Effects of Foot Core Exercises in Patients With Total Hip Arthroplasty

NCT07665801 | Recruiting

• 1 other identifier: FTREK26/20
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to investigate the effects of foot core exercises on lower extremity muscle strength, viscoelastic properties, functional parameters, foot and ankle posture, balance, and the morphological characteristics of periarticular structures of the foot and ankle in individuals with total hip arthroplasty. The main questions it aims to answer are:

• Does foot core exercises affect morphological characteristics of the periarticular structures surrounding the foot and ankle?
• Does foot core exercises affect viscoelastic properties of the periarticular structures surrounding the foot and ankle?
• Does foot core exercises affect lower extremity muscle strength?
• Does foot core exercises affect lower extremity functional parameters and balance in individuals with total hip arthroplasty? The researchers will compare the group performing foot core exercises with the group performing routine hip exercises that do not include foot core exercises. Participitants will:
• Participants will receive an exercise log after a specialist physiotherapist demonstrates the exercises in practice at the third postoperative mounth.
• Visit the clinic every two months from postoperative mounth 3 to month 7 for routine follow-ups and progression of exercises.
• Except for the control sessions held every two mounths, patients will be followed up through weekly phone calls.
• Participants will complete an exercise diary indicating that they performed the exercises prescribed for each week, and they will bring their diaries with them to the follow-up sessions.

Conditions

Total Hip Arthroplasty (THA)

Keywords

foot core exercises; ultrasound imaging; ultrasonography; Postoperative exercises

Outcome Measures

Primary Outcomes (8)

• Ultrasonographic muscle thickness of foot and ankle periarticular structures

  The muscle thickness of the foot and ankle periarticular structures will be evaluated using ultrasonography. Ultrasonographic examinations will be performed in accordance with the EURO-MUSCULUS/USPRM foot and ankle protocols (26, 27), using a Clarius ultrasound system (Clarius Mobile Health, 205-2980 Virtual Way, Vancouver, British Columbia, Canada) and a 4-13 MHz linear transducer. All measurements will be conducted by researchers who have received training in ultrasonographic imaging.

  From enrollment to the end of treatment at 12 weeks

• Ultrasonographic cross-sectional area of foot and ankle periarticular structures

  The muscle cross-sectional area of the foot and ankle periarticular structures will be evaluated using ultrasonography. Ultrasonographic examinations will be performed in accordance with the EURO-MUSCULUS/USPRM foot and ankle protocols (26, 27), using a Clarius ultrasound system (Clarius Mobile Health, 205-2980 Virtual Way, Vancouver, British Columbia, Canada) and a 4-13 MHz linear transducer. All measurements will be conducted by researchers who have received training in ultrasonographic imaging.

  From enrollment to the end of treatment at 12 weeks

• Tone (frequency) of foot and ankle periarticular structures

  The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the muscle tone (frequency) (F) of the gastrocnemius medialis (GM),gastrocnemius lateralis (GL) , tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). Frequency (F) characterizes muscle tone and is reffered as Hz (Hertz). All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement

  From enrollment to the end of treatment at 12 weeks

• Ultrasonographic tendon morphology of foot and ankle segments

  The tendon morphology of the foot and ankle muscles will be evaluated using ultrasonography. Ultrasonographic examinations will be performed in accordance with the EURO-MUSCULUS/USPRM foot and ankle protocols (26, 27), using a Clarius ultrasound system (Clarius Mobile Health, 205-2980 Virtual Way, Vancouver, British Columbia, Canada) and a 4-13 MHz linear transducer. All measurements will be conducted by researchers who have received training in ultrasonographic imaging.

  From enrollment to the end of treatment at 12 weeks

• Stiffness of foot and ankle periarticular structures

  The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the stiffness (S) of the gastrocnemius medialis (GM),gastrocnemius lateralis (GL) , tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). Stiffness (S) reflects the resistance of tissue to an external force that changes its shape and is reffered as N/m (Newton/metre). All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement

  From enrollment to the end of treatment at 12 weeks

• The damping coefficient of foot and ankle periaticular structures

  The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the the damping coefficient (D) of gastrocnemius, tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). The damping coefficient (D) characterizes elasticity. All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement

  From enrollment to the end of treatment at 12 weeks

• Relaxation time of foot and ankle periarticular structures

  The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the Rr relaxation time of the gastrocnemius, tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). The relaxation time (R) of is reffered as mechanical stress and is shown as ms (milliseconds). All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement

  From enrollment to the end of treatment at 12 weeks

• Creep parameters of foot and ankle periarticular structures

  The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the creep (C) parameters of the gastrocnemius, tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). Creep (C) is defined by the ratio of relaxation time to deformation time. All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement

  From enrollment to the end of treatment at 12 weeks

Secondary Outcomes (22)

• Evaluation of lower extremity alignment

  From enrollment to the end of treatment at 12 weeks

• Navicular height during weight-bearing condition

  From enrollment to the end of treatment at 12 weeks

• Assessment of Hip Flexor Muscle Strength

  From enrollment to the end of treatment at 12 weeks

• Assessment of Balance

  From enrollment to the end of treatment at 12 weeks

• Assessment of Hip Functional Status

  From enrollment to the end of treatment at 12 weeks

Study Arms (2)

Hip Exercise Only Group

ACTIVE COMPARATOR

Hip Rehabilitation Exercise Program

Other: Hip Rehabilitation Exercise Program

Hip exercise plus Foot Core exercise group

EXPERIMENTAL

Hip Rehabilitation Exercise Program with Foot-Core Exercise Program

Other: Hip Rehabilitation Exercise Program; Other: Foot-Core Exercise Program

Interventions

Hip Rehabilitation Exercise Program OTHER

5 days per week, 40 minutes per session, for 12 weeks.

Hip Exercise Only Group; Hip exercise plus Foot Core exercise group

Foot-Core Exercise Program OTHER

5 days per week, 40 minutes per session, for 12 weeks

Also known as: Exercise intervention

Hip exercise plus Foot Core exercise group

Eligibility Criteria

• Age: 50 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Being between 50 and 80 years old,
• Having at least 2 months elapsed since total hip arthroplasty surgery,
• Being willing to participate in the study,
• Being literate.

You may not qualify if:

• Having undergone revision total hip arthroplasty surgery,
• Having a cognitive level below 21 on the MoCA scale, or having any neurological or rheumatological disease,
• Inability to ambulate,
• Having any history of lower extremity trauma or other surgical procedures,
• Having toe-related pathologies that may affect pressure distribution and the course of exercise, such as hallux valgus or Morton's neuroma.

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Hacettepe University

Ankara, Altındağ, Turkey (Türkiye)

RECRUITING

Study Officials

• Gürsoy Coşkun, PT, PhD, Prof.

  Hacettepe University

  STUDY DIRECTOR

Central Study Contacts

Melike N Gürel, PT, MSc.

CONTACT

+905380307826; melikenazgurel@gmail.com

Gürsoy Coşkun, PT, PhD, Prof.

CONTACT

+905435394426; gursoycoskun@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD Candidate

Study Record Dates

• First Submitted: June 7, 2026
• First Posted: June 24, 2026
• Study Start: March 23, 2026
• Primary Completion (Estimated): May 3, 2027
• Study Completion (Estimated): May 31, 2027
• Last Updated: June 24, 2026

Record last verified: 2026-06

Locations

TU (1)