Association between flatfoot and lower limb fatigue during daily activities among university students
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Background: Variations in foot posture may influence lower-limb biomechanics and movement efficiency, but their relationship with perceived fatigue in young adults remains insufficiently understood. Objective: To determine the association between foot posture and self-reported fatigue severity among university students. Methods: This cross-sectional study included 126 university students aged 18–25 years. Foot posture was assessed using the Foot Posture Index-6 (FPI-6) and classified as neutral, pronated, or highly pronated. Perceived fatigue was assessed using the nine-item Fatigue Severity Scale (FSS) and categorized into study-defined lower, intermediate, and higher fatigue-score bands. Pearson's chi-square test was used to examine the association between foot-posture category and fatigue-score band. Results: Of the 126 participants, 36 (28.6%) had neutral foot posture, 48 (38.1%) had pronated foot posture, and 42 (33.3%) had highly pronated foot posture. Lower, intermediate, and higher fatigue-score bands included 37 (29.4%), 56 (44.4%), and 33 (26.2%) participants, respectively. Foot-posture category was significantly associated with fatigue-score band, χ²(4) = 74.034, p < 0.001, with Cramér's V = 0.542. Higher fatigue-score categories occurred more frequently among participants with increasingly pronated foot posture. Conclusion: Increasingly pronated foot posture was associated with higher self-reported fatigue scores among university students. Because of the cross-sectional design, temporal and causal relationships cannot be inferred. Keywords: Foot Posture; Foot Posture Index; Fatigue Severity Scale; Pronation; University Students; Cross-Sectional Study
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