Tibialis Posterior Muscle Morphology in Flexible Flatfeet Subjects

NCT07854535 | Not Yet Recruiting

• 1 other identifier: P.T.REC/012/006294
• Study Type: observational
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this observational study is to assess tibialis posterior muscle morphology in adults with flexible flatfeet. The main question it aims to answer is: Are there differences in tibialis posterior muscle morphology between adults with symptomatic flexible flatfeet, asymptomatic flexible flatfeet, and individuals with normal foot posture? Participants will undergo clinical assessment of foot posture and symptoms and an ultrasound assessment of the tibialis posterior muscle. The study will compare muscle thickness, cross-sectional area, and echo intensity among the three groups.

Conditions

Flexible Flatfoot

Keywords

Flexible Flatfoot; Tibialis Posterior Muscle; Muscle Morphology; Ultrasound; Foot Posture; Muscle thickness; Muscle Cross sectional Area

Outcome Measures

Primary Outcomes (2)

• Tibialis Posterior Muscle Thickness

  Tibialis posterior muscle thickness will be assessed using B-mode diagnostic ultrasonography with a high-frequency linear transducer. The ultrasound measurement site will be standardized at 30% of the shank length according to the predefined study protocol. Minimal transducer pressure will be applied to avoid muscle compression. Multiple images will be obtained, and the mean measurement will be used for statistical analysis.

  Baseline assessment during a single study visit.

• Tibialis Posterior Muscle Cross-sectional Area

  Tibialis posterior muscle cross-sectional area will be assessed using B-mode diagnostic ultrasonography with a high-frequency linear transducer. The ultrasound measurement site will be standardized at 30% of the shank length according to the predefined study protocol. Minimal transducer pressure will be applied to avoid muscle compression. Multiple images will be obtained, and the mean cross-sectional area measurement will be used for statistical analysis.

  Baseline assessment during a single study visit.

Secondary Outcomes (3)

• Tibialis Posterior Muscle Stiffness

  Baseline assessment during a single study visit.

• Foot Posture Index-6 (FPI-6)

  Baseline assessment during a single study visit.

• Pain intensity level

  Baseline assessment during a single study visit.

Study Arms (3)

Symptomatic Flexible Flatfoot

Participants with flexible flatfoot who have foot-related symptoms.

Other: Tibialis Posterior Muscle Morphology Assessment

Asymptomatic Flexible Flatfoot

Participants with flexible flatfoot who do not have foot-related symptoms.

Other: Tibialis Posterior Muscle Morphology Assessment

Normal Foot Posture (Control)

Participants with normal foot posture who do not meet the study criteria for flexible flatfoot.

Other: Tibialis Posterior Muscle Morphology Assessment

Interventions

Tibialis Posterior Muscle Morphology Assessment OTHER

Assessment of tibialis posterior muscle morphology using B-mode diagnostic ultrasound as a non-invasive measurement method. The assessment is performed for research purposes and does not involve administration of treatment or modification of participants' usual care.

Asymptomatic Flexible Flatfoot; Normal Foot Posture (Control); Symptomatic Flexible Flatfoot

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Participants will be recruited from individuals attending the outpatient clinics of the Faculty of Physical Therapy, Cairo University, and New Cairo Hospital. The study population will include individuals presenting with different foot postures, including those with flexible flatfoot and individuals with normal foot posture. Eligible participants who meet the study criteria and provide informed consent will be enrolled in the study.

You may qualify if:

• Adults aged 18 to 40 years.
• Both males and females will be eligible to participate.
• Body mass index (BMI) ≤30 kg/m².
• Participants with flexible flatfoot will demonstrate a visible medial longitudinal arch in the non-weight-bearing position and flattening of the arch during full weight-bearing.
• Participants with flexible flatfoot will have a Foot Posture Index-6 (FPI-6) score of ≥+6.
• Participants in the normal foot posture control group will have an FPI-6 score ranging from 0 to +5.
• Participants must be able to stand and walk independently without an assistive device.
• Participants must be willing to participate in the study and provide informed consent.

You may not qualify if:

• History of previous surgery involving the foot, ankle, or lower limb.
• History of significant trauma or fracture involving the foot, ankle, or lower limb.
• Presence of rigid flatfoot or other structural foot deformities.
• Presence of neurological disorders affecting the lower limb.
• Presence of neuromuscular disorders affecting the lower limb.
• Presence of systemic or inflammatory musculoskeletal conditions affecting the lower limb.
• Current lower-limb injury or condition that may affect standing, walking, foot posture, or tibialis posterior muscle morphology.
• Pregnancy.
• Participants who are unable to follow the assessment procedures or complete the required study measurements.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of Physical Therapy, Cairo University Cairo, Egypt

Cairo, Egypt

Location

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

• Nabil Abdo Abdellah Mohamed, PhD

  Ass. Professor, Cairo University

  STUDY CHAIR

• Hatem Mohamed Said El-Azizi, PhD

  Professor, Cairo University

  STUDY DIRECTOR

• Abdallah Mohamed Kamel, PhD

  Lecturer, Cairo University

  STUDY DIRECTOR

Central Study Contacts

Hend Ahmed, B.Sc

CONTACT

+201113097799; hendahmed63@gmail.com

Abdallah Mohamed Kamel, PhD

CONTACT

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: September 27, 2026
• First Posted: October 2, 2026
• Study Start: October 1, 2026
• Primary Completion (Estimated): February 1, 2027
• Study Completion (Estimated): March 1, 2027
• Last Updated: October 2, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)