46] did not report footwear. The basic information of the studies included in the meta-analysis is shown in Table 3.

Table 3 Characteristics of studies included
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Methodology quality assessment

The average JBI scale score of the studies included in the meta-analysis was 7.44 (Table 4). Four studies were excluded due to methodological quality assessment scores below 5. These excluded studies lacked comprehensive reporting on subject inclusion and exclusion criteria, anthropometric parameters, and the identification and addressing of confounding factors (refer to Appendix 3 for details on excluded articles).

Table 4 Methodological quality assessment of studies included
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Statistical analysis

Meta analysis and sensitivity analysis

Nine studies compared vertical jump height between flat foot and normal foot. Arévalo-Mora et al. a represents males, b represents females. Meta-analysis results (Fig. 2) showed low heterogeneity among studies (I2 = 6%, P = 0.39), and the combined effect size showed no significant difference between the groups (P = 0.73, ES = 0.13, 95%CI [-0.58, 0.83]). A sensitivity analysis was performed using the one-by-one elimination method. When any study was eliminated, the statistical results did not change in any direction, indicating that the meta-analysis results were stable.

Fig. 2
figure 2

Forest plot for total

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Publication bias analysis

Publication bias was assessed using funnel plots (Fig. 3). By visual inspection, the funnel plot showed a more symmetrical distribution of study results, with no obvious signs of publication bias. Therefore, the risk of publication bias was low in this Meta-analysis.

Fig. 3
figure 3

Funnel plot

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Subgroup analysis and sensitivity analysis

According to the age grouping standard of the World Health Organization (WHO), subgroup analysis was performed according to the age of the subjects, with those aged 18 years and above being the adult group and those aged 18 years and below being the adolescent group [54]. The intragroup heterogeneity of the adolescent subgroup was low (I2 = 22%, P = 0.27), and the combined statistical results showed no significant difference (ES = 0.07, 95%CI [-1.04, 1.18]). The sensitivity analysis using the one-by-one exclusion method showed that the statistical results of the adolescent subgroup were relatively stable. The intragroup heterogeneity of the adult subgroup was low (I2 = 4%, P = 0.37), and the combined statistical results showed no significant difference (ES = 0.16, 95%CI [-0.76, 1.08]). The sensitivity analysis using the one-by-one exclusion method showed that the statistical results of the adult subgroup were relatively stable. The results of the age subgroup analysis are shown in Fig. 4.

Fig. 4
figure 4

Subgroup forest plot for age

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According to the training background, the population were divided into athlete and amateur subgroups. The intra-group heterogeneity of the athlete subgroup was low (I2 = 30, P = 0.23). The combined statistical results of the athlete subgroup were not significant (ES = -0.08, 95%CI [-1.07, 0.90]). The sensitivity analysis using the one-by-one exclusion method showed that the statistical results of the athlete subgroup were relatively stable. The intra-group heterogeneity of the amateur subgroup was low (I2 = 10%, P = 0.35), and the combined statistical results were not significant (ES = 0.34, 95%CI [-0.67, 1.35]). The sensitivity analysis using the one-by-one exclusion method showed that the statistical results of the amateur subgroup were relatively stable. The results of the training background subgroup analysis are shown in Fig. 5.

Fig. 5
figure 5

Subgroup forest plot for training background

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Divided into CMJ and SJ subgroups based on jump type, the CMJ subgroup exhibited low within-group heterogeneity (I² = 1%, P = 0.42) and the pooled statistics for this group were not significant (ES = -0.10, 95% CI [-0.85, 0.65]). Sensitivity analyses by a case-by-case exclusion method showed relatively stable results in the CMJ subgroup. Similarly, the SJ subgroup showed low within-group heterogeneity (I² = 0%, P = 0.93), and the combined results were not significant (ES = 0.13, 95% CI [-0.12, 4.24]). Sensitivity analyses by a case-by-case exclusion method showed relatively stable results in the SJ subgroup. The results of the jump type subgroup analysis are shown in Fig. 6.

