Effect of Myofascial Release in Addition to Foot Core Exercises in Young Adults With Asymptomatic Flexible Pes Planus
Condition: Pes Planus
MeSH terms: Flatfoot
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): Foam Roller; Foot Core Exercises
Intervention type(s): Other; Other
Intervention description(s): 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.; 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.
Other intervention name(s): Foot Core Exercises
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A randomized controlled trial: Two parallel treatment groups; participants were randomly allocated to Group 1 [Foam Roller+Foot Core Exercises] and Group 2 [Foot Core Exercises]
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Pes Planus; Foot Core Exercises; Myofascial Release; Foam Rolling