Comparing the effect of short foot exercise and toe curl exercise on plantar pressure during single-leg standing in individuals with flatfoot: A randomized controlled trial.

Effect of short foot exercise on lower-limb motor control function during single-leg standing in university students with flatfoot: A randomized controlled trial

A comparison in the muscle activity of the abductor hallucis and the medial longitudinal arch angle during toe curl and short foot exercises

This study aimed to determine the effectiveness of gluteus maximus versus gluteus medius muscle strengthening exercises on the navicular drop (ND), balance, and foot posture index (FPI 6) among athletes with over-pronated feet. A pre-post experimental study design with a total of 54 athletes with bilateral over-pronated feet were randomly assigned into group A (n=18), group B (n=18), and group C (n=18). Medial longitudinal arch height (MLA) was assessed with the Navicular Drop Test, the static and dynamic balance was determined with the stork stance test (SST) and modified Star Excursion Balance Test, and Foot Posture was assessed with Foot Posture Index 6. Multivariate Repeated measures ANOVA was used to analyze the effects of gluteus maximus versus gluteus medius muscle strengthening and short foot exercises. At four weeks, the gluteus medius along with short foot exercises (group B) showed significantly less ND and FPI 6 while showing more excellent SST and modified SEBT than the gluteus maximus muscle strengthening along with short foot exercises (group A) and control group (group C). These results suggest that adding gluteus medius muscle strengthening exercises to short foot exercises (SFE) was more effective in supporting the medial longitudinal arch and improving balance than performing SFE alone.

BACKGROUND: Abnormal foot mechanics in foot over-pronation has an identified relationship with mechanical low back pain (MLBP). OBJECTIVE: To explore the use of short foot exercises (SFEs) as a standalone treatment for MLBP with foot over-pronation. METHODS: Forty-six patients with MLBP (PwMLBP) presenting with and foot over-pronation were analyzed. They were randomized into the SFE (short foot exercise), SFE plus traditional physical therapy treatment (SFE[Formula: see text]TPT), and control (CG) groups. Functional disability and pain level were measured using the Oswestry Disability Index (ODI) and visual analog scale (VAS), respectively. Ultrasonography measured the cross-sectional area (CSA) of the abductor hallucis (AbdH) muscle. The foot posture and navicular drop (ND) were investigated using the foot posture index-6 (FPI) score and ND test, respectively. RESULTS: The CSA of the AbdH and VAS scores improved significantly ([Formula: see text] 0.001) between the groups, more in the SFE[Formula: see text]TPT group than in the SFE group ([Formula: see text] 0.001). The ND, FPI, and ODI measures improved significantly among the groups ([Formula: see text] 0.001), with no significant difference ([Formula: see text] 0.002) between the SFE and SFE[Formula: see text]TPT groups. The CG did not show significant differences in the outcome measures ([Formula: see text] 0.002). Based on the effect size, SFEs significantly improved all the variables of interest ([Formula: see text]1). CONCLUSION: SFEs, with or without TPT may offer an effective treatment for PwMLBP with foot over-pronation.

Background: Flexible flat foot is that the medial longitudinal arch collapses in weight bearing and returns normal arch when weight is removed and the weight bearing shifts toward medial part of the foot, which can cause patho­logical problems in the alignment of the lower extremities and the entire body. Objective: To compare the foot pressure for adults with flexible flat foot. Design: Quasi-Experimental Study Methods: 24 participants with flexible flat foot were recruited and were ran­domly divided into Visual feedback Short Foot Exercise (VSFE) group and Short Foot Exercise (SFE) group. To compare changes of foot pressure about pre and post intervention, the contact pressure measurement was conducted. Results: In the VSFE, significant differences were observed for the foot pres­sure of the 1st toe, 1st, 3rd and 4-5th metatarsal, midfoot, medial and lateral heel (p<.05). The foot pressure of the 3rd and 4-5th metatarsal, midfoot showed sig­nificant differences in the SFE (p<.05). The contact pressure of the 1st toe, 3rd metatarsal showed significant differences between the groups. Conclusions: Visual feedback short foot exercise can be useful for moving the pressure from medial to lateral part, and can prevent possible pathological problems.

Electrical stimulation is an established method that is used to improve muscle strength. The present study compared changes in the navicular drop test (NDT), muscle size, the five times sit to stand (5TSTS) test, the timed up and go (TUG) test, and the risk of falls in response to transcutaneous electrical nerve stimulation (TENS) plus short foot exercise (SFE) and SFE alone in 68 healthy elderly participants aged 65–75 years. Participants were randomly assigned to two groups: TENS plus SFE and SFE alone (with sham TENS). Measurements of NDT, muscle size, 5TSTS, TUG, and risk of falls were made before and after 4 weeks of training. The NDT was significantly improved by a median of 0.31 mm in the TENS plus SFE group and 0.64 mm in the SFE alone group (p < 0.001). Similarly, there was a significant improvement in Falls Efficacy Scale International (FES-I), 5TSTS, and TUG for both groups (p < 0.001). The abductor hallucis muscle size increased by 0.23 cm2 in the TENS plus SFE group and 0.26 cm2 in the SFE alone group (p < 0.001). There were no significant differences between the two groups for any variables (p > 0.05) except TUG, which showed a greater improvement in the TENS plus SFE group (p = 0.008). Our findings demonstrated that TENS plus SFE and SFE alone improved intrinsic foot muscle size. However, TENS plus SFE tended to improve NDT more than SFE alone, particularly in cases of severe muscle weakness. Thus, the combined use of TENS plus SFE could be recommended for muscle strengthening and balance programs for fall prevention in older adults.

