Craniofacial Morphology and Foot Posture: Prevalence of Foot and Postural Deviations and Their Association with Sagittal Skeletal Class in a Cross-Sectional Clinical Study

Abstract

Objectives: To describe foot and global postural deviations in a mixed-age university-clinic sample and examine their associations with cephalometrically defined sagittal skeletal class and facial growth pattern. Methods: This cross-sectional study included 98 individuals aged 8–62 years; 76 participants (77.6%) were adults. Foot posture was assessed with the FPI-6 and plantar footprint, global posture by sagittal-plane visual analysis, and centre-of-pressure behaviour by instrumented gait in a subsample. Associations were tested using chi-square or Fisher–Freeman–Halton exact tests, Cramér’s V, and Bonferroni-adjusted p-values. Age- and sex-adjusted continuous modelling was not possible because complete data could not be reliably reconstructed. Results: Supination was the most frequent FPI-6 category (45.9%), and 30.8% showed ideal alignment. Sagittal skeletal class was not associated with any outcome (all p ≥ 0.341; all pBonf = 1.000). Facial pattern was associated with FPI-6 in the primary analysis (exact p = 0.007; V = 0.265), but not after Bonferroni correction (pBonf = 0.070). The five-category sensitivity analysis remained significant (exact p = 0.0016; pBonf = 0.016; V = 0.353), although intermediate groups were small. Conclusions: No detectable association was found between sagittal skeletal class and foot, postural, or gait variables. The facial-pattern finding remains exploratory, and the lack of age and sex adjustment limits inference.