Correlation Between Physical Activity Level and Flatfoots Degree in Individual with Intellectual Disabilities and Obesity: Comparison Between Athletes and Non-Athletes
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Published:
Jun 17, 2025
Keywords:
flatfoot, physical activity level, intellectual disability, obesity, special athlete
Main Article Content
Abstract
Abstract
Background: Increasing incident of obesity was also in the population of intellectual disability (ID). Some of them are an athlete. The research aims to assess the relationship between level of physical activity and the degree of flatfoot on individual with intellectual disability and obesity. This research also provide data on the prevalence and degree of flatfoot.
Method: This research was using analytic observational method in cross-sectional studies in groups of athletes and non-athletes with a total of 68 subjects. The data collected between July 2021 to October 2022. The data included subject characteristics, daily activities that converted to metabolic equivalent (MET) score of physical activity level (PAL), BMI, and footprints using the Harris Mat. The clinical outcomes were analysed using Spearman, Man Whitney, and Fisher’s exact test.
Result: Flatfoot occurred in 97% of the samples based on Viladot criteria. All the non-athlete group had flatfoot and more severe degree of flatfoot, and there were 2 individuals with normal feet in the athlete group. There was relationship between the degree of flatfoot in special athlete - obesity groups and gender. No relationship between the degree of flatfoot in both groups with age, degree of intellectual disability, degree of obesity and PAL, type of sport or duration of active as an athlete.
Conclusion: There is no relationship between the degree of flatfoot and the PAL in the athlete and non-athlete groups of intellectual disability and obesity.
Keywords: flatfoot, physical activity level, intellectual disability, obesity, special athlete
Background: Increasing incident of obesity was also in the population of intellectual disability (ID). Some of them are an athlete. The research aims to assess the relationship between level of physical activity and the degree of flatfoot on individual with intellectual disability and obesity. This research also provide data on the prevalence and degree of flatfoot.
Method: This research was using analytic observational method in cross-sectional studies in groups of athletes and non-athletes with a total of 68 subjects. The data collected between July 2021 to October 2022. The data included subject characteristics, daily activities that converted to metabolic equivalent (MET) score of physical activity level (PAL), BMI, and footprints using the Harris Mat. The clinical outcomes were analysed using Spearman, Man Whitney, and Fisher’s exact test.
Result: Flatfoot occurred in 97% of the samples based on Viladot criteria. All the non-athlete group had flatfoot and more severe degree of flatfoot, and there were 2 individuals with normal feet in the athlete group. There was relationship between the degree of flatfoot in special athlete - obesity groups and gender. No relationship between the degree of flatfoot in both groups with age, degree of intellectual disability, degree of obesity and PAL, type of sport or duration of active as an athlete.
Conclusion: There is no relationship between the degree of flatfoot and the PAL in the athlete and non-athlete groups of intellectual disability and obesity.
Keywords: flatfoot, physical activity level, intellectual disability, obesity, special athlete
Article Details
How to Cite
Putra, I., Zainuddin Tamin, T., Aryanti, L., & Kurniarobbi, J. (2025). Indonesian Journal of Physical Medicine and Rehabilitation, 14(1), 29 - 38. https://doi.org/10.36803/indojpmr.v14i1.437
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Original Article
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References
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4. Chen KC, Yeh CJ, Tung LC, Yang JF, Yang SF, Wang CH. Relevant factors influencing flatfoot in preschool-aged children. Eur J Pediatr. 2011;170(7):931-6.
5. Raj MA, DeCastro A, Seaman TJ, Kiel J. Pes Planus: StatPearls Publishing LLC; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430802/.
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9. Butte NF, Watson KB, Ridley K, Zakeri IF, McMurray RG, Pfeiffer KA, et al. A Youth Compendium of Physical Activities: Activity Codes and Metabolic Intensities. Medicine and science in sports and exercise. 2018;50(2):246-56.
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11. Riccio I, Gimigliano F, Gimigliano R, Porpora G, Iolascon G. Rehabilitative treatment in flexible flatfoot: a perspective cohort study. La Chirurgia degli organi di movimento. 2009;93:101-7.
12. Mharada CM, Siperstein GN. The sport experience of athletes with intellectual disabilities: a national survey of special olympics athletes and their families. Adapt Phys Activ Q. 2009;26(1):68-85.
13. Temple VA, Foley JT, Lloyd M. Body mass index of adults with intellectual disability participating in Special Olympics by world region. J Intellect Disabil Res. 2014;58(3):277-84.
14. Selikowitz M. Down syndrome. 3rd ed. United States: Oxford University Press; 2008. 27 p.
15. Cherif M, Said MA, Bannour K, Alhumaid MM, Chaifa MB, Khammassi M, et al. Anthropometry, body composition, and athletic performance in specific field tests in Paralympic athletes with different disabilities. Heliyon. 2022;8(3):e09023.
