Muscular Weakness
Conditions
Keywords
Therapeutic exercise
Brief summary
The foot intrinsic muscles are increasingly targeted in foot and ankle rehabilitation. The exercises are often difficult to learn initially. The purpose of the proposed study is to examine the effect training the intrinsic foot muscles on performance in selected physical and functional measures such as balance, plantar pressure during gait, vertical jump, and foot posture. In addition,the investigators will compare one group training with traditional exercise instruction methods and one group using an adjunctive modality (neuromuscular electric stimulation) during the introductory phases of exercise instruction. The investigators are interested in how this modality might affect physical and functional outcome measures and if it affects participants' frustration with learning a new exercise.
Detailed description
Arm 1: The purpose of this arm of the study is to determine if a 4-week trial of foot muscle exercises, instructed with passive, active-assisted, and active techniques, affect functional measures such as balance, plantar pressure during gait, and vertical jump. A frustration index will be employed to assess participant frustration with learning a new exercise. 15 will be enrolled in this arm of the study. Arm 2: The purpose of this arm of the study is to determine if a 4-week trial of foot muscle exercises, instructed with neuromuscular electric stimulation (NMES) and active techniques, affect functional measures such as balance, plantar pressure during gait, and vertical jump. A frustration index will be employed to assess participant frustration with learning a new exercise.15 will be enrolled in this arm of the study. Arm 3: This group will not engage in any training, but will serve as a comparator for the two intervention arms.
Interventions
OTHERShort foot exercise protocol
Exercises that target intrinsic foot muscles
OTHERShort foot exercise plus NMES
Exercises that target intrinsic foot muscles supplemented by NMES for muscle re-education
Sponsors
St. Louis University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Team members collecting outcomes data will not know participant allocation
Intervention model description
Randomized controlled trial with two intervention arms and one control arm
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
Yes
Inclusion criteria
* Individuals aged 18-30; Participate in physical activity 3 times/week; No neurologic injury/condition; No prior experience with study exercises; No injury to lower extremity in past 2 months; Inability to selectively extend the great toe while the lesser toes remain quiet (indicating INTRINSIC FOOT MUSCLES dysfunction)
Exclusion criteria
* Sedentary; Known neurologic injury or condition; Current LE injury that may affect neuromuscular function; Tarsal coalition; Absolute contradiction to manual therapy or neuromuscular electrical stimulation (NMES); Previous intrinsic foot muscle training protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Reaching Distance | Arm 1 and Arm 2: Baseline, 2 weeks, 4 weeks, 8 weeks. Arm 3: Baseline 4 weeks, 8 weeks | The change demonstrated in clinical test of single limb reach/balance in the anterior, posterolateral, and posteriomedial directions in cm |
| Center of pressure during walking gait | Arm 1 and Arm 2: Baseline, 2 wk, 4 wk, 8 wk. Arm 3: Baseline 4 wk, 8 wk | Changes in center of pressure during walking gait |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maximal vertical jump height | Arm 1 and Arm 2: Baseline, 2 weeks, 4 weeks, 8 weeks. Arm 3: Baseline 4 weeks, 8 weeks | Maximal height jump off of two feet will be measured in centimeters |
| Changes in foot posture over loading conditions | Arm 1 and Arm 2: Baseline, 2 weeks, 4 weeks, 8 weeks. Arm 3: Baseline 4 weeks, 8 weeks | Change in navicular height from 10% weight bearing to 90% weight bearing in mm |
| Perceived effort in learning novel exercise measured by NASA-Task Load Index (NASA-TLX) | Arm 1 and Arm 2: Supervised training sessions 1, 2, 3, 4, 5, and 6 | Participant reported workload estimates of Mental, Physical, and Temporal Demands, Frustration, Effort, and Performance. RAW TLX will be utilized, with each component considered individually; the subscales will not be combined. Subscales are rated 0-21; higher scores indicate greater load or difficulty |
| Changes in landing forces | Arm 1 and Arm 2: Baseline, 2 weeks, 4 weeks, 8 weeks. Arm 3: Baseline 4 weeks, 8 weeks | Change in vertical ground reaction force during landing after vertical jump |
| Arch Height Index | Arm 1 and Arm 2: Baseline, 2 weeks, 4 weeks, 8 weeks. Arm 3: Baseline 4 weeks, 8 weeks | Change in arch height from 10% weight bearing to 90% weight bearing relative to truncated foot length (in %) |
Countries
United States
Outcome results
None listed