BackgroundIt was well known that patellofemoral pain (PFP) has multifactorial aetiology. Increased navicular drop measures and especially more pronated foot posture in stance phase have been reported as distal factors.1,2...

PURPOSE The purpose of this study was to analysis the effective short foot exercise methods and verify the effect of short foot exercise (SFE) on medial longitudinal arch (MLA) and balance in order to utilize it as foundation data for clinical fields. METHODS In this study, research papers were collected by using RISS, KISS and PubMed as a search term for SFE, foot intrinsic muscle exercise (FIME) and MLA. RESULTS A total of 30 research were gathered, and 16 papers of data were related effect of SFE, and 9 papers was related to effective exercise methods, and 5 papers was related to a comparison with other FIME. The collected data were classified into the influence of SFE on the MLA, balance, and the efficient exercise methods. CONCLUSIONS The result of this study confirmed that SFE was very effective to maintain MLA and improve foot stability, dynamic balance and gait. In addition to, imagery training and biofeedback with SFE was efficient methods, and SFE applied with weight bearing, or windlass effect, or 30° ankle dorsiflexion strengthened abductor halluces muscle effectively. Therefore, SFE will be useful for rehabilitation of pes planus patients or athletes. 색인어: 단축발운동, 안쪽세로활, 발 내재근운동, ê· í˜•, 편평발 Keywords: Short foot exercise, Medial longitudinal arch, Intrinsic foot muscle exercise, Balance, Pes planus

BackgroundRecent research has found that strengthening hip joint stability can considerably affect foot mechanics. The purpose of this study was to determine the effect of short foot exercises (SFEs), combined exercises (CEs), and SFEs with isometric hip abduction (IHA) on navicular drop (ND), static parameters (SP), and postural sway in women with flat foot (FF).MethodsThis study recruited 45 women with flexible FF. The participants were divided into three groups: the CEs group, who performed a series of strengthening, stretching, and balancing exercises, the SFEs group, and the SFEs with IHA group. The groups carried out their assigned regimens daily for six weeks. ND, SP, and postural sway (center of pressure (CoP) parameters) were measured using the ND test and pedoscan device. The data was analysed using a repeated-measures ANOVA statistical test (p≤0.05).ResultsThe results showed that all three groups decreased in ND, surface, and foot rotation in the post-test compared to the pre-test (P < 0.05). No difference was observed in the maximum pressure (P = 0.616) and anteroposterior fluctuations (P = 0.065) of the CEs group. Both SFEs and SFEs with IHA groups showed a reduction in all CoP parameters. When comparing the ND (P = 0.22) and mediolateral sway (P = 0.035) of the SFEs with IHA group, a significant difference was observed compared to the CEs group. Additionally, the SFEs with IHA group had a higher percentage of changes in all variables compared to the other two groups.ConclusionsSFEs with IHA appear more effective than other training methods in reducing ND and decreasing CoP oscillations and stance parameters. Future studies should investigate the long-term effect of this exercise protocol.Trial registrationName of the registry: Iranian Registry of Clinical Trials.Trial registration numberIRCT20220409054456N.Date of registration28/09/2022.URL of trial registry recordhttps://fa.irct.ir/trial/63065.

ObjectivesFlatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot.MethodsThirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention.ResultsNo significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups (SFE=73.9±11.0% of maximal voluntary isometric contraction [MVIC]; SFE with NMES=81.4±8.3% of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group (pre-treatment=218.6±53.2 mm2; post-treatment=256.9±70.5 mm2; p<0.05).ConclusionsSFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

This study aimed to investigate the most effective exercise in relation to the effect on the cross-sectional area (CSA) and muscle tone of the abductor hallucis in patients with hallux valgus. Thirty-six patients (18 men, 18 women )with a mean age of 22.14 years (standard deviation of 2.47 years) participated voluntarily in this study. Hallux valgus was defined as an angle >15° of the 1st metatarsophalangeal joint(MPJ). A goniometer was used to determine the angle of the 1st MPJ. In addition, an ultrasound system and Myotone Pro were used to collect the CSA and muscle tone of the abductor hallucis of the dominant foot. CSA and muscle tone of the abductor hallucis were measured in four positions: resting position, during short foot (SF) exercise, during toe-spread-out (TSO) exercise, and during towel-curl(TC) exercise. For all data, one-way repeated analysis of variance test was used to compare the dependent variables according to the three exercise methods, and a post-hoc test was performed using the Bonferroni modification method. The significance level was set to p < .05. The CSA and muscle tone of the abductor hallucis were significantly increased in the TSO and SF exercises. In addition, a more significant increase was found in the TSO than in the SF exercise. However, no significant difference was found in TC. In conclusion, the TSO exercise is the most effective for selectively contracting the abductor hallucis than other exercises.

