Effectiveness of Manuel Therapy Methods in Pes Planus

NCT07326020 | Completed

• 1 other identifier: pesplanus2025
• Study Type: interventional
• Target: 33
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to compare the immediate effects of joint-oriented manual therapy and soft tissue-oriented manual therapy on dorsiflexion angle, static and dynamic balance, muscle-tendon mechanical properties, and thermal variables in physically active individuals with flexible pes planus. The research will be conducted between November 2025 and January 2026 at Hacettepe University, Faculty of Physical Therapy and Rehabilitation. Individuals aged 18-35 years with a Tegner Activity Score between 4 and 6 will be included. Participants will be allocated into three groups: soft tissue-oriented manual therapy group, joint-oriented manual therapy group, and healthy control group. Following randomization, the respective intervention will be applied to the intervention groups, while no intervention will be administered to the control group. Assessments will include the dorsiflexion range of motion (weight-bearing lunge test), myotonometric measurements (Myoton-Pro), static balance (Kinvent force platform), dynamic balance (Y-balance test), and thermographic imaging (FLIR E52). The outcomes of this study are expected to contribute to understanding the immediate effectiveness of manual therapy approaches applied in asymptomatic pes planus and to identify the method providing optimal benefit. Furthermore, the differences observed between individuals with pes planus and healthy controls will serve as a guide for clinical assessments of pes planus.

Conditions

Pes Planus

Keywords

pes planus; manuel therapy; balance; range of motion; stiffness

Outcome Measures

Primary Outcomes (2)

• static balance

  1 Static Balance Measurement Static balance will be assessed using the Kinvent K-Plates (Kinvent, Montpellier, France), a reliable portable force plate with a 1000 Hz sampling rate. Participants will stand on one leg with hands on hips and the other leg flexed, focusing on a point 5 m away for 10 s. The test will be repeated with eyes closed. Postural oscillations (mm) and center of pressure (COP) (mm) data will be reported instantly via the mobile app. Each condition will be measured three times.

  2 months

• dynamic balance

  Dynamic Balance Measurement Dynamic balance will be assessed using the Y-Balance Test platform (Move2Perform, Evansville, USA). Participants will reach in anterior, posteromedial, and posterolateral directions while maintaining single-leg stance, hands on hips. The maximum reach distance(cm) in each direction will be recorded. After practice trials, three valid attempts per direction will be completed. Results will be expressed as normalized composite scores(%) relative to limb length.

  2 months

Secondary Outcomes (4)

• myotonometric muscle tone

  2 months

• myotonometric muscle stiffness

  2 months

• ankle dorsiflexion range of motion

  2 months

• skin surface thermographic measurement

  2 months

Study Arms (3)

control

NO INTERVENTION

healthy control group without intervention

joint mobilization group

EXPERIMENTAL

subtalar and midtarsal joint mobilization in patients with flexible pes planus

Other: joint mobilization

myofascial release group

EXPERIMENTAL

calf and plantar fascia release in patients with flexible pes planus

Other: myofascial release

Interventions

joint mobilization OTHER

subtalar and midtarsal joint mobilization

joint mobilization group

myofascial release OTHER

calf and plantar fascia release

myofascial release group

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Navicular Drop Test ≥ 10 mm
• Foot Posture Index (FPI) \> 6
• Tegner Activity Scale score between 4 and 6 (inclusive)
• Age between 18 and 35 years
• Age between 18 and 35 years
• Navicular Drop Test \< 10 mm
• Foot Posture Index (FPI) between 0 and 6 (inclusive)
• Tegner Activity Scale score between 4 and 6 (inclusive)

You may not qualify if:

• Diagnosis of posterior tibial tendinopathy by an orthopedic surgeon
• Presence of plantar fasciitis or moderate/severe hallux valgus
• History of lower extremity surgery or trauma
• Presence of neurological, metabolic, or other musculoskeletal disorders that may affect gait or balance performance
• Receipt of any treatment for pes planus within the past year
• Body mass index (BMI) greater than 30 kg/m²
• Regular participation in sports activities
• Presence of plantar fasciitis or moderate/severe hallux valgus
• Presence of pes cavus deformity
• History of lower extremity surgery or trauma
• Presence of neurological, metabolic, or other musculoskeletal disorders that may affect gait or balance performance
• Body mass index (BMI) greater than 30 kg/m²
• Participation in professional-level sports activities

Sponsors & Collaborators

• Hande Guney Deniz: lead

Study Sites (1)

Hacettepe University

Ankara, 06100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Flatfoot

Interventions

Myofascial Release Therapy

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

Intervention Hierarchy (Ancestors)

Massage; Therapy, Soft Tissue; Musculoskeletal Manipulations; Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Officials

• Hande Guney-Deniz, Prof. Dr

  Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Departmen of Musculoskeletal Physiotherapy and Rehabilitation, Ankara, Türkiye

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Prof. Dr.

Study Record Dates

• First Submitted: November 29, 2025
• First Posted: January 8, 2026
• Study Start: December 20, 2025
• Primary Completion: February 8, 2026
• Study Completion: February 15, 2026
• Last Updated: February 18, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF

Locations

TU (1)