Corrective Exercises With Neuromuscular Electrical Stimulation In Children With Flexible Flatfeet
Condition: Sports Physical Therapy
MeSH terms: Flatfoot
Study type: Interventional

Summary: 
      flexible flatfoot is a common foot misalignment in children. various treatment procedures are
      used to correct or to avoid future complain among adults and pediatric population.
    

Detailed description: 
      Ethics Statement This study was approved by the Institutional Review Board of the Faculty of
      Physical Therapy, Cairo University, Egypt (no. P.T.REC/012/0016370) and strictly adhered to
      the criteria proclaimed in the latest version of the Declaration of Helsinki code of ethics.
      Children's participation was commissioned by asking their legal guardian to sign a consent
      form prior to data collection.

      Study design A prospective double-masked randomized controlled trial was carried out from
      September 1, 2018 to December 31, 2019 at the Out-patient Physical Therapy Clinic of Faculty
      of Physical Therapy, Cairo University.

      Sample size estimation Sample size calculation was performed prior to the study using G*POWER
      statistical software (version 3.1.9.2; Franz Faul, Universitat Kiel, Germany) [F tests-
      MANOVA. Estimates of means of SAI were calculated from a preliminary study included 10
      children who were assigned to the two treatment groups (5 children for each). Repeated
      measures, within-between interaction, α=0.05, β=0.2, Pillai V = 0.1, and large effect size]
      and revealed that the appropriate sample size for this study was not less than 65 children.
      ¬then, 70 children were recruited to account for the possible dropout rates.

      Randomization Seventy-two volunteer children who were recruited from governmental schools at
      Cairo and Giza Provinces. The online Graph Pad software was used to allocate study
      participants to either intervention group (corrective exercise and NMES) control group
      (corrective exercise and placebo NMES). All children/legal and examiners were unaware of
      group allocation.
    

Intervention name(s): Corrective exercises; Neuromuscular electrical stimulation
Intervention type(s): Other; Other
Intervention description(s): The experimental and control groups performed a designed strengthening exercises included short-foot exercise, toes-spread-out exercise, toes-extension exercise and toe-curls for 60 minutes; The experimental group received NMES aiming to reinforce the planter intrinsic foot muscles for 30 minutes. The surface electrodes were placed over the abductor halluces. The control group received placebo NMES with no current stimulation.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Intervention:
Corrective exercises The experimental and control groups performed a designed strengthening exercises included short-foot exercise, toes-spread-out exercise, toes-extension exercise and toe-curls for 60 minutes. Each exercise was performed for 30 repetitions holding each repetition for 5 seconds (about three minutes).
Neuromuscular electrical stimulation The experimental group received NMES aiming to reinforce the planter intrinsic foot muscles. The surface electrodes were placed over the abductor halluces based on the evidence that it has the largest cross-sectional area of the intrinsic foot muscles
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Foot arch; Foot print; Idiopathic flexible flatfoot; Navicular height; Short foot exercises.