16. Gomez-Hixson K, Batista N, Brown M. Retrospective analysis of the Special Olympics Health Promotion database for nutrition-specific variables. Heliyon. 2021;7(12):e08586.
17. Tamin TZ. Model dan Efektivitas latihan endurans untuk peningkatan kebugaran penyandang disabilitas intelektual dengan obesitas [dissertation]. Jakarta: Universitas Indonesia. 2009.
18. Walsh D, Belton S, Meegan S, Bowers K, Corby D, Staines A, et al. A comparison of physical activity, physical fitness levels, BMI and blood pressure of adults with intellectual disability, who do and do not take part in Special Olympics Ireland programmes. Journal of intellectual disabilities : JOID. 2017;22:1744629516688773.
19. Segal M, Eliasziw M, Phillips S, Bandini L, Curtin C, Kral TV, et al. Intellectual disability is associated with increased risk for obesity in a nationally representative sample of U.S. children. Disabil Health J. 2016;9(3):392-8.
20. Hove O. Survey on dysfunctional eating behavior in adult persons with intellectual disability living in the community. Research in developmental disabilities. 2007;28:1-8.
21. Rizzi M, Gambini O, Marras CE. Chapter 7 - Posterior hypothalamus as a target in the treatment of aggression: From lesioning to deep brain stimulation. In: Swaab DF, Buijs RM, Kreier F, Lucassen PJ, Salehi A, editors. Handbook of Clinical Neurology. 182: Elsevier; 2021. p. 95-106.
22. Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev. 2007;8(1):21-34.
23. Bibro M, Jankowicz-Szymańska A, Wódka K, Łaczek-Wójtowicz M. Impact of intellectual disability on longitudinal arch and symmetry of the lateral and medial load of the foot. Health Promotion & Physical Activity. 2019;6(1):28-32 (29-34).
24. Stolzman S, Irby MB, Callahan AB, Skelton JA. Pes planus and paediatric obesity: a systematic review of the literature. Clin Obes. 2015;5(2):52-9.
25. Xu L, Gu H, Zhang Y, Sun T, Yu J. Risk Factors of Flatfoot in Children: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(14).
26. Pourghasem M, Kamali N, Farsi M, Soltanpour N. Prevalence of flatfoot among school students and its relationship with BMI. Acta Orthop Traumatol Turc. 2016;50(5):554-7.
27. Maia N, Nabais Sá MJ, Melo-Pires M, de Brouwer APM, Jorge P. Intellectual disability genomics: current state, pitfalls and future challenges. BMC Genomics. 2021;22(1):909.
28. Ariani Y, Soeharso P, Sjarif DR. Genetics and genomic medicine in Indonesia. Mol Genet Genomic Med. 2017;5(2):103-9.
29. Zhao X, Tsujimoto T, Kim B, Katayama Y, Wakaba K, Wang Z, et al. Effects of increasing physical activity on foot structure and ankle muscle strength in adults with obesity. J Phys Ther Sci. 2016;28(8):2332-6.
30. Song J, Kane R, Tango DN, Veur SS, Furmato J, Komaroff E, et al. Effects of weight loss on foot structure and function in obese adults: a pilot randomized controlled trial. Gait Posture. 2015;41(1):86-92.
2. Tamin TZ, Idris F, Mansyur M, Rusli Sjarif D. Prevalence and determinants of obesity in students with intellectual disability in Jakarta. Medical Journal of Indonesia. 2014;23:106.
3. Wolan-Nieroda A, Guzik A, Bazarnik-Mucha K, Rachwał M, Drzał-Grabiec J, Szeliga E, et al. Assessment of Foot Shape in Children and Adolescents with Intellectual Disability: A Pilot Study. Medical science monitor : international medical journal of experimental and clinical research. 2018;24:2149-57.
4. Chen KC, Yeh CJ, Tung LC, Yang JF, Yang SF, Wang CH. Relevant factors influencing flatfoot in preschool-aged children. Eur J Pediatr. 2011;170(7):931-6.
5. Raj MA, DeCastro A, Seaman TJ, Kiel J. Pes Planus: StatPearls Publishing LLC; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430802/.
6. Shapiro BK, O'Neill ME. Developmental delay and intellectual disability. In: Kliegman RM, Geme JS, editors. Nelson textbook of pediatrics. 1. 21 ed. Philadelphia: Elsevier; 2019. p. 283-94.
7. Indonesia SO. Program Olahraga 2019 [updated 2018. Available from: http://www.soina.id/pages/olahraga/id.
8. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9 Suppl):S498-504.
