Effect of Myofascial Release in Addition to Foot Core Exercises in Young Adults With Asymptomatic Flexible Pes Planus

NCT05774327 | Completed DMC

• 1 other identifier: 2022-1073
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

Pes planus is a foot deformity characterized by a low medial longitudinal arch. It is more common in young adults. With low arch, tension occurs in the plantar fascia. Fascia and soft tissue loading may lead to different musculoskeletal problems such as plantar fasciitis, medial tibial stress syndrome, patellofemoral disorders and back pain. In addition, pes planus can affect individuals' activities of daily living, productivity in occupational settings, and injury risk and performance in sports. Treatment of pes planus includes strengthening, stretching, taping and orthotics for the foot muscles. Among these applications, strengthening of the foot core muscles is one of the most common and effective methods. By strengthening the foot core muscles, it is aimed to reduce the effect of the kinetic chain. Pes planus is a postural deformity that affects the kinetic and fascial chain, but the treatment program is usually planned regionally. With fascial continuity and fascial conduction, the tension on the plantar fascia in pes planus affects the gastro-soleus, peroneus longus and brevis, hamstring muscles, iliotibial band and thoracolumbar fascia. Stretching of the plantar fascia, which is included in current treatment programs, has only a local effect and thus cannot prevent fascial chain involvement. Myofascial release, one of the methods used to reduce the tension in the fascia, has been used frequently in recent years. Myofascial release is performed with methods such as manual, foam roller and instrument assisted release. Foam roller (cylinder foam) is a practical myofascial release method that can be self-applied by the individual. In addition to strengthening the intrinsic muscles of the foot in individuals with pes planus, it has been reported that fascial chain involvement should also be taken into consideration due to the tension in the plantar fascia with low arch. This study was planned to investigate the effect of myofascial release methods on lower extremity performance in addition to foot core exercises used effectively in the treatment of pes planus.

Conditions

Pes Planus

Keywords

Pes Planus; Foot Core Exercises; Myofascial Release; Foam Rolling

Outcome Measures

Primary Outcomes (1)

• Change in Balance

  The Y balance test is used for balance assessment. A "Y" shaped design is made using three tape measures placed on the ground. After the first tape measure is placed in the anterior (ant) direction, the other two tape measures are placed on the ground in the posteromedial (pm) and posterolateral (pl) directions to form a 135-degree angle. How the test will be performed is clearly explained to the individuals before the test and they are allowed to perform three trials. With the hands on the waist, the fingertip reach in each of the three directions is recorded in centimeters (cm). The maximum distance they can reach in three reaches in each direction is recorded. This process is also repeated while standing on the other limb and recorded. Lower limb length is calculated by measuring the distance between the spina iliaca anterior superior and the medial malleolus with a tape measure. With the results obtained, the normalized reach and the composite reach for both limbs are calculated.

  Change from Baseline Y Balance Test Results at 6 weeks.

Secondary Outcomes (3)

• Change in Flexibility

  Change from Baseline Sit and Reach Test Results at 6 weeks.

• Change in Power

  Change from Baseline Vertical Jump Test Results at 6 weeks.

• Change in Gait

  Change from Baseline 10-Meter Walk Test Results at 6 weeks.

Study Arms (2)

Foam Roller+Foot Core Exercises Group

EXPERIMENTAL

Participants in the foam roller+exercise group underwent foam roller application, which is a self-myofascial release method, 2 days a week for 6 weeks in addition to exercises. Medium-hard foam rollers were used in the applications. Foam roller application was performed on thoracolumbar fascia, iliotibial band, hamstring, gastro-soleus, peroneals and plantar fascia for 60 seconds on each region. A metronome was used to determine the rhythm during foam roller application. The rhythm of the metronome was set to 60 beats per minute (60 rpm). When determining the amount of load on the tissue, the participants were told to give the maximum amount of load possible.

Other: Foam Roller; Other: Foot Core Exercises

Foot Core Exercises Group

EXPERIMENTAL

The foot core exercises in the treatment program for young adults with pes planus were taught to the participants one by one. It was checked that each exercise in the program was performed correctly by the participants. An exercise brochure was prepared and given to all participants so that the participants could learn the exercises better and perform them correctly. The exercise program follow-up of the participants and gradual progression of the difficulty levels were performed by the responsible researcher. The exercises were performed two days a week for six weeks under the supervision of the researcher. On the other days, the exercise program follow-up was checked daily via an online platform.

Other: Foot Core Exercises

Interventions

Foam Roller OTHER

Participants will be shown 7 different foot core exercises and will be instructed to do 10 repetitions 3 times a day. For 6 weeks, in addition to foot core exercises, myofascial release will be applied with foam roller 2 days a week. Myofascial release application areas; thoracolumbal fascia, iliotibial band, hamstring, gastro-soleus, peroneal, plantar fascia.

Also known as: Foot Core Exercises

Foam Roller+Foot Core Exercises Group

Foot Core Exercises OTHER

Participants will be shown 7 different foot core exercises and will be instructed to do 10 repetitions 3 times a day. Foot core exercises; short foot exercise, toe flexion exercise, heel lift exercise,toe abduction exercise, big toe and other toes extension exercise, front swing exercise, back walking exercises. Participants will do the exercises with the researcher two days a week and the other days follow-up will be provided through the online platform.

Foam Roller+Foot Core Exercises Group; Foot Core Exercises Group

Eligibility Criteria

• Age: 18 Years - 25 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Be between the ages of 18-25,
• Bilateral navicular drop distance of 10 mm or more,
• Bilateral asymptomatic flexible pes planus,
• Volunteering to participate in the study and being able to continue.

