Document Type : Original Articles


1 Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences,Shiraz,Iran

2 Department of Physiotherapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

3 Clinical Research Graduate of Oxford College, Oxford, UK

4 Rehabilitation Research Center, Department of Physical Therapy, School of Rehabilitation Science, Shiraz University of Medical Science, Shiraz,Iran


Background: Several peripheral and central factors are believed to contribute to the pathology of tension type headache (TTH). The current study aimed to identify a connection between TTH and flat feet.
Methods: In this cross-sectional comparative study, a total of 61 people with chronic TTH (13 male and 48 female) and 61 matched controls participated. The frequency of flat feet in the two groups was the primary outcome of this study. The presence of myofascial trigger points in the head and neck areas and the degree of neck disability were also assessed in both groups. Pearson’s chisquare test and logistic regression models were used to determine the relative contribution of demographic and clinical predictive variables to the TTH.
Results: The chi-square test showed that frequency of flat feet, uni- or bilateral,was significantly higher (x2=17.5, df=2, P<0.001) in the TTH group compared with the control group. Further analysis revealed that people with flat feet are 4.32 to 5.05 times more likely to develop TTH than people who have normal foot posture. The probability of developing TTH was 7.93 times higher in participants with 4 or more trigger points than in participants with less than 4 trigger points. Similarly, the probability of participants with a Neck Disability Index score of 4 or more developing TTH was 11.96 times higher than those with a score less than 4.
Conclusion: The current findings indicate a probable link between the presence of flat feet and chronic TTH.


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