Background: Excessive increases in weight bearing forces caused by obesity may negatively affect the lower limbs and feet but minimal research has examined the long-term loading effects of obesity on the musculoskeletal system, particularly in reference to the feet. Objectives: The purpose of the study was to investigate the effect of obesity on medial longitudinal arch of foot in young adults. Method: 60 subjects, 30 obese & 30 non obese were assessed for height & weight using standard technique. Radiographic images under static condition were used for calculating the arch index. Result: The arch index of obese subjects was significantly lower than the non obese subjects & there is a negative correlation between the BMI & the arch index. Conclusion: These results suggests that obesity lowers the medial longitudinal arch of foot

Ganu, SS

Panhale, V

English

Sneha Sameer Ganu

Vrushali Panhale

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Effect of Obesity on Arch Index in Young Adults

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Original Article: 
Effect of Obesity on Arch Index in Young Adults 
Authors 
Sneha Sameer Ganu, Lecturer, MGM College of Physiotherapy, Kamothe, Navi Mumbai, 
Vrushali Panhale, Associate Professor, MGM College of Physiotherapy, Kamothe, Navi Mumbai. 
Address for Correspondence 
Sneha Sameer Ganu, 
Lecturer, 
MGM College of Physiotherapy, 
Kamothe, Navi Mumbai, INDIA.  
E-mail: ganusneha@gmail.com 
Citation 
Ganu SS, Panhale V. Effect of Obesity on Arch Index in Young Adults. Online J Health Allied Scs. 2012;11(4):8. Available at 
URL:http://www.ojhas.org/issue44/2012-4-8.html 
Open Access Archives 
http://cogprints.org/view/subjects/OJHAS.html 
http://openmed.nic.in/view/subjects/ojhas.html 
Submitted: Oct 23, 2012; Accepted: Jan 4, 2013; Published: Jan 25, 2013 
Abstract: Background: Excessive increases in weight 
bearing forces caused by obesity may negatively affect the 
lower limbs and feet but minimal research has examined the 
long-term loading effects of obesity on the musculoskeletal 
system, particularly in reference to the feet. Objectives: The 
purpose of the study was to investigate the effect of obesity 
on medial longitudinal arch of foot in young adults. Method: 
60 subjects, 30 obese & 30 non obese were assessed for 
height & weight using standard technique. Radiographic 
images under static condition were used for calculating the 
arch index. Result: The arch index of obese subjects was 
significantly lower than the non obese subjects & there is a 
negative correlation between the BMI & the arch index. 
Conclusion: These results suggest that obesity lowers the 
medial longitudinal arch of foot. 
Key Words: Obesity; Medial longitudinal arch; Arch index 
 
Introduction: 
Feet, as the body's base of support, continually endure often 
high ground reaction forces generated during activities of 
daily living. The component primarily responsible for 
absorbing and dissipating these forces in the feet is the 
longitudinal arch. Although this arch comprises bony 
articulations, ligaments and muscles, it is primarily the 
ligaments that support and stabilize the longitudinal arch, as 
well as acting as powerful energy-storing 
mechanisms.1,2Muscles provide secondary support by 
maintaining the arch during dynamic tasks. Ligaments rarely 
incur physiological fatigue and therefore offer a greater 
resistance to stress compared to muscles.3 However, repeated 
excessive loading may stretch ligaments beyond their elastic 
limit, damaging soft tissues and increasing the risk of foot 
discomfort and subsequent development of foot pathologies. 
Various authors have suggested that excessive increases in 
weight bearing forces caused by obesity may negatively 
affect the lower limbs and feet. Although studies pertaining 
to temporary and short-term loading effects on lower limb 
and foot mechanics are available,4,5 minimal research has 
examined the long-term loading effects of obesity on the 
musculoskeletal system, particularly in reference to the feet. 
Therefore the purpose of the study was to investigate the 
effect of obesity on medial longitudinal arch of foot in young 
adults. 
 
Methodology: 
Thirty subjects (mean age: 22years, Mean BMI 30,) without 
other health problems were selected as experimental subjects 
& 30 non obese subjects matched to the obese subjects for 
gender, age & height (mean age: 22 years, mean BMI 22) 
were selected as controls. Height and weight were measured 
on subject in light clothes and without shoes using standard 
apparatus. The weighting scale used could be read to the 
nearest 0.1 kg. It was calibrated at the beginning of each 
working day and at frequent intervals throughout the day. 
Height was measured to the nearest 0.5 cm, using a 
measuring tape. To measure height, the measuring tape was 
fixed to the wall. Height was measured while the subject 
stood with heels, buttocks, shoulders and occiput touching 
the vertical tape. The head was held erect with the external 
auditory meatus and the lower border of the orbit in one 
horizontal plane. Each subject's body mass index (BMI) was 
then calculated using the standard Quetelet Index protocol: 
body mass divided by height squared (kg/m2).All 
measurements were taken by the author. 
Lateral x-rays were taken by a standard technique. Patients 
stood on a wooden platform with their knees extended and 
their heels and toes at same level. The x-ray film pack was 
placed vertically between the feet. Patients were instructed to 
place equal weight on both feet. The x-ray tube was oriented 
parallel to floor with the central beam targeted immediately 
above base of fifth metatarsal. Arch Index was calculated 
using the formula: Navicular height/ Truncated foot 
length.6 Following image describes the method used for 
calculating the Arch Index. For calculating the truncated foot 
length a perpendicular was drawn from posterior surface of 
calcaneum and another from the head of first metatarsal and a 
 
