Three-Dimensional Ankle Exercise with Combined Isotonic Technique for an Obese Subject with Plantar Fasciitis: A Case Study

Three-dimensional foot-ankle exercise versus clam exercise in addition to short-foot exercise in individuals with flexible flatfoot: a randomized controlled trial

BACKGROUND

Three-Dimensional (3D) foot-ankle exercise and clam exercise have been used to improve foot posture in flatfoot. However, studies on this topic are limited, and more supporting evidence is needed to investigate the benefits of these exercises on flatfoot.

PURPOSE

To compare the effects of 3D foot-ankle and clam exercise in addition to Short-Foot exercise on navicular drop, foot posture and structure in individuals with flexible flatfoot.

METHODS

Single-blind, randomized controlled trial. Fifty-six participants were divided into Foot Exercise Group (FEG), Hip Exercise Group (HEG), and a Control Group (CG). FEG performed 3D foot-ankle+Short-Foot exercise. HEG performed clam+Short-Foot exercise. CG performed only Short-Foot exercise. The Navicular Drop Test (NDT), Foot Posture Index-6 (FPI-6), Clarke's Angle (CA), Staheli Index (SI), Wejsflog Index, hallux valgus angle, and varus deformity angle of the fifth toe were assessed pre-and post-intervention (six week later).

RESULTS

Post-intervention, NDT, CA, and SI scores improved significantly more in FEG compared to other groups (p  =  <0.001, η2 = 0.425-0.802). FPI-6 score decreased similarly in FEG and HEG (p = .477), significantly more than in CG (p  =  <0.001, r = -0.692; p  =  <0.001, r= -0.560, respectively). CA and SI scores improved more in HEG than in CG (p =  <0.001, r = -0.851; p =  <0.001, r= -0.536, respectively).

CONCLUSION

The 3D foot-ankle and clam exercise may be an effective intervention that provides satisfactory functional results for navicular drop, foot pronation, and anthropometric properties of the foot in flexible flatfoot.

CLINICAL TRIAL REGISTRATION NUMBER

NCT06313125.

Comparing the effect of rhythmic stabilization and combination of isotonic technique on grip strength, pinch strength and dexterity of hand among middle aged healthy individuals - a randomized clinical trial

Purpose: The aim of the study was to evaluate and compare the effects of Rhythmic Stabilization and a combination of isotonic technique on grip  strength, pinch strength, and dexterity of hand among middle aged healthy individuals. Methods Forty middle aged healthy individuals were selected on the basis of inclusion and exclusion criteria. Participants were randomly allocated to two groups, with 20 in group A (Rhythmic Stabilization) and 20 in group B (Combination of Isotonic Technique). Treatment was given for 4 weeks, thrice a week. Outcome measures: grip strength, pinch strength, and dexterity were assessed by the Jamar hand dynamometer, the Pinch gauge, and the Perdue peg board, respectively. Outcome measures were assessed at baseline and after 4 weeks of treatment. Results Notably, Group A participants showed a significant improvement in all outcome measures compared to Group B (p<0.05) when compared. Both the interventions were effective for dexterity outcome in both groups (p<0.05).  Conclusion: This study provides evidence that application of Rhythmic Stabilization improves grip strength and pinch strength.  This suggests that static Proprioceptive Neuromuscular Facilitation (PNF) exercises performed on the fingers can improve dexterity, grip strength, and pinch strength in the middle-aged population. Highlights As age increases, there is decrease in grip strength and dexterity of a person. The grip strength, finger strength and dexterity are inter-related. The Proprioceptive Neuromuscular Facilitation increases strength of muscles. The static PNF exercises are more effective than the dynamic PNF exercises to improve strength of grip strength, finger strength and dexterity.

Effects of Two Foot-Ankle Interventions on Foot Structure, Function, and Balance Ability in Obese People with Pes Planus

Obese people are prone to foot deformities such as flat feet. Foot management programs are important to prevent them. This study investigated the effects of two foot-ankle interventions on balance ability, foot arch, ankle strength, plantar fascia thickness, and foot functions in obese people with pes planus for four weeks. The experiment was designed as a randomized controlled trial. Twenty-four participants who met the inclusion criteria were selected, and they were randomly assigned to either a short foot group (SFG) or proprioceptive neuromuscular facilitation group (PNFG) according to foot-ankle intervention. Two interventions were commenced three times a week for 20 min over four weeks. The tests were conducted at two intervals: pre-intervention and at four weeks. The tests were conducted in the following order: the patient-specific functional scale test (PSFS), an ultrasound of the plantar fascia, the navicular drop test, balance test, and the four-way ankle strength test. Two groups showed significant differences in balance ability, foot arch, ankle strength, plantar fascia thickness, and foot functions between pre-test and post-test (p < 0.05). PNFG had significantly higher dorsiflexor and invertor strength than SFG (p < 0.05). SF and PNF interventions were effective to improve balance ability, foot arch, ankle strength, plantar fascia thickness, and foot functions in obese people with pes planus. Additionally, PNF intervention is more beneficial in increasing the dorsiflexor and invertor strength compared to SF intervention.

Comparison of the Intrinsic Foot Muscle Activities between Therapeutic and Three-Dimensional Foot-Ankle Exercises in Healthy Adults: An Explanatory Study

Background: In recent years, a three-dimensional ankle exercise has been proposed as a practice for strengthening the intrinsic foot muscles, however this topic still requires further research. This study aimed to compare the activities of the intrinsic muscles in healthy participants during 3D foot–ankle exercises, namely, short foot (SF), and toe spread out (TSO). Methods: Prior to the experiment, 16 healthy adults were trained on how to perform SF, TSO, and 3D foot–ankle exercises for an hour. Once all participants passed the foot–ankle exercise performance test, we randomly measured the activity of the intrinsic foot muscles using electromyography while the patients were performing foot–ankle exercises. Results: The abductor hallucis (AbH), extensor hallucis longus (EHL), and flexor hallucis brevis (FHB) activities showed significant differences among the exercises for intrinsic foot muscle strengthening (p < 0.01). Additionally, the AbH/AdH (adductor hallucis) ratio showed significant differences among the exercises for strengthening the intrinsic foot muscles (p < 0.01). Conclusions: Our results showed that the 3D extension exercise is as effective as the therapeutic exercise in terms of the AbH and FHB activities, and the AbH/AdH ratio. On the contrary, the 3D flexion exercise showed superiority in terms of the EHL activity.