Fig. 6
figure 6

Subgroup forest plot for jumping type

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Qualitative synthesis

Two studies compared the biomechanical differences between flat foot and normal foot during vertical jumping (Table 5). In the kinematic analysis of the lower limbs [43], the dorsiflexion-plantarflexion range, eversion-inversion range, and internal-external rotation range of the ankle joint during jumping were significantly greater in the flat foot than in the normal foot. The knee flexion-extension and internal-external rotation ranges were significantly smaller in flat foot than in normal foot. In the lower limb muscle activation analysis [46], the activation of gastrocnemius medialis was greater in the flat foot than in the normal foot during jumping.

Table 5 Qualitative synthesis
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Discussion

Previous reports [55] have shown that the prevalence of flat foot in adults is as high as 13.4%. This means that at least one in ten adults has flat foot. This proportion suggests that flat foot are occurring more prevalently in the adult population and have become a common structural abnormality of the foot. Flat foot not only harm strength and balance performance [13,14,15,16] but also reduce muscle activation during walking [56]. However, it remains uncertain whether flat foot affect vertical jump. The main findings of this study were (i) flat foot did not affect vertical jump height; (ii) flat foot did not affect vertical jump height in either age or training background subgroups; (iii) flat foot did not affect either CMJ or SJ height; and (iv) there were differences in the biomechanics of vertical jumping between flat and normal foot.

The present study found that at least in terms of vertical jump height, flat foot did not perform worse than normal foot. However, in vertical jumping, the range of joint motion and muscle activation of flat foot are different from those of normal foot. Contarli et al.(2022) [48] investigated muscle activation during squat jump by surface electromyography in 28 flat foot and 16 normal foot gymnasts. The study examined the activation of gastrocnemius medialis, soleus, tibialis anterior and peroneus longus. The results showed that among these four calf muscle groups, activation of gastrocnemius medialis during the jumping phase was significantly lower in flat foot athletes than in normal foot athletes. This result may indicate that although there are differences in calf muscle activation patterns, these differences are not sufficient to affect vertical jump height. However, this conclusion should still be viewed with caution as the study was limited to the calf muscle group and muscle activation in the thigh muscle group was not detected. Therefore, the possibility that flat foot athletes maintain jump height through compensatory effects of the thigh muscle groups cannot be ruled out. Future studies should further extend the examination to include muscle activation of thigh muscle groups (e.g., quadriceps) to fully assess the effects of flat foot on overall lower extremity muscle activation. Fu et al.(2016) [45] found significant differences in the range of joint motion during jumping between flat and normal foot. The ankle joint had a significantly greater angular range of motion in plantar flexion and dorsi flexion movements, while the knee joint had a significantly smaller angular range of flexion and extension movements in flat foot. The greater ankle range of motion in flat foot during vertical jumping may reflect a compensatory mechanism to maintain overall jumping height. Compensation is a complex process aiming to counteract deficiencies and adapt to the environment under pathological morphological and functional conditions arising from an illness or injury [57]. Compensation is the body’s natural ability to provide alternative means of performing lost functions [58]. Previous studies [59] have shown that there is a neuromuscular compensatory mechanism that minimizes the loading of the medial longitudinal arch of the flat foot during the contact phase of walking. No studies have investigated whether flat foot also possess the neuromuscular compensatory mechanisms during vertical jumping. It is not sufficient to draw this conclusion that neuromuscular compensation from kinematic data (e.g., joint range of motion) alone. Although greater ankle joint activity may have been intended to compensate for reduced knee joint activity, further exploration through kinetic studies is required to accurately verify this hypothesis. By analyzing the moments at each joint, a more precise understanding of the forces on the different joints during jumping can be obtained, thus supporting the hypothesis of a compensatory mechanism.