The short foot (SF) exercise is a strengthening exercise for the intrinsic foot muscles that is difficult to master. To examine the effect of three different electromyographic (EMG) biofeedback methods on learning the SF exercise. Thirty-six healthy subjects were randomly allocated to the control group (CTG), EMG-controlled electrical stimulation group (ESG), visual EMG biofeedback group (VSG), and combination EMG-controlled electrical stimulation with visual EMG biofeedback group (CBG). The CTG practiced the SF exercise for 5 minutes using the conventional method. The other groups each used the EMG biofeedback method and the conventional method. The EMG activity of the abductor hallucis (ABH), the medial longitudinal arch (MLA) angle, and the foot length during the SF exercise were measured before and after 5 minutes of practice. The EMG activity of the ABH in the VSG and CBG was significantly higher than that before practice. There were no intergroup differences in MLA morphology. These results suggest that visual EMG biofeedback is an effective method of increasing the EMG activity of the ABH during the SF exercise in a short practice time.

Patellofemoral pain (PFP) is a common knee problem. The foot posture in a relaxed stance is reported as a distal factor of PFP. However, the effects of short foot exercise (SFE) on the knee and functional factors have not yet been investigated in patients with PFP. This study aimed to investigate the additional effects of SFE on knee pain, foot biomechanics, and lower extremity muscle strength in patients with PFP following a standard exercise program. Thirty patients with a 'weak and pronated' foot subgroup of PFP were randomized into a control group (ConG, n= 15) and a short foot exercise group (SFEG, n= 15) with concealed allocation and blinded to the group assignment. The program of ConG consisted of hip and knee strengthening and stretching exercises. SFEG program consisted of additional SFE. Both groups performed the supervised training protocol two times per week for 6 weeks. Assessment measures were pain visual analog scale (pVAS), Kujala Patellofemoral Score (KPS), navicular drop test (NDT), rearfoot angle (RA), foot posture index (FPI), and strength tests of the lower extremity muscles. Both groups displayed decreases in pVAS scores, but it was only significant in favor of SFEG. NDT, RA, and FPI scores decreased in SFEG whereas they increased in ConG. There was a significant group-by-time interaction effect in hip extensor strength and between-group difference was found to be significantly in favor of SFEG. An intervention program consisting of additional SFE had positive effects on knee pain, navicular position, and rearfoot posture. An increase in the strength of the hip extensors may also be associated with improved stabilization by SFE.

Studies on the effects of performing short foot exercises (SFEs) on the medial longitudinal arch (MLA) have been inconclusive. This study aimed to conduct a systematic review of the effects of SFEs. 'SFE' and 'intrinsic foot muscle' were keywords used to search for randomized controlled trials. One researcher screened relevant articles based on their titles and abstracts, and two independent researchers closely read the texts, accepting nine studies for inclusion. Outcomes, intervention duration, frequency, and the number of interventions were investigated. Of 299 potential studies identified, the titles and abstracts of 211 studies were reviewed, and 192 were excluded. The full texts of 21 studies were obtained and evaluated according to inclusion and exclusion criteria. Nine studies met the inclusion criteria. Six studies concerning the MLA were identified, with four reporting MLA improvement. There was no consensus concerning the number and frequency of SFEs performed, and the mechanism of MLA improvement was unclear. MLA improvement was observed in participants who undertook ⩾ 5weeks of interventions. The results suggest that performing SFEs for ⩾ 5weeks is effective in improving the MLA. Randomized controlled trials with details concerning the number and frequency of treatments are required.

Clinical Scenario: Deformation of the arch, as measured by navicular drop (ND), is linked to lower-extremity musculoskeletal injuries. The short foot exercise (SFE) has been used to strengthen the intrinsic foot muscles that support the arch. Clinical Question: Does the SFE decrease ND in healthy adults? Summary of Key Findings: Three studies that examined the use of the SFE on ND were included. A randomized control trial that compared the SFE to a towel-curl exercise and a control group found no significant differences between the 3 groups. A randomized control trial compared the SFE to the use of arch support insoles in individuals with a flexible flatfoot and found a significant improvement in the SFE group. A prospective cohort study, without a control group, reported a significant decrease in ND following a 4-week SFE intervention without a regression at an 8-week follow-up. Overall, two of the three studies reported a significant reduction in ND following an SFE. Clinical Bottom Line: There is preliminary data supporting the use of the SFE to decrease ND-particularly in individuals with a flexible flatfoot. However, issues with the study designs make it difficult to interpret the data. Strength of Recommendation: Due to limited evidence, there is grade B evidence to support the use of the SFE to decrease ND.