Effect of tibialis posterior strengthening program on reducing mechanical low back pain in nursing staff with pronated feet: A Randomized Controlled Trail

Title: Effect of Tibialis Posterior Strengthening Program on Reducing Mechanical Low Back Pain in Nursing Staff with Pronated Feet: A Randomized Controlled Trial

Background: Nursing staff often experience mechanical low back pain (MLBP) due to prolonged standing, walking, lifting patients, and poor lower-limb biomechanics. Pronated feet can alter lower-limb alignment, increase tibial internal rotation, and affect pelvic and lumbar mechanics, thereby contributing to low back pain. The tibialis posterior muscle plays a key role in maintaining the medial longitudinal arch and controlling pronation. Strengthening this muscle may improve foot alignment and reduce stress on the lumbar spine.

Aim: To determine the effectiveness of a tibialis posterior strengthening program in reducing mechanical low back pain among nursing staff with pronated feet.

Objectives:

1. To assess pain intensity before and after intervention.
2. To evaluate functional disability related to low back pain.
3. To examine changes in foot posture and pronation control.
4. To compare outcomes between experimental and control groups.

Methodology:

• Design: Randomized controlled trial.

• Participants: Nursing staff with mechanical low back pain and pronated feet (based on foot posture index/navicular drop test).

• Sample: Participants randomly divided into:

• Experimental group – received tibialis posterior strengthening + conventional physiotherapy.

• Control group – received only conventional physiotherapy or general exercises.

• Intervention duration: 6 weeks 3 sessions/week

• Outcome measures:

• Pain: Numerical Rating Scale (NPRS)

• Disability: Oswestry Disability Index (ODI) or Roland-Morris Questionnaire

• Foot posture: Navicular drop test

Intervention (Experimental): Specific tibialis posterior strengthening exercises such as:

• Resisted foot inversion with plantarflexion
• Heel raises with medial arch support
• Short foot exercises
• Functional weight-bearing strengthening