9. Butte NF, Watson KB, Ridley K, Zakeri IF, McMurray RG, Pfeiffer KA, et al. A Youth Compendium of Physical Activities: Activity Codes and Metabolic Intensities. Medicine and science in sports and exercise. 2018;50(2):246-56.
10. McComb J, Carnero E, Iglesias-Gutiérrez E. Estimating Energy Requirements. 2014. p. 411-49.
11. Riccio I, Gimigliano F, Gimigliano R, Porpora G, Iolascon G. Rehabilitative treatment in flexible flatfoot: a perspective cohort study. La Chirurgia degli organi di movimento. 2009;93:101-7.
12. Mharada CM, Siperstein GN. The sport experience of athletes with intellectual disabilities: a national survey of special olympics athletes and their families. Adapt Phys Activ Q. 2009;26(1):68-85.
13. Temple VA, Foley JT, Lloyd M. Body mass index of adults with intellectual disability participating in Special Olympics by world region. J Intellect Disabil Res. 2014;58(3):277-84.
14. Selikowitz M. Down syndrome. 3rd ed. United States: Oxford University Press; 2008. 27 p.
15. Cherif M, Said MA, Bannour K, Alhumaid MM, Chaifa MB, Khammassi M, et al. Anthropometry, body composition, and athletic performance in specific field tests in Paralympic athletes with different disabilities. Heliyon. 2022;8(3):e09023.
16. Gomez-Hixson K, Batista N, Brown M. Retrospective analysis of the Special Olympics Health Promotion database for nutrition-specific variables. Heliyon. 2021;7(12):e08586.
17. Tamin TZ. Model dan Efektivitas latihan endurans untuk peningkatan kebugaran penyandang disabilitas intelektual dengan obesitas [dissertation]. Jakarta: Universitas Indonesia. 2009.
18. Walsh D, Belton S, Meegan S, Bowers K, Corby D, Staines A, et al. A comparison of physical activity, physical fitness levels, BMI and blood pressure of adults with intellectual disability, who do and do not take part in Special Olympics Ireland programmes. Journal of intellectual disabilities : JOID. 2017;22:1744629516688773.
19. Segal M, Eliasziw M, Phillips S, Bandini L, Curtin C, Kral TV, et al. Intellectual disability is associated with increased risk for obesity in a nationally representative sample of U.S. children. Disabil Health J. 2016;9(3):392-8.
20. Hove O. Survey on dysfunctional eating behavior in adult persons with intellectual disability living in the community. Research in developmental disabilities. 2007;28:1-8.
21. Rizzi M, Gambini O, Marras CE. Chapter 7 - Posterior hypothalamus as a target in the treatment of aggression: From lesioning to deep brain stimulation. In: Swaab DF, Buijs RM, Kreier F, Lucassen PJ, Salehi A, editors. Handbook of Clinical Neurology. 182: Elsevier; 2021. p. 95-106.
22. Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev. 2007;8(1):21-34.
23. Bibro M, Jankowicz-Szymańska A, Wódka K, Łaczek-Wójtowicz M. Impact of intellectual disability on longitudinal arch and symmetry of the lateral and medial load of the foot. Health Promotion & Physical Activity. 2019;6(1):28-32 (29-34).
24. Stolzman S, Irby MB, Callahan AB, Skelton JA. Pes planus and paediatric obesity: a systematic review of the literature. Clin Obes. 2015;5(2):52-9.
25. Xu L, Gu H, Zhang Y, Sun T, Yu J. Risk Factors of Flatfoot in Children: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(14).
26. Pourghasem M, Kamali N, Farsi M, Soltanpour N. Prevalence of flatfoot among school students and its relationship with BMI. Acta Orthop Traumatol Turc. 2016;50(5):554-7.
27. Maia N, Nabais Sá MJ, Melo-Pires M, de Brouwer APM, Jorge P. Intellectual disability genomics: current state, pitfalls and future challenges. BMC Genomics. 2021;22(1):909.
28. Ariani Y, Soeharso P, Sjarif DR. Genetics and genomic medicine in Indonesia. Mol Genet Genomic Med. 2017;5(2):103-9.
29. Zhao X, Tsujimoto T, Kim B, Katayama Y, Wakaba K, Wang Z, et al. Effects of increasing physical activity on foot structure and ankle muscle strength in adults with obesity. J Phys Ther Sci. 2016;28(8):2332-6.
30. Song J, Kane R, Tango DN, Veur SS, Furmato J, Komaroff E, et al. Effects of weight loss on foot structure and function in obese adults: a pilot randomized controlled trial. Gait Posture. 2015;41(1):86-92.