Biofeedback-Assisted Short Foot Exercises in Flexible Flatfoot

NCT ID: NCT07286773

Last Updated: 2025-12-31

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

RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-22

Study Completion Date

2026-10-22

Brief Summary

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This study aims to compare the effects of biofeedback-assisted short foot exercises and traditional short foot exercises on plantar pressure distribution, balance, foot posture, and functional capacity in individuals with flexible pes planus.

Eligibility Criteria

Voluntary participants aged 10 to 35 years, diagnosed with flexible pes planus, with no history of lower extremity surgery, fracture, or psychiatric disorder, will be included in the study.

Research Questions

Does biofeedback-assisted short foot exercise improve plantar pressure distribution more effectively than traditional short foot exercise?

Does biofeedback-assisted training lead to greater improvements in foot posture, dynamic balance, and functional ability compared with traditional short foot exercise?

Detailed Description

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Study Design and Objective

This randomized controlled trial aims to compare the effects of biofeedback-assisted short foot exercises and traditional short foot exercises on plantar pressure distribution, foot posture, balance, and functional ability in individuals with flexible pes planus.

Participants

Voluntary participants aged 10 to 35 years, diagnosed with flexible pes planus, with no history of foot or ankle surgery, fracture, or psychiatric disorder, will be included in the study.

Individuals diagnosed with rigid pes planus, those younger than 10 or older than 35 years, or those with a history of psychiatric illness or lower extremity trauma will be excluded.

Randomization and Groups

Participants will be randomly assigned to two equal groups using a simple randomization method:

Group 1: Short Foot Exercise (SFE) group (without biofeedback)

Group 2: Biofeedback-Assisted Short Foot Exercise (SFE) group

Exercise Intervention

Both groups will participate in a structured 6-week exercise program, performed twice per week, for a total of 12 sessions.

Each session will begin with a 5-minute warm-up period, including:

Towel curl exercises

Resisted ankle movements using a theraband (dorsiflexion, plantar flexion, inversion)

Ball-grasping exercises with the foot

The main intervention, the short foot exercise (SFE), aims to activate the medial longitudinal arch by drawing the first metatarsal head toward the heel without toe flexion. Exercise intensity and body positions will be progressively adjusted throughout the intervention period.

Outcome Measures

Assessments will be conducted before and after the 6-week intervention period using the following outcome measures:

Pedobarographic Analysis: Measurement of plantar pressure distribution (g/cm²) and contact area (cm²) to evaluate plantar load during static stance.

Navicular Drop Test: Measurement of the change in navicular tuberosity height between sitting and standing positions to assess medial longitudinal arch collapse.

Foot Posture Index (FPI-6): Assessment of static foot posture based on six clinical observations, scored from -12 (highly supinated) to +12 (highly pronated).

Y-Balance Test: Evaluation of dynamic balance performance in three directions: anterior, posteromedial, and posterolateral.

Foot and Ankle Ability Measure (FAAM): Self-reported assessment of functional ability using the Activities of Daily Living (ADL) and Sports subscales.

Ankle Range of Motion (ROM): Measurement of ankle dorsiflexion and plantar flexion angles using a goniometer.

Data Analysis

Statistical analyses will be performed using SPSS version 20.0.

Data normality will be assessed using the Shapiro-Wilk test.

Parametric data will be presented as mean ± standard deviation.

Categorical variables will be reported as frequency and percentage.

Between-group comparisons will be conducted using the Independent Samples t-test or the Mann-Whitney U test, depending on data distribution.

Within-group comparisons will be analyzed using the Paired Samples t-test or the Wilcoxon signed-rank test.

Categorical variables will be analyzed using the Pearson chi-square test.

A p-value \< 0.05 will be considered statistically significant.

Sample Size Calculation

Sample size and power analysis were performed using the PS-Power and Sample Size program. For the primary outcome measure, the Foot and Ankle Ability Measure (FAAM) score, the minimum clinically important difference (MCID) was set at 8 points, with a standard deviation of 7, based on previously published studies.

Calculations were performed with a 95% confidence level, 80% statistical power, and a significance level of 0.05. The analysis indicated that at least 13 participants per group were required. Considering a potential 20% dropout rate, a total of at least 30 participants (15 per group) will be included in the study.

Conditions

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Pes Planus

Keywords

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Flexible Flatfoot Short Foot Exercise Biofeedback Training

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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BF Group

Group Type EXPERIMENTAL

Biofeedback assisted exercises

Intervention Type OTHER

Biofeedback-assisted short foot exercise group

Exerc Group

Group Type ACTIVE_COMPARATOR

Supervised exercises

Intervention Type OTHER

Short foot exercise only group

Interventions

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Biofeedback assisted exercises

Biofeedback-assisted short foot exercise group

Intervention Type OTHER

Supervised exercises

Short foot exercise only group

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Voluntary participants aged 18 to 45 years
* Diagnosis of flexible pes planus
* No history of surgery, fracture, or psychiatric disorder

Exclusion Criteria

* Diagnosis of rigid pes planus
* Age younger than 18 years or older than 45 years
* History of psychiatric disorder or lower extremity trauma
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istanbul University - Cerrahpasa

OTHER

Sponsor Role lead

Responsible Party

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Taner Alparslan

Principal Investigator, Physiotherapist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Taner ALPARSLAN, PT, Master's student

Role: PRINCIPAL_INVESTIGATOR

Istanbul University - Cerrahpasa

Sezen KARABÖRKLÜ ARGUT, Asst. Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Istanbul University - Cerrahpasa

Locations

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İstanbul University-Cerrahpaşa

Istanbul, Büyükçekmece, Turkey (Türkiye)

Site Status NOT_YET_RECRUITING

Department of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University

Istanbul, Fatih, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Taner Alparslan, Physiotherapist

Role: CONTACT

Phone: 00902128663700

Email: [email protected]

Sezen KARABÖRKLÜ ARGUT, Asst. Prof. Dr.

Role: CONTACT

Phone: 00902128663700

Email: [email protected]

Facility Contacts

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Taner ALPARSLAN

Role: primary

Mehmet Demirel, Assistant Professor

Role: primary

Other Identifiers

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0a747ZHs - 2025/689

Identifier Type: -

Identifier Source: org_study_id