This work is licensed under a 
Creative Commons Attribution- 
No Derivative Works 2.5 India License 
Online Journal of Health and Allied Sciences 
Peer Reviewed, Open Access, Free Online Journal 
Published Quarterly :  Mangalore, South India : ISSN 0972-5997 
Volume 11, Issue 4; Oct-Dec 2012 
 2 
 
line passing through the base of calcaneum was intersected to 
the two perpendicular line. For measuring the Navicular 
height a perpendicular was intersected from the navicular 
tuberosity to the truncated foot length, both the 
measurements were taken in cm. 
 
Figure 1: Arch index calculation on radiographic image 
in static condition: 
Results: 
 
Graph 1 shows the comparison of mean AI of Rt foot in 
obese and non-obese. The graph shows a significant 
difference in the mean value (p <0.001) 
 
Graph 2 shows the comparison of mean AI of Lt foot in 
obese and non- obese and shows a significant difference in 
the mean value. (p <0.001) 
 
Graph 3 shows correlation between BMI and AI (Right foot), 
showing a negative correlation between BMI and AI (r= -0.6) 
 
Graph 4 shows correlation between BMI and AI (Left Foot) 
and shows a negative correlation between BMI and AI (r= -
0.6) 
 
Discussion 
The study shows that the arch index in obese is lower as 
compared to the control group. There is a negative 
correlation between the body weight & arch index. Increased 
loading of the feet may be classified according to time-frame 
and described as temporary, short-term or long-term. A 
temporary loading effect occurs, for example, when carrying 
a backpack or wearing a weighted belt that temporarily 
increases body mass. In contrast, a long-term loading effect 
occurs over an extended period, such as in obesity, where the 
increase in mass is continuous.7The significantly lower 
plantar arch height found in the overweight/obese suggests 
that their flatter feet may be caused by a lowering of the 
longitudinal arch, most probably caused by their feet 
continually bearing excess mass. It is postulated that these 
structural changes, which may adversely affect the functional 
capacity of the medial longitudinal arch, might be 
exacerbated if excess weight bearing continues throughout 
adulthood. A recent review of the impact of childhood 
obesity on musculoskeletal form revealed that obese children 
exhibit a variety of biomechanical changes in the lower 
extremities. The authors noted that these changes have the 
potential to produce obesity-associated musculoskeletal pain 
in children and adolescents; however, data are limited.8 As 
feet are our base of support during most weight bearing 
activities, it is postulated that foot dysfunction associated 
with obesity may act as a deterrent on obese individuals to 
participate in physical activity & in turn perpetuate the cycle 
of obesity. 
 
Conclusion: 
These results suggest that obesity lowers the medial 
longitudinal arch of foot. 
 
Conflict of Interest: None 
Source of Support: None 
Acknowledgement:The authors are thankful to the 
Radiology Department of M.G.M. Hospital, Kamothe, Navi 
Mumbai for kindly providing the X- ray facilities to carry out 
this work. 
Ethical Approval: Granted by M.G.M. Medical College 
Research & Ethical Committee. 
 
References: 
1. Jahss MH. Disorders of the foot. WB Saunders 
Company: Philadelphia;1982. 
2. Ker RF, Bennett MB, Bibby SR, Kester RC, Alexander 
RMcN. The spring in the arch of the human 
foot. Nature 1987;325:147-149. 
3. Dowling AM, Steele JR. Does obesity influence foot 
structure and plantar pressure patterns in prepubescent 
children? International journal of obesity. 2001;25:845-
852. 
 3 
 
4. Cavanagh PR, Kram R. Stride length in distance 
running: velocity, body dimensions, and added mass 
effects. Med Sci Sports Exerc. 1989;21:467-479. 
5. Nyska M, Linge K, McCabe C, Kienerman L. The 
adaptation of the foot to heavy loads plantar foot 
pressures study. In: Cavanagh P(ed). Proceedings of the 
V Emed Scientific Meeting. Penn state: 
Pennsylvania.1996. 
6. Steel MW, Johnson KA, Dewitz MA, Ilstrup DM: 
Radiographic measurement of normal adult foot. Foot 
Ankle 1980;1:151-158. 
7. Nyska M, Linge K. The adaptation of the foot to heavy 
loads plantar foot pressures study. In: Cavanagh 
P(ed). Proceedings of the V Emed Scientific 
Meeting. Penn state: Pennsylvania.1996. 
8. Peltonen M, Lindroos AK, Torgerson JS. 
Musculoskeletal pain in the obese: a comparison with a 
general population and long-term changes after 
conventional and surgical obesity 
treatment. Pain 2003;104:549–557. 


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Effect of Obesity on Arch Index in Young Adults

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