Tuncer Deniz, Erekdag Aysenur, Senaran Hakan, Uzer Gokcer
Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Merkez Mahallesi, Silahtaraga Caddesi, No:189, 34050, Eyupsultan, Istanbul, Turkey.
Department of Orthopedics and Traumatology, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvari, Vatan Caddesi, 34093, Fatih, Istanbul, Turkey.
Eur J Pediatr. 2025 Sep 25;184(10):636. doi: 10.1007/s00431-025-06480-3.
This study aimed to compare the effects of an 8-week intrinsic foot muscle strengthening and a combined intrinsic-extrinsic foot muscle strengthening on foot posture, balance, and functional mobility in children aged 4 to 7 years with pes planovalgus. A total of 36 children with pes planovalgus were randomly assigned to either the intrinsic foot muscle strengthening group (IMSG) or intrinsic-extrinsic foot muscle strengthening group (IEMSG). Of these, 32 children completed the study. Both interventions lasted 8 weeks, consisting of supervised weekly sessions and a home exercise program. Outcome measures included foot posture assessments with navicular drop test (NDT) and foot posture index-6 (FPI-6), static and dynamic balance assessments with single-leg stance test (SLST) and timed up and go (TUG) test, and functional mobility assessments with sit-to-stand (STS) test and 6-min walk test (6MWT). Both groups showed significant within-group improvements in all parameters (p < 0.001). Between-group comparisons revealed significantly greater improvements in favor of the IEMSG across all parameters. The analysis of foot posture measurements revealed statistically significant group-by-time interactions in favor of the IEMSG for NDT and FPI-6 results on both right (NDT: ηp = 0.13, FPI-6: ηp = 0.13) and left sides (NDT: ηp = 0.15, FPI-6: ηp = 0.26). Furthermore, IEMSG showed superior effects in SLST (ηp = 0.27). Conclusion: This study demonstrates that both intrinsic and extrinsic muscle strengthening programs can significantly enhance foot posture, balance, and mobility in children aged 4 to 7 years with pes planovalgus. The superior outcomes achieved by the IEMSG program underscore the importance of integrated muscle training in early physiotherapeutic interventions.Trial registration: This study was approved by the Bezmialem Vakif University Non-Interventional Clinical Research Ethics Committee (approval no: 168537, date: 12.10.2024) and registered with ClinicalTrials.gov under the registration number NCT06548750 (date: 08.08.2024).
本研究旨在比较为期8周的足内在肌强化训练与足内在肌和外在肌联合强化训练对4至7岁扁平足外翻儿童足部姿势、平衡和功能活动能力的影响。共有36名扁平足外翻儿童被随机分配到足内在肌强化训练组（IMSG）或足内在肌和外在肌联合强化训练组（IEMSG）。其中，32名儿童完成了研究。两种干预均持续8周，包括每周一次的监督训练课程和家庭锻炼计划。结果测量包括通过舟骨下降试验（NDT）和足部姿势指数-6（FPI-6）进行的足部姿势评估、通过单腿站立试验（SLST）和计时起立行走试验（TUG）进行的静态和动态平衡评估，以及通过坐立试验（STS）和6分钟步行试验（6MWT）进行的功能活动能力评估。两组在所有参数上均显示出显著的组内改善（p < 0.001）。组间比较显示，IEMSG在所有参数上的改善均显著更大。足部姿势测量分析显示，在右侧（NDT：ηp = 0.13，FPI-6：ηp = 0.13）和左侧（NDT：ηp = 0.15，FPI-6：ηp = 0.26）的NDT和FPI-6结果方面，存在有利于IEMSG的统计学显著的组×时间交互作用。此外，IEMSG在SLST中显示出更好的效果（ηp = 0.27）。结论：本研究表明，足内在肌和外在肌强化训练计划均可显著改善4至7岁扁平足外翻儿童的足部姿势、平衡和活动能力。IEMSG计划取得的更好结果强调了综合肌肉训练在早期物理治疗干预中的重要性。试验注册：本研究经贝兹米亚勒姆瓦基夫大学非介入性临床研究伦理委员会批准（批准号：168537，日期：2024年10月12日），并在ClinicalTrials.gov上注册，注册号为NCT06548750（日期：2024年8月8日）。
