The effect of 6 week of short foot exercises with isometric hip abduction on Navicular drop, dynamic balance and step up kinematics in adults with flexible flat foot: a randomized control trial

Flexible flat foot is characterized by a weakened medial longitudinal arch and compromised abductor halluces muscle function, which increases compensatory Tibialis anterior activity, leading to Hyperpronation of foot, tibial internal rotation, and altered lower-limb kinematics. Additionally, hip abductor and external rotator weakness contribute to dynamic knee valgus and hip adduction, further impairing lower-limb alignment. Short Foot Exercises (SFE) are commonly prescribed to strengthen intrinsic foot muscles, but evidence suggests that combining them with isometric hip abduction (IHA) may provide better outcomes. Prior studies have demonstrated improvements in static balance when SFE is combined with IHA, but their impact on dynamic balance and lower-limb kinematics remains unexplored. Therefore, this study seeks to investigate whether adding IHA to SFE enhances dynamic balance and lower-limb kinematics  in adults with flexible flat feet.

AIMS AND OBJECTIVES-

The aim is to compare the effects of a 6-week program of SFE with IHA against SFE alone on Navicular drop, dynamic balance, step-up kinematics, and arch index

• PRIMARY OBJECTIVES

1.To compare the effect of 6 week of short foot exercises with isometric hip abduction treatment protocol with short foot exercise alone on Dynamic balance assessed by Star excursion Balance Test in adults with flexible flat foot.

2. To compare the effect of 6 week of short foot exercises with isometric hip abduction treatment protocol with short foot exercise alone on Step up kinematics assessed by Kinovea software in adults with flexible flat foot.

• SECONDARY OBJECTIVES:

1. To compare the effect of 6 week of short foot exercises with isometric hip abduction treatment protocol with short foot exercise alone on Navicular drop test in adults with flexible flat foot.

2.To compare the effect of 6 week of short foot exercises with isometric hip abduction treatment protocol with short foot exercise alone on Arch index in adults with flexible flat foot.

MATERIALS AND METHODOLOGY-

The Interventional study will be conducted for 6 weeks. 36 subjects with flexible flat foot based on inclusion and exclusion criteria will be recruited. Participants will be allocated into two groups: one receiving SFE alone, and the other SFE with IHA using resistance bands. After baseline assessment , participants will undergo a 6 week exercise protocol, performed three time a week under supervision. The intervention will last 6 weeks, with 3 sessions per week (45 minutes each)

Outcome measures include Star Excursion Balance Test, step-up kinematics (hip abduction angle and dynamic knee valgus using Kinovea), Navicular drop test, and arch index . Data will be statistically analyzed using t-tests and ANOVA at the end of the study to determine the effectiveness of the training program.