You may not qualify if:

• Musculoskeletal disorders other than pes planus,
• Having chronic ankle instability,
• Any lower extremity injury in the last 6 months,
• Receiving a treatment related to pes planus in the last 6 months,
• Use of insoles.

Sponsors & Collaborators

• Ankara Yildirim Beyazıt University: lead

Study Sites (1)

Ankara Yıldırım Beyazıt University, Institute of Health Sciences, Department of Physiotherapy and Rehabilitation

Ankara, Turkey (Türkiye)

Location

Related Publications (15)

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  PMID: 27336689 BACKGROUND

• Matias AB, Taddei UT, Duarte M, Sacco IC. Protocol for evaluating the effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: a randomized controlled trial. BMC Musculoskelet Disord. 2016 Apr 14;17:160. doi: 10.1186/s12891-016-1016-9.

  PMID: 27075480 BACKGROUND

• Unver B, Erdem EU, Akbas E. Effects of Short-Foot Exercises on Foot Posture, Pain, Disability, and Plantar Pressure in Pes Planus. J Sport Rehabil. 2019 Oct 18;29(4):436-440. doi: 10.1123/jsr.2018-0363. Print 2020 May 1.

  PMID: 30860412 BACKGROUND

• Moon D, Jung J. Effect of Incorporating Short-Foot Exercises in the Balance Rehabilitation of Flat Foot: A Randomized Controlled Trial. Healthcare (Basel). 2021 Oct 13;9(10):1358. doi: 10.3390/healthcare9101358.

  PMID: 34683038 BACKGROUND

• Peacock CA, Krein DD, Silver TA, Sanders GJ, VON Carlowitz KA. An Acute Bout of Self-Myofascial Release in the Form of Foam Rolling Improves Performance Testing. Int J Exerc Sci. 2014 Jul 1;7(3):202-211. doi: 10.70252/DTPM9041. eCollection 2014.

  PMID: 27182404 BACKGROUND

• Behm DG, Alizadeh S, Hadjizadeh Anvar S, Mahmoud MMI, Ramsay E, Hanlon C, Cheatham S. Foam Rolling Prescription: A Clinical Commentary. J Strength Cond Res. 2020 Nov;34(11):3301-3308. doi: 10.1519/JSC.0000000000003765.

  PMID: 33105383 BACKGROUND

• D'Amico A, Silva K, Gallo J. Time Course of Acute Hip Adduction Range of Motion Changes Following Foam Rolling. Int J Sports Phys Ther. 2021 Apr 1;16(2):431-437. doi: 10.26603/001c.21417.

  PMID: 33842038 BACKGROUND

• Park DJ, Lee KS, Park SY. Effects of Two Foot-Ankle Interventions on Foot Structure, Function, and Balance Ability in Obese People with Pes Planus. Healthcare (Basel). 2021 Jun 3;9(6):667. doi: 10.3390/healthcare9060667.

  PMID: 34205155 BACKGROUND

• Rose GK, Welton EA, Marshall T. The diagnosis of flat foot in the child. J Bone Joint Surg Br. 1985 Jan;67(1):71-8. doi: 10.1302/0301-620X.67B1.3968149.

  PMID: 3968149 BACKGROUND

• Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, Childs JD. Y-balance test: a reliability study involving multiple raters. Mil Med. 2013 Nov;178(11):1264-70. doi: 10.7205/MILMED-D-13-00222.

  PMID: 24183777 BACKGROUND

• Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2006 Dec;36(12):911-9. doi: 10.2519/jospt.2006.2244.

  PMID: 17193868 BACKGROUND

• Lai WC, Wang D, Chen JB, Vail J, Rugg CM, Hame SL. Lower Quarter Y-Balance Test Scores and Lower Extremity Injury in NCAA Division I Athletes. Orthop J Sports Med. 2017 Aug 8;5(8):2325967117723666. doi: 10.1177/2325967117723666. eCollection 2017 Aug.

  PMID: 28840153 BACKGROUND

• Williams W, Selkow NM. Self-Myofascial Release of the Superficial Back Line Improves Sit-and-Reach Distance. J Sport Rehabil. 2019 Oct 18;29(4):400-404. doi: 10.1123/jsr.2018-0306. Print 2020 May 1.

  PMID: 30860410 BACKGROUND

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• Soulard J, Vaillant J, Balaguier R, Vuillerme N. Spatio-temporal gait parameters obtained from foot-worn inertial sensors are reliable in healthy adults in single- and dual-task conditions. Sci Rep. 2021 May 13;11(1):10229. doi: 10.1038/s41598-021-88794-4.

  PMID: 33986307 BACKGROUND

MeSH Terms

Conditions

Flatfoot

Condition Hierarchy (Ancestors)

Talipes; Foot Deformities, Acquired; Foot Deformities; Musculoskeletal Diseases; Foot Deformities, Congenital; Lower Extremity Deformities, Congenital; Limb Deformities, Congenital; Musculoskeletal Abnormalities; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities

Study Officials

• Tuğba Ulusoy, PT, MSc

  Ankara Yildirim Beyazıt University

  PRINCIPAL INVESTIGATOR

• Ertuğrul Demirdel, Assoc.prof.

  Ankara Yildirim Beyazıt University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: A randomized controlled trial: Two parallel treatment groups; participants were randomly allocated to Group 1 \[Foam Roller+Foot Core Exercises\] and Group 2 \[Foot Core Exercises\]

Study Record Dates

• First Submitted: March 4, 2023
• First Posted: March 17, 2023
• Study Start: March 20, 2023
• Primary Completion: May 26, 2023
• Study Completion: June 9, 2023
• Last Updated: October 10, 2023

Record last verified: 2023-10

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)