College of Applied Medical Sciences, Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Physical Therapy, King Saud Medical City, Riyadh, Saudi Arabia.
Eur J Phys Rehabil Med. 2023 Jun;59(3):396-405. doi: 10.23736/S1973-9087.23.07846-2. Epub 2023 Mar 29.
Flatfoot is a musculoskeletal problem associated with dysfunctional active and passive supporting structures of the normal foot curvature. Strengthening of the intrinsic foot muscles or using shoe orthosis are recommend treatment approaches. However, investigating the effect of combining both approaches is still warranted.
To examine the effect of applying short foot exercises (SFE) combined with shoe insole versus shoe insole alone on foot pressure measures, pain, function and navicular drop in individuals with symptomatic flexible flatfoot.
Prospective, active control, parallel-group, assessor-blinded, randomized controlled trial and intention-to-treat analysis.
Outpatient physical therapy clinic of a university teaching hospital.
Forty participants with symptomatic flexible flatfoot.
A six-week treatment protocol of SFE (three sets of 10 repetitions a day) in addition to shoe insole (eight hours a day) (experimental group, N.=20) or shoe insole only (eight hours a day) (control group, N.=20). Clinic visits were made at baseline and every two weeks for monitoring and follow-up. The static and dynamic foot area, force and pressure measures, pain, lower extremity function, and navicular drop were assessed at baseline and postintervention.
Forty participants joined the study and 37 (92.5%) completed the six-week intervention period. Foot pressure, pain and function showed a significant interaction (P=0.02 - <0.001) and time (P<0.001) effects with a non-significant group effect in favor of the experimental group. Post-hoc analysis revealed that the experimental group had lesser pain (P=0.002) and better function (P=0.03) than the control group at six weeks. Navicular drop decreased equally in both groups.
Implementation of shoe insole and SFE for six weeks improved pain and function and altered foot pressure distribution greater than shoe insole alone in patients with symptomatic flatfoot.
Wearing shoe insole is an easy, but passive, treatment approach for a flatfoot problem. This study provided evidence regarding the added benefit of SFE. It is recommended that rehabilitation practitioners implement a comprehensive treatment protocol including both shoe insole and SFE for at least six weeks to achieve better results for their flatfoot patients.
平足是一种与正常足弓的功能性主动和被动支撑结构功能障碍相关的肌肉骨骼问题。推荐强化足部内在肌肉或使用矫形鞋垫作为治疗方法。然而，仍需要研究联合这两种方法的效果。
研究短足运动（SFE）联合鞋垫与单独使用鞋垫对有症状的柔韧性平足患者的足底压力测量、疼痛、功能和舟骨下降的影响。
前瞻性、主动对照、平行组、评估者盲法、随机对照试验和意向治疗分析。
大学教学医院的门诊物理治疗诊所。
40 名有症状的柔韧性平足患者。
SFE（每天三组，每组 10 次）加鞋垫（每天 8 小时）（实验组，N=20）或仅鞋垫（每天 8 小时）（对照组，N=20）的六周治疗方案。在基线和每两周进行监测和随访时进行临床就诊。在基线和干预后评估静态和动态足部面积、力和压力测量、疼痛、下肢功能和舟骨下降。
40 名参与者参加了研究，其中 37 名（92.5%）完成了六周的干预期。足部压力、疼痛和功能显示出显著的交互作用（P=0.02-<0.001）和时间（P<0.001）效应，而组间效应无统计学意义，实验组有优势。事后分析显示，实验组在六周时疼痛（P=0.002）和功能（P=0.03）均优于对照组。两组的舟骨下降量相等。
六周内使用鞋垫和 SFE 可改善疼痛和功能，并改变足底压力分布，优于单独使用鞋垫的患者。
佩戴矫形鞋垫是一种简单但被动的平足治疗方法。本研究提供了 SFE 额外益处的证据。建议康复从业者实施至少六周的综合治疗方案，包括鞋垫和 SFE，以获得更好的平足患者效果。
