Comparative Effects of Big Toe Flexor and Calf Strengthening Exercises on Medial Arch in Athletes With Flat Foot

NCT ID: NCT06479525

Last Updated: 2024-06-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-23

Study Completion Date

2024-05-30

Brief Summary

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Flexible flatfoot is common in young adults. One of its causes is the failure of dynamic stabilizers, which play an important role in the medial longitudinal arch support, and their appropriate function is necessary for the integrity of the lower extremity and the spine. The metatarsal phalangeal joint (MPJ) and its crossing toe flexor muscles (TFM) represent the link between the large energy generating leg extensor muscles and the ground. Asymptomatic flat foot deformity is associated with gastrocnemius muscle tightness and a higher prevalence of gastrocnemius and soleus tightness was found in female subjects compared with males.

The study will be a randomized clinical trial. The study will be conducted in Pakistan Sports Board (PSB) Lahore. The sample size will be calculated by convenience sampling technique. The inclusion criteria will be participants of age between eighteen and thirty years old. Both male and female participants will be included. Athletes involved in sports more than one year and with asymptomatic flexible flatfeet (NDT \> 10mm) will be included. Navicular drop test, Foot function index questionnaire, arch height index, toe/hip dynamometer and vertical jump test will be the tools used for assessment and evaluation. Participants who meet the inclusion criteria will be divided into two groups. Baseline measures and eight-week assessment of navicular drop test and arch height index will be taken. Strength of toe flexors will be evaluated with toe dynamometer. Participants who will meet the inclusion criteria will be provided with ethical consent forms and after baseline assessments, exercise program will be guided. Group A will perform big toe flexor strengthening exercises in addition to the sports plan they already follow. Group B will be assigned with calf strengthening exercises in addition to the plan they are following. Eight-week intervention program will be provided that will include warm up, therapeutic exercises including toe raises, towel curls and therapeutic band exercises, and then cool down period that includes stretching exercises.

Detailed Description

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The main objective of the study is to apply big toe flexor and calf muscles strengthening exercises and to compare the results to identify their influence on medial longitudinal arch in flexible flat foot athletes.

Conditions

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Sports Physical Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Group A

16 participants will be in experimental group giving them Big Toe flexor strengthening exercises protocol along with their normal sports training plan for eight weeks, measuring all values before giving them protocol and after protocol.

Group Type EXPERIMENTAL

Big Toe Flexor Strengthening Exercises

Intervention Type OTHER

16 participants will be in experimental group A giving them Big Toe Flexor strengthening exercise protocol along with the sports training plan for eight weeks measuring all values before giving them protocol and after protocol.

Group B

16 participants will be in experimental group giving them calf strengthening exercises protocol along with their normal sports training plan for eight weeks, measuring all values before giving them protocol and after protocol.

Group Type EXPERIMENTAL

Calf Strengthening Exercises

Intervention Type OTHER

16 participants will be in experimental group B giving them calf strengthening exercises including towel curls and thera band exercises along with the sports training plan for eight weeks measuring all values before giving them protocol and after protocol.

Interventions

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Big Toe Flexor Strengthening Exercises

16 participants will be in experimental group A giving them Big Toe Flexor strengthening exercise protocol along with the sports training plan for eight weeks measuring all values before giving them protocol and after protocol.

Intervention Type OTHER

Calf Strengthening Exercises

16 participants will be in experimental group B giving them calf strengthening exercises including towel curls and thera band exercises along with the sports training plan for eight weeks measuring all values before giving them protocol and after protocol.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age between 18 and 30 years' old
* Both male and female
* Athletes involved in sports with more than one year
* Athletes with asymptomatic flexible flatfoot (NDT \> 10mm) (5)

Exclusion Criteria

* Congenital flatfoot
* Athletes using foot orthoses
* Any lower limb muscle injury or trauma in the past 6 months
* Had undergone lower limb surgery
* Had lower extremity deformities: pes cavus, pes equinus, hallux valgus with greater angle than 15°, or clubfoot.(5)
* Had a sign of neurological deficit over the lower extremities.
* Female subjects if they were pregnant.
Minimum Eligible Age

18 Years

Maximum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Riphah International University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aamir Gul Memon, MS

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

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Pakistan Sports Board

Lahore, Punjab Province, Pakistan

Site Status

Countries

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Pakistan

References

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Hashimoto T, Sakuraba K. Strength training for the intrinsic flexor muscles of the foot: effects on muscle strength, the foot arch, and dynamic parameters before and after the training. J Phys Ther Sci. 2014 Mar;26(3):373-6. doi: 10.1589/jpts.26.373. Epub 2014 Mar 25.

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Lee MS, Vanore JV, Thomas JL, Catanzariti AR, Kogler G, Kravitz SR, Miller SJ, Gassen SC; Clinical Practice Guideline Adult Flatfoot Panel. Diagnosis and treatment of adult flatfoot. J Foot Ankle Surg. 2005 Mar-Apr;44(2):78-113. doi: 10.1053/j.jfas.2004.12.001. No abstract available.

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DiGiovanni CW, Langer P. The role of isolated gastrocnemius and combined Achilles contractures in the flatfoot. Foot Ankle Clin. 2007 Jun;12(2):363-79, viii. doi: 10.1016/j.fcl.2007.03.005.

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Saeki J, Tojima M, Torii S. Clarification of functional differences between the hallux and lesser toes during the single leg stance: immediate effects of conditioning contraction of the toe plantar flexion muscles. J Phys Ther Sci. 2015 Sep;27(9):2701-4. doi: 10.1589/jpts.27.2701. Epub 2015 Sep 30.

Reference Type BACKGROUND
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Jung DY, Kim MH, Koh EK, Kwon OY, Cynn HS, Lee WH. A comparison in the muscle activity of the abductor hallucis and the medial longitudinal arch angle during toe curl and short foot exercises. Phys Ther Sport. 2011 Feb;12(1):30-5. doi: 10.1016/j.ptsp.2010.08.001. Epub 2010 Sep 15.

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Tahmasbi A, Shadmehr A, Attarbashi Moghadam B, Fereydounnia S. Does Kinesio taping of tibialis posterior or peroneus longus have an immediate effect on improving foot posture, dynamic balance, and biomechanical variables in young women with flexible flatfoot? Foot (Edinb). 2023 Sep;56:102032. doi: 10.1016/j.foot.2023.102032. Epub 2023 Mar 31.

Reference Type BACKGROUND
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Aboelnasr EA, El-Talawy HA, Abdelazim FH, Hegazy FA. Sensitivity and specificity of normalized truncated navicular height in assessment of static foot posture in children aged 6-12 years. Hong Kong Physiother J. 2019 Jun;39(1):15-23. doi: 10.1142/S1013702519500021. Epub 2018 Oct 12.

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Reference Type BACKGROUND
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Mickle KJ, Caputi P, Potter JM, Steele JR. Efficacy of a progressive resistance exercise program to increase toe flexor strength in older people. Clin Biomech (Bristol). 2016 Dec;40:14-19. doi: 10.1016/j.clinbiomech.2016.10.005. Epub 2016 Oct 7.

Reference Type BACKGROUND
PMID: 27780109 (View on PubMed)

Raj MA, Tafti D, Kiel J. Pes Planus. 2023 May 23. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK430802/

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PMID: 28613553 (View on PubMed)

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Reference Type BACKGROUND
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Other Identifiers

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REC/RCR & AHS/23/0488 Mannan

Identifier Type: -

Identifier Source: org_study_id

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