Effect of comprehensive exercises on lower limb alignment factors in young adults with flexible flatfoot: an experimental study

Flat foot, also known as pes planus, is characterized by a reduced curvature of the medial longitudinal arch, causing the entire sole to make close to complete contact with the ground.There exists a variation in the prevalence of flat foot. The likelihood of having flat feet varies with age, sex, body mass index, ethnicity, type of population being investigated, and presence of other associated musculoskeletal pathologies. The prevalence of flat foot in children is high due to ligament laxity, which reduces with age. Among children aged two to six, the prevalence of flexible flat foot ranges from 21 to 57%. In elementary school, the percentage drops to 13–28%. 42% of people between the ages of 11 and 16 have the prevalence, of which 23% have bilateral flat feet and 19% have unilateral flat foot. At least 20% to 30% of young adults have reported having flat feet; the frequency is slightly higher in girls (14.4%) than in boys (12.8%).Although individuals with asymptomatic flexible flatfoot do not report foot pain, discomfort, or fatigue, this condition can impair dynamic foot functions and is also associated with a higher risk of lower limb overuse injuries. A model of biomechanical linkages of the lower extremity in closed-kinetic chain activities hypothesizes that the increased pronation of the foot may have an impact on the movement pattern of proximal joints. Weakness and dysfunction of the hip external rotator may result in hip adduction, medial rotation, and dynamic knee valgus, influencing foot pronation.Weakness in the gluteal muscles can contribute to internal hip joint rotation, leading to foot pronation.Individuals with flat feet exert increased plantar pressure on the midfoot region compared to that of normal foot individuals. Restoring appropriate muscle recruitment patterns and improving strength and performance can be accomplished by reactivating the gluteal muscles.Studies have shown that gluteal strengthening exercises along with foot exercises are effective in decreasing navicular drop and medial plantar pressure and increasing arch height index and static balance. However, there is a lack of good certainty evidence about the effectiveness of comprehensive exercises over entire lower limb alignment factors.GaitON® software is one such 2-D posture analysis system that analyses the standing posture of the patient and identifies key postural deviation from multiple views & exports all data to a report.It is an appropriate evaluation tool for diagnosing initial postural disorders, postural comparisons before and after rehabilitation programswith excellent Inter-rater and Intra-rater reliability: ICC > 0.99 for hip and knee angles.Thus, this study intends to evaluate how a comprehensive exercise program will help in improving the lower extremity alignment of individuals with flexible flatfoot.

This research may also help to determine the extent of alterations in the lower limb alignment factors following the initiation of comprehensive exercises for individuals with flexible flatfoot. Our findings may provide a resolution to the challenges associated with determining the role of static lower extremity alignment in increasing the risk of lower extremity injury. Incorporating measures of static lower extremity alignment in prospective study designs will help us identify individuals at greatest risk of injury and contribute to the development of more effective intervention programs to mitigate such risks.

Thus, this study intends to evaluate how a comprehensive exercise program will help in improving the lower extremity alignment of individuals with flexible flatfoot.

This research may also help to determine the extent of alterations in the lower limb alignment factors following the initiation of comprehensive exercises for individuals with flexible flatfoot. Our findings may provide a resolution to the challenges associated with determining the role of static lower extremity alignment in increasing the risk of lower extremity injury. Incorporating measures of static lower extremity alignment in prospective study designs will help us identify individuals at greatest risk of injury and contribute to the development of more effective intervention programs to mitigate such risks.