Foot Muscle Strengthening Exercises for Pes Planovalgus

NCT06548750 | Completed

• 1 other identifier: DT2024-AE
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

Pes planovalgus is a common foot condition affecting the child population. It is characterized by the partial or complete collapse of the medial longitudinal arch with rearfoot eversion and forefoot abduction, which is associated with changes in lower extremity kinematics during dynamic activity. The lower extremity chain includes the foot, ankle, knee, and hip joints, with the feet acting as the base of support. However, due to their small size, maintaining balance can be challenging. Any small dynamic change in the foot, as the support base, can impact overall body posture. The foot arch, which can be pronated or supinated, affects proprioceptive input by altering joint movement, contact area, and muscle strategy for stability. Pes planovalgus, characterized by excessive subtalar pronation, lead to instability and hypermobility, requiring more neuromuscular control to maintain balance. As a result, flat feet can cause pathomechanical issues and compensatory actions in the lower extremity chain, affecting overall body balance. The effectiveness of exercise interventions, particularly foot intrinsic muscle strengthening exercises, in increasing the medial longitudinal arch in individuals with pes planus has been investigated in numerous studies. It is widely accepted that both intrinsic and extrinsic muscle groups play a crucial role in the formation, maintenance, and enhancement of foot arches. However, there is a lack of studies specifically examining the effectiveness of exercises aimed at strengthening these muscles in children with pes planovalgus. Therefore, the purpose of this study is to compare the effects of two corrective exercise programs focused on the improvement of the medial longitudinal arch in children with pes planovalgus: one incorporating routine intrinsic muscle exercises and the other combining them with extrinsic muscle exercises.

Conditions

Pes Planus

Keywords

Intrinsic foot muscle; Physiotherapy; Foot core; Flat foot; Extinsic foot muscle

Outcome Measures

Primary Outcomes (2)

• Single Leg Stance Test

  It evaluates the participants' standing balance. The entire lower extremity will be positioned in full extension, while the other side will be positioned in 90 degree flexion of the lower extremity hip and knee. The time will be started when the participants' eyes are closed and the untested feet lose contact with the ground, and the time will be stopped when they put their feet back on the ground or when their body sway increases too much.

  change from baseline balance at 2 months

• Timed-up and Go Test

  TUG is a measure of dynamic balance and the risk of falling. It entails individuals rising from a chair, walking a distance of 3 feet, turning, and then sitting back down.

  change from baseline balance at 2 months

Secondary Outcomes (7)

• Range of Motion

  2 times for 8 weeks

• Thomas Test

  2 times for 8 weeks

• Duncan-Ely Test

  2 times for 8 weeks

• Popliteal Angle Assessment

  2 times for 8 weeks

• Navicular Drop Test (NDT)

  2 times for 8 weeks

Study Arms (2)

Intervention Group

EXPERIMENTAL

Individuals with a diagnosis of pes planovalgus who underwent supervised exercise under the guidance of a physiotherapist for 8 weeks, 1 day a week.

Other: Intrinsic and Ectrinsic Exercise

Control Group

ACTIVE COMPARATOR

Individuals with a diagnosis of pes planovalgus who underwent supervised exercise under the guidance of a physiotherapist for 8 weeks, 1 day a week.

Other: Intrinsic Exercise

Interventions

Intrinsic and Ectrinsic Exercise OTHER

Intrinsic and extrinsic muscle strengthening exercises

Intervention Group

Intrinsic Exercise OTHER

Intrinsic muscle strengthening exercises

Control Group

Eligibility Criteria

• Age: 4 Years - 7 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Presence of bilateral pes planovalgus,
• Being between 4-7 years of age,
• Having a body mass index within normal limits

You may not qualify if:

• Having high femoral anteversion, internal tibial torsion and metatarsus adductus
• Having leg length inequality
• Having any neurological, rheumatic, musculoskeletal, metabolic and connective tissue disease
• Having a history of pain, deformity or surgery related to the vertebral column and lower extremities
• Having a cognitive, mental or serious psychiatric disease
• Having been involved in any exercise program or sports activity in the last six months

Sponsors & Collaborators

• Istanbul University - Cerrahpasa: lead

Study Sites (1)

Bezmialem Vakif University

Istanbul, 34093, Turkey (Türkiye)

Location

Related Publications (7)

• Huang C, Chen LY, Liao YH, Masodsai K, Lin YY. Effects of the Short-Foot Exercise on Foot Alignment and Muscle Hypertrophy in Flatfoot Individuals: A Meta-Analysis. Int J Environ Res Public Health. 2022 Sep 22;19(19):11994. doi: 10.3390/ijerph191911994.

  PMID: 36231295 BACKGROUND

• Hara S, Kitano M, Kudo S. The effects of short foot exercises to treat flat foot deformity: A systematic review. J Back Musculoskelet Rehabil. 2023;36(1):21-33. doi: 10.3233/BMR-210374.

  PMID: 35871320 BACKGROUND

• Okamura K, Fukuda K, Oki S, Ono T, Tanaka S, Kanai S. Effects of plantar intrinsic foot muscle strengthening exercise on static and dynamic foot kinematics: A pilot randomized controlled single-blind trial in individuals with pes planus. Gait Posture. 2020 Jan;75:40-45. doi: 10.1016/j.gaitpost.2019.09.030. Epub 2019 Sep 29.

  PMID: 31590069 BACKGROUND

• Pabon-Carrasco M, Castro-Mendez A, Vilar-Palomo S, Jimenez-Cebrian AM, Garcia-Paya I, Palomo-Toucedo IC. Randomized Clinical Trial: The Effect of Exercise of the Intrinsic Muscle on Foot Pronation. Int J Environ Res Public Health. 2020 Jul 7;17(13):4882. doi: 10.3390/ijerph17134882.

  PMID: 32645830 BACKGROUND

• Haun C, Brown CN, Hannigan K, Johnson ST. The Effects of the Short Foot Exercise on Navicular Drop: A Critically Appraised Topic. J Sport Rehabil. 2020 May 8;30(1):152-157. doi: 10.1123/jsr.2019-0437.

  PMID: 32384261 BACKGROUND

• Moon DC, Kim K, Lee SK. Immediate Effect of Short-foot Exercise on Dynamic Balance of Subjects with Excessively Pronated Feet. J Phys Ther Sci. 2014 Jan;26(1):117-9. doi: 10.1589/jpts.26.117. Epub 2014 Feb 6.

  PMID: 24567688 BACKGROUND

• Tuncer D, Erekdag A, Senaran H, Uzer G. Intrinsic vs. combined foot muscle strengthening for pes planovalgus in children aged 4-7 years: a randomized controlled trial. Eur J Pediatr. 2025 Sep 25;184(10):636. doi: 10.1007/s00431-025-06480-3.

  PMID: 40999032 DERIVED

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

• Deniz Tuncer, PhD

  Bezmialem Vakif University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Masking Details: The assessor will not know which participant received which intervention.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Investigator

Model Details: There will be an equal number of participants in the two groups randomized by the computer

Study Record Dates

• First Submitted: August 8, 2024
• First Posted: August 12, 2024
• Study Start: September 2, 2024
• Primary Completion: January 15, 2025
• Study Completion: February 5, 2025
• Last Updated: August 13, 2025

Record last verified: 2025-08

Locations

TU (1)