Pes Planus
Conditions
Keywords
Short Foot Exercises (SFE), Basic Body Awareness Therapy (BBAT), Pes Planus, Balance, Proprioception, Flatfoot
Brief summary
This study investigates whether adding Basic Body Awareness Therapy (BBAT) to Short Foot Exercises (SFE) improves pes planus, balance, and body awareness in adults with flexible pes planus. Fifty participants aged 18-45 will be randomly assigned to either a BBAT + SFE group or an SFE-only control group. The interventions will last eight weeks with supervised sessions twice weekly and additional home exercises. Outcomes will be measured before, after, and two months post-intervention.
Detailed description
Pes planus is a common orthopedic condition characterized by the collapse of the medial longitudinal arch of the foot, which negatively affects lower extremity biomechanics, postural stability, and balance. Currently, interventions targeting muscle activation-such as short foot exercises (SFE)-are widely used in the management of pes planus. However, it is believed that holistic approaches incorporating sensory input and body awareness may further enhance functional outcomes in these individuals. Basic Body Awareness Therapy (BBAT) is a physiotherapeutic method designed to improve movement quality, balance, and posture. In this study, BBAT will be applied for the first time in individuals with pes planus. This project aims to investigate the effects of BBAT, when combined with SFE, on medial longitudinal arch height, foot function, gait, balance, proprioception, plantar sensation, and body awareness in individuals with pes planus. The study will be conducted as a randomized controlled trial. Fifty participants who meet the inclusion criteria will be randomly assigned into two groups of 25: a BBAT group (SFE + BBAT) and a control group (SFE only). Interventions will be administered twice a week for a duration of eight weeks. Assessments will be conducted at three time points: before the intervention, immediately after the eight-week intervention period, and two months post-intervention (follow-up). This study aims to demonstrate that BBAT can provide significant improvements in both somatic and sensory parameters in individuals with pes planus, offering a holistic complement to traditional exercise-based approaches. In doing so, it is expected to contribute an innovative perspective to clinical physiotherapy practices and address a significant gap in the existing literature.
Interventions
BEHAVIORALBasic Body Awareness Therapy (BBAT)
Participants will perform Basic Body Awareness Therapy (BBAT) combined with SFE for 8 weeks. BBAT sessions are 45 minutes, twice weekly in small groups under a certified physiotherapist. Exercises target postural control, motor coordination, body awareness, balance, and functional movement, progressing from supine to sitting, standing, and walking positions. After each BBAT session, participants perform SFE following the same progression as the Control Group.
BEHAVIORALShort Foot Exercises (SFE)
Participants will perform Short Foot Exercises (SFE) for 8 weeks. Sessions are twice weekly under physiotherapist supervision in small groups (3-8 participants) and 5 days/week at home. Exercises progress from sitting (weeks 1-2), standing (weeks 3-4), single-leg (weeks 5-6), to functional activities (weeks 7-8). Each session lasts \ 20 minutes, 3 sets of 10 reps with 1-minute rest. Participants receive instruction on proper technique and adherence is monitored online
Sponsors
Mardin Artuklu University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants are randomly assigned to either the Control Group (Short Foot Exercises only) or the Experimental Group (BBAT + SFE) in parallel arms for comparison.
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Aged 18-45 years * Willing to participate in the study * Flexible pes planus (Navicular Drop ≥10 mm and positive Jack's Toe Raise Test)
Exclusion criteria
* Pain in lower extremity joints * Obesity (BMI \>30) * Pregnancy * Systemic, neuromuscular, or neurological disorders * Posterior tibial tendon dysfunction (unable to perform heel-rise test) * History of lower limb surgery * Previous treatment for pes planus or use of foot orthoses * Lower extremity injury in past 6 months * Orthopedic conditions other than pes planus and mild hallux valgus (Manchester Scale C or D excluded) * Participation in regular exercise program in past 6 months * Prior personal experience with TBFT and/or short foot exercises
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Navicular Drop Test | Baseline (pre-intervention), post-intervention (8 weeks), follow-up (2 months after intervention) | Assessment of medial longitudinal arch height to determine presence and severity of pes planus. Test performed in both sitting (non-weight-bearing) and standing (weight-bearing) positions. Difference ≥10 mm indicates pes planus. |
| Dynamic Balance | Baseline, post-intervention (8 weeks), follow-up (2 months) | Y Balance Test measuring reach distance in anterior, posteromedial, and posterolateral directions. Results normalized to leg length. |
| Proprioception | Baseline, post-intervention (8 weeks), follow-up (2 months) | Active and passive joint position sense of the ankle measured with digital goniometer. Eyes closed; angular error from target angle recorded. |
| Light Touch Sensation | Baseline, post-intervention (8 weeks), follow-up (2 months) | Semmes-Weinstein Monofilament Test at seven foot reference points. Threshold of sensation recorded. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Static Balance | Baseline, post-intervention (8 weeks), follow-up (2 months) | Flamingo Balance Test. Participant stands on one leg on a narrow beam for 1 minute; balance errors recorded. |
| Foot Function Index - Pain Subscale | Baseline, post-intervention (8 weeks), follow-up (2 months) | The Pain subscale of the Foot Function Index (FFI) assesses foot pain during daily activities. It includes 9 items rated on a 0-10 Likert-type scale. Higher scores indicate worse pain.self-rate 23 items using a visual analog scale. |
| Body Awareness | Baseline, post-intervention (8 weeks), follow-up (2 months) | Body Awareness Questionnaire assessing participant's perception of bodily sensations and processes. Score range 18-126; higher scores indicate better awareness. |
| Gait Performance | Baseline, post-intervention (8 weeks), follow-up (2 months) | 10-Meter Walk Test performed at comfortable walking speed. Time recorded and averaged over three trials. |
| Foot Function Index - Disability Subscale | Baseline, post-intervention (8 weeks), follow-up (2 months) | The Disability subscale of the Foot Function Index (FFI) evaluates difficulty in performing functional activities. It contains 9 items scored on a 0-10 Likert-type scale. Higher scores indicate greater disability. |
| Foot Function Index - Activity Limitation Subscale | Baseline, post-intervention (8 weeks), follow-up (2 months) | The Activity Limitation subscale of the Foot Function Index (FFI) measures limitations in essential daily activities. It consists of 5 items rated on a 0-10 Likert-type scale. Higher scores indicate greater activity limitation. |
| Foot Function Index - Total Score | Baseline, post-intervention (8 weeks), follow-up (2 months) | The Total Score of the Foot Function Index (FFI) is calculated by combining all pain, disability, and activity limitation items (23 items in total). Each item is rated on a 0-10 Likert-type scale. The total score reflects the overall foot-related functional status, with higher scores indicating worse function. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactFatma Betül Yardımcı
Backup ContactBahar Anaforoglu
Outcome results
None listed