Analysis of Postural Control in Children Suffering From Triceps Suralis Shortening.

Study Overview
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Brief Summary
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The central nervous system (CNS) coordinates balance through the visual, vestibular, and somatoproprioceptive systems, which produce muscle activation for postural control. Among the important muscle activations for postural control are those produced in the ankle joint, which is crucial for maintaining postural control in sports settings, along with the gastrocnemius and soleus muscles. Studies show that children who practice sports improve their postural stability and accelerate sensory maturation, which can affect the development of the lower limb extremity, specifically the insertional musculature of the ankle and foot. The present study aims to analyze postural control in school-aged children with triceps suralis retraction and assess the effectiveness of treatment with stretching versus a heel pad for 3 and 6 months. Additionally, the study will analyze whether the physical activity the children engage in influences their stability

Detailed Description
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A randomized controlled trial will be conducted to evaluate the effectiveness of using a heel pad and a gastrocnemius and soleus stretching protocol. The outcomes of both interventions will be evaluated and compared, including pre-intervention and post-intervention assessments at 3 months and 6 months.

Official Title
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Analysis of Postural Control in Children After of Exercise Therapy Versus Passive Heel Pad Treatment: Randomized Controlled Trial.

Conditions
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Ankle Disease

Intervention / Treatment
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* Procedure: Streching Group
* Procedure: Heel group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children 8-12 years old Regular sports practice Decreased range of flexión Exclusion Criteria: Having neurological, vestibular, muscular, psychological or visual visual disease. Traumatic pathology 12 months prior to the measurement (sprains, talalgias, etc.). Diseases of balance or motor control. Surgeries in the last 12 months. Taking medications that may affect the neuromuscular system. Sports practice in the last 48 hours.

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Stretching Group<br>The pattern will be performed 3 times per day (10 repetitions, 30 seconds each repetition). A daily control diary will be filled in when performing the exercise. | Procedure: Streching Group<br>* The Streching group will perform a conventional stretching exercise.<br>|
| Active Comparator: Heel Cup Group<br>The heel cup will be 5mm high (Eva Shore 65) | Procedure: Heel group<br>* The heel pad group will be applied a plantar support during the months of the study.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline of Physical Activity Questionnaire for Children (PAQ-C) at 6 months | The data on the type and amount of physical activity performed by the participants will be collected using the Spanish version of the Physical Activity Questionnaire for Children (PAQ-C) (Appendix 3). The PAQ-C has been validated by Manchola-González, Bagur-Calafat, and Girabent-Farrésby Manchola-González, Bagur-Calafat, and Girabent-Farrés will be used to collect data on the type and amount of physical activity performed by the participants. | At baseline; post 1 (3 months) and post 2 (6 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stabilometry | For collecting stabilometry data, an inertial measurement instrument called Gyko® (Janusz Jaworski et al., 2020) (Figure 5) will be used. It is a state-of-the-art device that allows for objective assessment of acceleration, angular velocity, and with an acquisition frequency of 100Hz | At baseline; post 1 (3 months) and post 2 (6 months) | 
| Instability test | The instability test will be performed using a foam rubber pad model Balance _Pand Elite ® with dimensions of 50 x 41 x 6cm, a weight of 0.7kg, and a density of 55kg/m (Figure 6). The foam has a nominal density of 40kg/m3 and a vertical compressive strength of 0.45N mm2 and a vertical compressive elasticity of 34N mm2 according to the manufacturer | At baseline; post 1 (3 months) and post 2 (6 months) | 
| Lunge Test | he Lunge Test will be used to determine the dorsal flexion of the ankle (Figure 10) using the Leg MOtion® system | At baseline; post 1 (3 months) and post 2 (6 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Muscle Stretching Exercises, Balance, Exercise, Range of Motion