Correlation between Arch Height Index and Low Back Pain among primary school teachers :An Observational study

Published: 9 June 2020| Version 2 | DOI: 10.17632/fdfs2656ys.2


Background: Low Back Pain (LBP) is the leading cause of disability among primary school teachers. Alterations in the Arch Height Index (AHI) can influence the lumbo- pelvic alignment and contribute to low back pain in teachers. Objective: To find out the association between Arch Height Index (AHI) and Low Back Pain (LBP) among primary school teachers. Methods: For this observational study, 178 primary school teachers aged 25-35 years with chronic low back pain were included. After the anthropometric measurements, standardized procedure i.e Visual analog scale (VAS) to measure the pain intensity and Oswestry Low Back Pain Disability Questionnaire for disability due to LBP were used. Arch height index of the MLA was evaluated the by the Navicular Drop Test (NDT). Data analysis: Kolmogorv –Smirnov test was used to check the normality of the data. Non- parametric test i.e Spearman Rank Correlation Coefficient was used to find out the correlation between Arch Height Index (AHI) and Low back pain (LBP). Values of the VAS and disability% of left and right foot were analysed. Results: Arch Height Index of right foot (ρ=.290) (p<0.05) had fair positive relation with disability. Arch Height Index of left foot (ρ=.266) (p<0.05) also had fair positive relation with disability. No to little correlation was found between AHI of right foot (ρ=.023) (p>0.05) and VAS. Whereas a negative correlation was found between AHI of left foot (ρ = -.011) (p>0.05) and VAS. Conclusion: Researchers concluded that the ankle and foot deviations can be considered a potential cause for LBP as there is disruption in the kinetic chain from the foot to the lumbar spine. However, more research is required to determine the association between Arch Height Index and LBP among primary school teachers because of their workplace conditions.


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Procedure Participants were screened according to the inclusion and exclusion criteria. Participants were screened according to the inclusion and exclusion criteria. The purpose of the study was explained to the participant following which the informed consent was collected. The entire demographic data (name, age, gender) and anthropometrics (weight and height) of each subject was documented in the pre designed Performa. Anthropometric measurements Height of the subject was measured by measuring tape with bare foot and the weight was measured with the help of non- digital weighing machine with minimal clothing. BMI was calculated using the standard formula [BMI= weight (in kilograms) / height (in meter2)]. Standardized procedure was followed by the rater for the outcome measures used which are Visual analog scale (VAS), Oswestry Low Back Pain Questionnaire, Arch Height Index (AHI). Methods of data collection Visual Analog Scale For measuring the pain VAS was used (Annexure. The 10 point VAS scale for used for the study. It consists of a straight line with the endpoints defining extreme limits such as ‘no pain at all’ and ‘pain as bad as it could be’. The patient was asked to mark his/her pain level on the line between the two endpoints. Arch Height Index The static arch height indices were measured by Navicular drop test (NDT). Participants were asked to sit on chair with hip, knee and knee at 90 of angle to maintain the neutral position of ankle. Navicular tuberosity was palpated and with help of a ruler the height of navicular from the ground was measured. Later participant was asked to stand in a weight bearing position and again the height of Navicular tuberosity was measured with a ruler. Oswestry Low Back Pain Questionnaire Oswestry low back pain questionnaire was used to assess the functional disability. All the study participants were provided with the questionnaire and asked them to provide the necessary details about each section. T The test is considered the ‘gold standard’ of low back functional outcome tools. It includes 10 sections related to the activities of the daily living and the percentage of the disability measured through the scoring. For each section the total possible score is 5. It deals with pain intensity, personal care, lifting, walking, standing, sleeping, sex life, social life and travelling. It is expressed as an easy to interpret percentage (0–20% – minimal disability, 20–40% – moderate disability, 40–60% – severe disability, 61-80% -crippled, 81-100% is bed bound) . Primary Outcome Measure,Arch height index (AHI), Oswestry Low Back Pain Questionnaire Secondary Outcome Measure Visual analog scale (VAS)


Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation


Physical Therapy