Foot Core Training in Individuals With Pes Planus

Study Overview
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Brief Summary
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Foot core training is very important for the intrinsic muscles of the foot, but it is often neglected in exercise programs given to individuals with pes planus. The aim of our study is to reveal the effects of foot core training, which will be added to the exercise program routinely given to individuals with asymptomatic flexible pes planus, on walking, muscular activations, balance and lower extremity functional performance with objective, evidence based results.

Detailed Description
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This study is a randomized controlled study and will be carried out on volunteer individuals with asymptomatic flexible pes planus aged between 18-25, studying at Alanya Alaaddin Keykubat University. Persons meeting the inclusion criteria will be determined by the specialist physiotherapist. Surface electromyography (sEMG) measurements will be made by a doctorate physiotherapist. Other evaluations will be made by a specialist physiotherapist. Individuals who meet the inclusion criteria, who volunteered to participate in the study and signed the consent sheet will be randomly divided into two groups, the control group and the foot core group. Individuals with initial evaluations will be followed up in an exercise program planned for 8 weeks. The control group will be given exercises to strengthen the weakened muscles, stretch the shortened structures and increase proprioception. Foot core training will be given to the study group in addition to the exercises given to the control group. Before and after exercise, the subjects will be assessed with navicular height measurement, muscle activation evaluation, evaluation of walking parameters, functional lower extremity performance evaluation and balance evaluation.

Official Title
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The Effects of Foot-Core Training on Muscle Activations, Walking, Balance and Lower Extremity Performance in Individuals With Pes Planus

Conditions
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Pes Planus

Intervention / Treatment
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* Other: Exercise program
* Other: Foot core training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals who volunteer to participate in the study Individuals between the ages of 18-25 Individuals with a body mass index between 18.5-30. Individuals with a difference of 10 mm or more between weighted and unweighted measurements by applying the navicular drop test Individuals who are considered to have flexible pes planus with a positive Jack's finger lift test Exclusion Criteria: Individuals with symptoms such as any pain in the foot and ankle, fatigue. Individuals with any neurological or orthopedic disease affecting the lower extremity. Individuals with a history of foot-ankle trauma-surgery Individuals with lower extremity inequality of more than 1 centimeter (cm)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: A randomized controlled trial: Two parallel treatment groups; The control group will only receive exercise therapy, while the other group will receive foot core training in addition to exercise therapy
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control grup<br>All individuals participating in the study will be taught the exercises given to strengthen weakened muscles, stretch shortened structures and increase proprioception by the physiotherapist and will be asked to do these exercises at least twice a day for 8 weeks. The home program will be followed by the exercise daily form. | Other: Exercise program<br>* Strengthening with resistance bands for tibialis posterior, tibialis anterior, peroneus longus, finger flexors, hip and knee muscles, sheet gathering exercises, fingertip walking exercises, Stretching exercises for gastrocnemius and soleus muscles, plantar fascia stretching, weight transfer on one leg<br>|
| Experimental: Foot core grup<br>In addition to the exercise program given to the control group, foot core training will be added and taught by the physiotherapist and they will be asked to do these exercises at least twice a day for 8 weeks. | Other: Exercise program<br>* Strengthening with resistance bands for tibialis posterior, tibialis anterior, peroneus longus, finger flexors, hip and knee muscles, sheet gathering exercises, fingertip walking exercises, Stretching exercises for gastrocnemius and soleus muscles, plantar fascia stretching, weight transfer on one leg<br>Other: Foot core training<br>* Short foot exercises with passive modeling, active assisted modeling, active modeling, functional training<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of muscle activation | In our study, muscle activations of the tibialis anterior, peroneus longus and abductor hallucis muscles both during maximum isometric contraction and during walking will be evaluated by a trained and experienced researcher using the sEMG device. | Change from baseline muscle activation at 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Y balance test (YBT): | There are 3 bars of 1.5 meters long fixed to a 2.54 cm high central foot plate at an angle of 135 and 90 degrees between them. It is asked to lie down with the tip of the toe in 3 directions and the measurements are recorded. | Just before the training and at the end of 8-week training | 
| Vertical jump, flight time | Vertical jumping and jumping on one foot will be evaluated with MicroGate Opto-jump Next®. With this test, flight time will be measured during vertical jump, and it will be recorded by seconds. | Just before the training and at the end of 8-week training | 
| Vertical jump, jump height | Vertical jumping and jumping on one foot will be evaluated with MicroGate Opto-jump Next®. Jump height wil be recorded by centimeters. | Just before the training and at the end of 8-week training | 
| Vertical jump, power | Vertical jumping and jumping on one foot will be evaluated with MicroGate Opto-jump Next®. Power will be recorded by watt/kilogram. | Just before the training and at the end of 8-week training | 
| vertical jump, position difference | Vertical jumping and jumping on one foot will be evaluated with MicroGate Opto-jump Next®. Position difference will be measured by centimeters. | Just before the training and at the end of 8-week training | 
| Cadence | It will be evaluated using a digital miniature gait analysis system. Participants will be asked to walk on the 20-meter track and as a result of the analysis cadence will be recorded as steps per minute. | Just before the training and at the end of 8-week training | 
| Gait speed | It will be evaluated using a digital miniature gait analysis system. Participants will be asked to walk on the 20-meter track and as a result of the analysis, gait speed will be measured as meter/seconds. | Just before the training and at the end of 8-week training | 
| Step width | It will be evaluated using a digital miniature gait analysis system. Participants will be asked to walk on the 20-meter track and step width will be measured as centimeter. | Just before the training and at the end of 8-week training | 
| Ratio of step length to step height | It will be evaluated using a digital miniature gait analysis system. Participants will be asked to walk on the 20-meter track and as a result of the analysis, ratio of step length to step height will be calculated as a percentage. | Just before the training and at the end of 8-week training | 
| Standing phase duration | It will be evaluated using a digital miniature gait analysis system. Participants will be asked to walk on the 20-meter track. Standing phase duration will be recorded as seconds. | Just before the training and at the end of 8-week training | 
| Swing phase duration | It will be evaluated using a digital miniature gait analysis system. Participants will be asked to walk on the 20-meter track. Swing phase duration will be recorded as seconds. | Just before the training and at the end of 8-week training | 
| Double support period duration | It will be evaluated using a digital miniature gait analysis system. Participants will be asked to walk on the 20-meter track and as a result of the analysis, double support period duration will be recorded as seconds. | Just before the training and at the end of 8-week training | 
| Single support period time | It will be evaluated using a digital miniature gait analysis system. Participants will be asked to walk on the 20-meter track and as a result of the analysis, single support period time will be recorded as seconds. | Just before the training and at the end of 8-week training | 
| Acceleration | It will be evaluated using a digital miniature gait analysis system. Participants will be asked to walk on the 20-meter track and as a result of the analysis, at what moments and at what speed the acceleration during walking will be reached as seconds and meter/second, respectively. | Just before the training and at the end of 8-week training | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pes planus, Electromyography, Gait, Balance