There are a wide variety of jumping tests [60] and they are performed for different purposes, with CMJ and SJ being the core metrics for assessing vertical jumping ability. Despite the differences between CMJ and SJ, the results of the subgroup analyses showed that flat foot had no significant effect on the height of either jump type. This result is reasonable because both CMJ and SJ involve multiple effect factors, and foot morphology alone may not be sufficient to significantly change overall jump height. Future studies could consider using other types of jumping tests, such as the pogo jump. The pogo jump is a jumping maneuver that relies primarily on ankle dorsiflexion and extension, with less hip and knee movement, and is designed to assess the fast stretch-shortening cycle (SSC), specifically reaction strength [61]. The pogo jump allows for the direct measurement of ankle strength and reaction time, thus more precisely analyzing the specific effects of foot structure on fast reactive jumping performance.

Unfortunately, none of the nine included articles described the severity or type of flat foot. Previous study [62] have shown that different degrees of flat foot severity have different effects on physical performance. Therefore, it is critical to consider the severity of flat foot when assessing its impact on jumping performance. In addition, the type of flat foot is also important. There are different states of flexible flat foot or rigid flat foot, which may have different effects on jumping performance. Flexible flat foot [63] have a collapsed arch under weight-bearing, but the arch can be restored under non-weight-bearing conditions. In contrast, rigid flat foot [64] always have a collapsed arch whether weight-bearing or not, which may lead to a less efficient foot movement. Future studies should further categorize and quantify the different levels of severity of flat foot in order to delve into the specific effects of these different levels of flat foot on jumping performance. In this study, only Fu et al.(2016) [45] and Contarli et al.(2022) [48] reported the shoe condition of the subjects. They asked the subjects to perform the vertical jump test barefoot. LaPorta et al.(2013) [65] observed that vertical jump heights were significantly higher when barefoot (without arm swing) than when wearing shoes. Another study [66] showed that the use of insoles improved vertical jump kinetics in athletes with flat foot, bringing their performance closer to that of athletes with normal arches who did not use insoles. The variability in footwear conditions between studies highlights the need for standardized protocols in future research. Ensuring consistent footwear conditions, or at least reporting them thoroughly, is critical to reducing confounding variables and improving the reliability of comparisons.

A total of five flat foot assessment methods were used in the included studies, with the footprint method being the most common. This method includes various indices such as the CA [41], the SI [42], the HAI [43], and the CAI [44], which are mainly calculated based on footprint characteristics. To quantify the arch structure, these indices use different calculation methods, including area ratio, length ratio, coordinate method, or deviation angle. Another widely used method is to assess the drop in navicular height under weight-bearing and non-weight-bearing conditions [40]. The measurement accuracy of each method is inconsistent. Menz et al. [67] conducted a study comparing the effectiveness of the CAI and navicular height (NH) measurements in assessing static foot posture in the elderly. They found that both the CAI and NH were effective in providing insight into the structure of the medial longitudinal arch, but the NH had greater clinical utility. Queen et al.(2007) [68] demonstrated that the footprint index was the most reliable measurement method for assessing foot structure, followed by the SI and the Chippaux-Smirak index (CSI). Different flat foot measures each possess different criteria and sensitivities, which may lead to inconsistent diagnostic results. Such diagnostic differences will directly affect the consistency of results in Meta-analyses, increasing the heterogeneity of analyses, which in turn will adversely affect the interpretability and comparability of study results. Therefore, there is a need for standardization of flat foot assessment methods in future studies.

