Clinical trial NCT06678139: The Effect of Physiotherapy on Lower Extremity Function and Gait in Children with Isolated Gastrocnemius Muscle Tightness
Official title: The Effect of a Physiotherapy on Lower Extremity Function and Gait in Children with Isolated Gastrocnemius Muscle Tightness
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Lower Extremity Biomechanics
Gastrocnemius Tightness
Pes Planovalgus
Keywords: Isolated gastrocnemius muscle tightness
physiotherapy
lower extremity function
gait
Lead sponsor: Bezmialem Vakif University
Sponsor class: OTHER
First posted: 2024-11-07
Enrollment: 30
Sex: ALL
Minimum age (years): 4
Maximum age (years): 10
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: Since the gastrocnemius muscle crosses both joints, the joint kinematics of the ankle are affected by knee flexion. According to the Kendall \& McCreary assessment of normal joint motion angles, the generally accepted normal range of motion for ankle dorsiflexion is 20° when the knee joint is in extension and can approach 30° when the knee joint is flexed due to relaxation of the gastrocnemius. In the mid-stance phase of gait, it is observed that the ankle joint allows 8-10° dorsi flexion movement.

In this study, a minimum 13° increase in dorsiflexion with knee flexion compared to dorsiflexion with knee extension will be considered as isolated gastrocnemius muscle tightness. Isolated gastrocnemius muscle tightness has been associated with many biomechanical changes such as pes planus, talar equinus, hindfoot pronation and symptoms such as plantar fasciitis, leg pain, metatarsalgia, achilles tendinopathy by compensatory effects on the lower extremity and foot during gait. The association of increased hindfoot pronation with isolated gastrocnemius tightness has been shown in many studies. Regardless of the etiology of pronation of the hindfoot, there will be adaptive isolated gastrocnemius tightness with talar plantar flexion. Isolated gastrocnemius tightness, which causes plantar flexion in the ankle joint and pronation in the subtalar joint, also prevents the distribution of the load to the base of the foot within normal limits during weight bearing. However, no study investigating the effect of physiotherapy program on function and gait has been encountered. The aim of this study was to investigate the effect of a physiotherapy program on lower extremity function and gait in children with isolated gastrocnemius muscle tightness.


Eligibility criteria: Inclusion Criteria:

* Presence of bilateral pes planovalgus due to the isolated gastrocneius tightness
* Being the ages between 4-10 years old
* Having body mass index between within normal limits

Exclusion Criteria:

* Presence of high femoral anteversion (Craig test \> 30 degrees) and/or internal tibial torsion and/or metatursus adductus
* Having of leg length discrepancy
* Accompanying any neurological, rheumatologic, musculoskeletal, metabolic and connective tissue disease
* Presence of pain associated with the vertebral column and lower extremities
* Presence of any lower extremity and/or vertebral column deformity or history of surgery
* Cognitive, mental, serious psychiatric illness
* Participation in any exercise program and/or sportive activity in the last six months

Primary outcomes:
measure: Gait analyses with Kinovea ® software
timeFrame: Baseline and immediately after the physiotherapy program
measure: Edinburgh Observational Gait Score
timeFrame: Baseline and immediately after the physiotherapy program
measure: Lower Extremity Function Scale
timeFrame: Baseline and immediately after the physiotherapy program
Secondary outcomes:
measure: Foot Posture Index (FPI-6)
timeFrame: Baseline and immediately after the physiotherapy program
measure: Navicular Drop Test
timeFrame: Baseline and immediately after the physiotherapy program
measure: Sit to Stand Test
timeFrame: Baseline and immediately after the physiotherapy program
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Bezmialem Vakif University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation
Study officials:
References: