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Completed

NCT Number: NCT05774327

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

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.

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Key information

Conditions

Pes Planus Congenital Abnormalities Congenital, Hereditary, and Neonatal Diseases and Abnormalities Flatfoot Foot Deformities Foot Deformities, Acquired Foot Deformities, Congenital Limb Deformities, Congenital Lower Extremity Deformities, Congenital Musculoskeletal Abnormalities Musculoskeletal Diseases Talipes

Age range

18 year–25 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

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

Ankara, Turkey (Türkiye)

About this study

This study will be carried out with a Randomized Controlled Prospective Study design. For this study, individuals between the ages of 18-25 years with a fall amount of 10 millimeters or more according to the navicular fall test and flexible pes planus according to Jack's finger lift test will be informed about the study and consent for participation will be obtained. Demographic information of the individuals who accept participation will be collected. This study, 2 randomized groups of young adults with flexible pes planus will be formed and one group will be applied an exercise program including only foot core exercises, while the other group will be applied self myofascial release with foam rollers, which is a myofascial release method, in addition to foot core exercises.

Both the experimental and control groups will receive a program consisting of 7 different foot core exercises, each of which will be progressed gradually for 6 weeks, 3 sets of 10 repetitions per day. A brochure for the exercises will be prepared and given to the participants to do at home. In order to follow up the exercise of the participants, the individuals will be called weekly during this period and exercise follow-up will be performed. The experimental group will also be planned to perform 60 seconds of myofascial release on each tissue on the thoracolumbar fascia, iliotibial band, hamstring, gastro-soleus, peroneals and plantar fascia 2 days a week for 6 weeks with foam roller, which is a self-myofascial release method. The amount of load on the tissue will be determined by instructing the individuals to apply the maximum amount of load possible. At the end of six weeks, the initial evaluations will be performed again on all individuals and the measurement results will be analyzed.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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.

Exclusion criteria

  • 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.

Treatment and study plan

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.

Other names: Foot Core Exercises

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.

Primary outcomes

  1. Change in Balance

    Time frame: Change from Baseline Y Balance Test Results at 6 weeks.

    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.

Secondary outcomes

  1. Change in Flexibility

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

    Flexibility is assessed with the sit and reach test. Individuals are trained on how to perform the sit and reach test using three warm-up trials. All individuals sit with the heels/soles of their feet resting on the box, knees fully extended, and fingertips extended as far as possible in the correct position on the metal slide. Individuals are instructed to reach as far forward as possible by pushing the measurement indicator with their fingertips and to hold the maximum reach for two seconds. Three measurements are recorded and the mean calculated.

  2. Change in Power

    Time frame: Change from Baseline Vertical Jump Test Results at 6 weeks.

    Power will be evaluated by vertical jump test. Individuals are measured in a fully rested state and 3 repetitions of vertical jump with 45 seconds rest interval, the best score is recorded.

  3. Change in Gait

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

    Gait is assessed with the 10-meter walk test. The test is performed at a comfortable walking speed on a 14 m walkway for 10 m walk, start (2 m) and finish (2 m). Measurements are repeated 3 times and the average time is recorded in seconds. Cadence is calculated and recorded during the test.

Sponsors and collaborators

Lead sponsor

Ankara Yildirim Beyazıt University

Other

Registry information

Official study title

The Effect of Myofascial Release in Addition to Foot Core Exercises on Lower Extremity Performance in Young Adults With Asymptomatic Flexible Pes Planus

Important dates

Study start
2023
Primary completion
2023
Study completion
2023
First posted
Mar 17, 2023
Registry last updated
Oct 10, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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