Clinical trial NCT06300671: The Effect of Subtalar Joint Pronation Amount on Lower Extremity Alignment and Performance
Official title: Investigation of the Effects of Different Subtalar Joint Pronation Amounts on Lower Extremity Anatomical Measurements, Jump Performances and Postural Stability in Healthy Individuals
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Balance Disorders
Foot Injury
Lower Extremity Problem
Keywords: Subtalar joint
Hyperpronation
Kinetic Chain
Balance
Lead sponsor: Bahçeşehir University
Sponsor class: OTHER
First posted: 2024-03-08
Enrollment: 48
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: 48 healthy individuals between the ages of 18-40 constitute the population of the study. Participants randomized into neutral, pronation, and hyperpronation groups.
Primary purpose: SCREENING

Brief summary: The lower extremity consists of segments that can be affected by the relative position of each other. Deviation of one segment from its normal alignment in the lower extremity also affects the alignment of other segments. The hip joint can affect the frontal plane alignment from proximal to distal, while the foot and ankle complex can also affect it from distal to proximal. Increased subtalar joint pronation in the kinetic chain from distal to proximal; is associated with decreased dorsiflexion angle and increased frontal plane projection angle. It has been shown that ankle dorsiflexion limitation causes changes in the biomechanics and kinematics of landing after jumping, but no study examining the effect of foot pronation on jump tests has been found in the literature. Since the foot is located at the most distal point and acts as a support base for the kinematic chain, the smallest dynamic change in the foot affects the balance of the whole body. Due to foot pronation, changes in the sole contact surface may make it difficult for the foot to adapt to the ground, balance and postural stabilization may be adversely affected, and an increase in the workload of the muscles around the joint may be observed. In another study, it is mentioned that there is limited evidence about the effect of foot posture on postural stability. Although there are studies in the literature examining the effects of subtalar joint pronation on lower extremity alignment and postural stability, studies need to examine the effects of different subtalar joint pronation amounts on lower extremity alignment, jumping performance, and postural stability. Our study will contribute to the literature with this aspect.

Detailed description: The foot has an important role as it supports body weight and plays a vital role during movement. The ankle complex consists of the talocrural and subtalar joints, which have diagonal axes that perform multi-planar movements. Because of its oblique axis, the subtalar joint can produce three-planar movements, pronation, and supination. Foot pronation consists of medial rotation and adduction of the talus, eversion of the calcaneus, and abduction and supination of the forefoot. Medial longitudinal arch height decreased or disappeared in feet in pronation posture. Loss of medial longitudinal arch height requires that the foot cannot absorb enough energy and must produce more force to stabilize it. In particular, abnormal alignment in the hyper pronation posture or prolonged pronation is defined as both a risk factor and an etiologic factor for increased navicular drop and malalignment patterns in the lower extremities. It is a possible etiologic cause for the development of most lower extremity overuse injuries by altering kinematics and force distribution. The lower extremity consists of segments that can be affected by the relative position of each other. Deviation of one segment from its normal alignment in the lower extremity also affects the alignment of other segments. In the frontal plane alignment, the hip joint can be affected from proximal to distal, while the foot and ankle complex can be affected from distal to proximal. Increased subtalar joint pronation in the kinetic chain from distal to proximal is associated with decreased dorsiflexion angle and increased frontal plane projection angle. It has been shown that ankle dorsiflexion limitation causes changes in the biomechanics and kinematics of landing after jumping, but no study examining the effect of foot pronation on jump tests has been found in the literature.

Since the foot is located at the most distal point and acts as a support base for the kinematic chain, the smallest dynamic change in the foot affects the balance of the whole body. Due to foot pronation, changes in the sole contact surface may make it difficult for the foot to adapt to the ground, balance and postural stabilization may be adversely affected, and an increase in the workload of the muscles around the joint may be observed. It is mentioned that there is limited evidence about the effect of foot posture on postural stability. there is a need for studies examining the effects of different subtalar joint pronation amounts on lower extremity alignment, jumping performance, and postural stability. Our study will contribute to the literature with this aspect.

Eligibility criteria: Inclusion Criteria:

- Being between the ages of 18-40

* Pain, difficulty in walking and loss of function, etc. not having complaints
* Foot posture index value should be between 6-12
* Not having any orthopedic disease
* Not having visual or hearing impairment
* Not having been involved in any physical therapy program in the last 6 months.
* Not having undergone any surgical procedure on the lower extremity
* Not using analgesic medication within the specified treatment days throughout the research period.

Exclusion Criteria:

* Having a lower extremity congenital anomaly
* Having a history of lower extremity surgery or planned lower extremity surgery within the next 12 months
* Having any signs of pain in the lower extremities
* Having ligament hyperlaxity
* Having a history of tendon or cartilage injury
* Having serious illnesses
* Predominant knee pain from other knee structures, hip or lumbar spine
* Having a history of using any shoe insert-orthosis-insoles or knee injection in the last 3 months
* Having any neurological or systemic inflammatory arthritis disorder (neurological involvement that affects movement)

Primary outcomes:
measure: Postural Stability
timeFrame: Baseline
Secondary outcomes:
measure: Frontal Plane Projection Angle
timeFrame: Baseline
measure: Foot and Ankle Ability Measurement
timeFrame: Baseline
measure: Navicular Drop Test
timeFrame: Baseline
measure: Weight bearing lunge test
timeFrame: Baseline
measure: Countermovement jump test without arm swing
timeFrame: Baseline
Other outcomes:
Locations:
city: Besiktas
country: Turkey
facility: Bahcesehir University
state: Istanbul
Study officials:
affiliation: Bahcesehir University, Faculty of Health Sciences
name: Pelin Pişirici, PT, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Acibadem Mehmet Ali Aydinlar University, Faculty of Health Sciences
name: Ozlem Feyzioğlu, PT, PhD
role: STUDY_CHAIR
affiliation: Bahcesehir University, Health Sciences Faculty, Physiotherapy and Rehabilitation
name: Nurefşan Kaygaz, PT
role: STUDY_CHAIR
affiliation: Bahcesehir University, Health Sciences Faculty, Physiotherapy and Rehabilitation
name: Yahya Süleyman Mollaibrahimoğlu, PT
role: STUDY_CHAIR
References: