Exercises for Pes Planus

Primary outcomes

1. The navicular drop test

   Time frame: Change from Baseline at 8 weeks

   The navicular drop test is a test used in the clinic to determine the presence and degree of pes planus. It will be used to distinguish participants with and without pes planus.). In this test, first the navicular tubercle is palpated and marked, and the distance between the navicular tubercle and the floor is measured with a ruler while the person is in a sitting position and the feet are only in contact with the floor (without putting weight on the feet). Then the person stands up and puts equal weight on their feet, and the distance between the navicular tubercle and the floor is measured again. Measurements are made bilaterally and recorded in millimeters (mm) or centimeters (cm). In the navicular drop test, the difference between the weighted and unweighted measurements is considered normal (neutral) between 5-9 mm, excessive pronation of 10 mm and above, and excessive supination of 4 mm and below.

2. STAR BALANCE TEST

   Time frame: Change from Baseline at 8 weeks

   Star balance test (SBT) is one of the tests frequently used to evaluate lower extremity dynamic balance and postural control. SBT is a test that measures the maximum extension an individual can achieve by maintaining balance and performing a single-leg squat on lines drawn at 45-degree intervals in eight different directions.

3. The foot function index

   Time frame: Change from Baseline at 8 weeks

   The foot function index is a test used to determine pain, disability and activity limitation. It is a scale consisting of a total of three parameters and 23 items. The pain subscale contains nine items and measures the severity of foot pain in different situations. The disability subscale contains 9 items and evaluates the severity of the difficulty in performing functional activities due to the person's foot problems. The activity limitation subscale contains 5 items and measures the person's activity limitations due to foot problems. The AFI is a scale filled out by the person himself. A high score indicates more pain, disability and activity limitation.

4. Gait Assessment (Footprint method):

   Time frame: Change from Baseline at 8 weeks

   Gait Assessment (Footprint method): General gait parameters are temporal and distance factors, cycle time (cadence), step length and speed. These are the simplest form of objective gait assessment. Only a stopwatch, a tape measure and some talcum powder are required. The individual will be asked to walk naturally and will be allowed to stand on their own feet. The individual will step on a tray of talcum powder and then will be asked to walk across a black bag. The left and right step lengths, step length, toe angle and an idea of the foot contact pattern are obtained.

5. Dynamic Gait Index

   Time frame: Change from Baseline at 8 weeks

   The Dynamic Gait Index (DGI) is a clinical measure that assesses the ability of a person to adapt to complex walking tasks commonly encountered in daily life. The DGI is based on a person-environment mobility disability model in which environmental demands are categorized as distance, time, environment, terrain, physical load, attention, postural transitions, and intensity, and represents the external demand that must be met for an individual to move in a given environment. Item 1 of the DGI is considered the reference or baseline task and examines the ability to walk under low-intensity conditions (self-paced, level-surface walking). The remaining 7 items examine the person's ability to adapt their gait to task demands in 4 environmental dimensions.Each item is scored on an ordinal scale (0-3) based on gait pattern, speed, and assistance level, with total scores ranging from 0 (worst) to 24 (best)."

6. Functional Muscle Strength Evaluation

   Time frame: Change from Baseline at 8 weeks

   Functional Muscle Strength Evaluation: The number of repetitions of the movement in a certain period of time is a valid and reliable method used effectively in functional muscle strength evaluation. In our study, individuals' lower extremity functional muscle strength will be evaluated with a 30-second maximum repetition test. Within the scope of this evaluation, individuals are asked to perform 3 closed kinetic chain exercises involving large muscle groups for standing and walking. These are (1) "Lateral Step-up" test (taking a side step to a 20 cm bench), (2) "Sitto-Stand" test (standing up without sitting without using the arms), (3) "Attain Stand Through Half Knee" (moving from kneeling position to half kneeling position) test. The maximum number of repetitions the person does in 30 seconds is noted. A higher number of repetitions indicates better functional performance.