Traditionally, it might be thought that flat foot would significantly affect athletic performance. However, the present study found that jump height is not significantly affected, even when flat foot’s jumping biomechanics are different. This finding breaks the stereotype of flat foot athleticism and shows that individuals with flat foot can also excel in jumping. Therefore, this may help to eliminate the excessive concern that athletes and coaches have about flat foot and encourage individuals with flat foot to participate more confidently in all types of sports. In addition, when selecting and developing potential athletes, flat foot individuals should not be easily excluded because of differences in arch morphology. Such findings provide coaches, sports scientists, and sport selectors with a more scientific basis for selecting and developing athletes with a greater focus on the overall ability and potential of the athlete, rather than making judgments based on foot type alone. However, the review is not without its limitations. One notable constraint is the potential for language bias, as the inclusion criteria were restricted to studies published in English. This language restriction may have excluded relevant studies published in other languages, possibly impacting the comprehensiveness and generalizability of the results. Despite these limitations, this meta-analysis provides valuable insights into the potential impact of flat foot on vertical jump performance.

Conclusions

This study comprehensively assessed the effect of flat foot on vertical jumping. The results of the study showed that flat foot did not affect vertical jump height regardless of age or training background. And flat foot did not affect jumping height whether CMJ or SJ was used. However, flat foot alter vertical jump biomechanics and future studies are needed to investigate whether there are compensatory mechanisms for flat foot in vertical jumping. The flat foot diagnostic methods varied, highlighting the need for standardized assessment protocols to improve the comparability and reliability of future studies. The findings of this study help to break down stereotypes of flat foot sports performance and show that individuals with flat foot can still perform well in vertical jumping.

Data availability

Data from this study can be found in the included references or in Appendix 4.

Abbreviations

JBI:

Joanna Briggs Institute

MLA:

Medial Longitudinal Arch

LLA:

Lateral Longitudinal Arch

TA:

Transverse Arch

NDT:

Navicular Drop Test

TFS:

Toe Flexor Strength

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

JBI:

Joanna Briggs Institute

CI:

Confidence Interval

CA:

Clarke Angle

SI:

Staheli Index

HAI:

Harris Arch Index

CAI:

Cavanagh Arch Index

WHO:

World Health Organization

GM:

Gastrocnemius Medialis

NH:

Navicular Height

CSI:

Chippaux-Smirak Index

FFF:

Flexible Flat Foot

RFF:

Rigid Flat Goot

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Funding

This research was supported by the China Postdoctoral Science Foundation Project (No.2023M730600); the Industry-University-Research Cooperation Project of the Fujian Provincial Department of Science and Technology (No.2022H6034); the Fujian Provincial Social Science Planning Project (No.FJ2022B023); the Special Support Project for Taiwan Compatriots (No.FJ2023T011); and the Fujian Provincial Education Research Project for Young and Middle-aged Teachers (No.JAT220269).

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Authors and Affiliations

  1. Chengdu Sport University, Sichuan, Chengdu, 610000, China

    Haibin Yu & Weihsun Tai

  2. School of Sports Science, Fujian Normal University, Fuzhou, 350117, China

    Wenjian Wu

  3. School of Physical Education, Quanzhou Normal University, Quanzhou, 362000, China

    Haibin Yu, Wenjian Wu, Weihsun Tai, Jing Li & Rui Zhang

  4. Key Laboratory of Bionic Engineering (Ministry of Education China), Jilin University, Changchun, 130022, China

    Rui Zhang

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Contributions

Topic selection, (W.-H.T. ,H.-B.Y. and W.-J.W.); Registration of the project, (W.-J.W.); Pilot study, (H.-B.Y. and W.-J.W.); Data collection (H.-B.Y. and W.-J.W.); Quality assessment (W.-H.T. ,H.-B.Y. and W.-J.W.); Data analysis (H.-B.Y. and L.J.); Data and results verification (W.-J.W. and R.Z.); Writing the original draft (W.-H.T. ,H.-B.Y.); Manuscript revision (W.-H.T. ,H.-B.Y.,W.-J.W., L.J. and R.Z.); Funding (W.-H.T. ,H.-B.Y.)

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Yu, H., Wu, W., Tai, W. et al. The arch myth: investigating the impact of flat foot on vertical jump height: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 16, 236 (2024). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s13102-024-01018-w

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BMC Sports Science, Medicine and Rehabilitation

ISSN: 2052-1847

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