Effects of short foot exercise on Q-angle in individuals with flatfoot
Article Sidebar
Main Article Content
Abstract
Background: Flatfoot is a predominant chronic condition associated with lower extremity musculoskeletal injuries. Current studies have illustrated that a flatfoot deformity may result in an increased Q-angle which can cause knee disorders. Short foot exercise (SFE) is a broadly acknowledged strategy for strengthening the intrinsic foot muscles. The exercise is recommended to be performed to improve the medial longitudinal arch (MLA). However, there is a lack of studies examining the effects of SFE on the Q-angle.
Objectives: The primary purpose of this study was to investigate the effects of SFE on Q-angle in individuals with flatfoot. The second purpose was to examine the effects of SFE on the navicular drop test (NDT).
Materials and methods: This randomized controlled trial study included 16 participants aged 18-25 years with flexible flatfoot on both feet based on the results of NDT. Q-angle and NDT were measured at the beginning of the study. The participants were randomly assigned to either the experimental or control groups. The experimental group performed SFE three days a week for five consecutive weeks, while the control group did not perform the exercise. Q-angle and NDT were reassessed after five weeks of the exercise.
Results: Q-angle significantly decreased in the exercise group after the program for both legs (Right leg: from 21.62±1.87 to 19.83±1.63 degrees; Left leg: from 21.42±1.92 to 20.04±1.89 degrees). In addition, NDT significantly improved in the exercise group after SFE for both feet (Right foot: from 11.08±1.18 to 6.83±2.09 mm; Left foot: from 10.58±1.50 to 6.58±1.60 mm).
Conclusion: This present study demonstrated that SFE effectively improved Q-angle and NDT in individuals with flexible flatfoot.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
References
Unver B, Erdem EU, Akbas E. Effects of short-foot exercises on foot posture, pain, disability and plantar pressure in pes planus. J Sport Rehabil. 2019; 29(4): 436-40. doi: 10.1123/jsr.2018-0363.
Haun C, Brown CN, Hannigan K, Johnson ST. The effects of the short foot exercise on navicular drop: A critically appraised topic. J Sport Rehabil. 2020; 30(1): 152-7. doi: 10.1123/jsr.2019-0437.
Namsawang J, Eungpinichpong W, Vichiansiri R, Rattanathongkom S. Effects of the short foot exercise with neuromuscular electrical stimulation on navicular height in flexible flatfoot in Thailand: A randomized controlled trial. J Prev Med Public Health. 2019; 52(4): 250-7. doi: 10.3961/jpmph.19.072.
Ullah H. Correlation of flexible flatfoot and Q-angle among secondary school students by using Dennis method. Pak J Rehabil [Internet]. 2020; 8(2): 44-9. Available from: http://ojs.zu.edu.pk/ojs/index.php/pjr/article/view/707.
AlKhouli MN, Ghait AS, Abogazya, AA. Relationship between flatfoot and Q angle in male secondary school students. Int J Physiother Res. 2017; 5: 2477- 81. doi: 10.16965/ijpr.2017.232.
Kumar M, Sanghi D, Arya P, Kataria J. A correlation between navicular drop and quadriceps angle amongst normal and overweight middle-aged individuals. Biosci Biotechnol Res Commun. 2021; 14(2): 897-902. doi: 10.21786/bbrc/14.2.69.
Heggannavar A, Battula l, Metgud s. A correlation between leg-heel alignment, tibial torsion and Q angle amongst normal, overweight and obese individuals. Int J Physiother Res. 2016; 4(3): 1530-4. doi: 10.16965/ijpr.2016.125.
Banwell HA, Paris ME, Mackintosh S, Williams CM. Paediatric flexible flat foot: How are we measuring it and are we getting it right? A systematic review. J Foot Ankle Res. 2018; 11: 21. doi: 10.1186/s13047- 018-0264-3.
Aenumulapalli A, Kulkarni MM, Gandotra AR. Prevalence of flexible flat foot in adults: A crosssectional study. J Clin Diagn Res. 2017; 11(6): 17-20. doi: 10.7860/JCDR/2017/26566.10059.
Aliberti S, Costa MS, Joao S, Passaro AD, Arnone AC, Sacco IC. Clinical rearfoot and knee static alignment measurements are not associated with patellofemoral pain syndrome. 2012; 19: 45-51. doi: 10.1590/S1809-29502012000100009.
Dileep KS, Harish K, Mohammed RP. Correlation of rearfoot angle to Q-angle in patellofemoral pain syndrome: A prospective study. Int J Res Orthop. 2017; 3(4): 688-91. doi: 10.18203/issn.2455-4510. IntJResOrthop20172089.
McKeon PO, Hertel J, Bramble D, Davis I. The foot core system: A new paradigm for understanding intrinsic foot muscle function. Br J Sports Med. 2015; 49(5): 290. doi: 10.1136/bjsports-2013-092690.
Kelly LA, Cresswell AG, Racinais S, Whiteley R, Lichtwark G. Intrinsic foot muscles have the capacity to control deformation of the longitudinal arch. J R Soc Interface. 2014; 11(93): 20131188. doi: 10.1098/ rsif.2013.1188.
Latey PJ, Burns J, Nightingale EJ, Clarke JL, Hiller CE. Reliability and correlates of cross-sectional area of abductor hallucis and the medial belly of the flexor hallucis brevis measured by ultrasound. J Foot Ankle Res. 2018; 11: 28. doi: 10.1186/s13047-018-0259-0.
Nam KS, Kwon JW, Kwon OY. The relationship between activity of abductor hallucis and navicular drop in the one-leg standing position. J Phys Ther Sci. 2012; 24(11): 1103-06. doi: 10.1589/jpts.24.1103.
Park DJ, Park SY. Comparison of subjects with and without pes planus during short foot exercises by measuring muscular activities of ankle and navicular drop height. J Korean Soc Phys Med [Internet]. 2018; 13(3): 133-39. Available from: http://dx.doi. org/10.13066/kspm.2018.13.3.133.
Kim EK, Kim JS. The effects of short foot exercises and arch support insoles on improvement in the medial longitudinal arch and dynamic balance of flexible flatfoot patients. J Phys Ther Sci. 2016; 28(11): 3136-9. doi: 10.1589/jpts.28.3136.
Hara S, Kitano M, Kudo S. The effects of short foot exercises to treat flat foot deformity: A systematic review. J Back Musculoskelet Rehabil. 2023; 36(1): 21-33. doi: 10.3233/BMR-210374.
Weiss L, DeForest B, Hammond K, Schilling B, Ferreira L. Reliability of goniometry-based Q-angle. PM R. 2013; 5(9): 763-8. doi: 10.1016/j.pmrj.2013.03.023.
Khasawneh RR, Allouh MZ, Abu-El-Rub E. Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PLoS One. 2019; 14(6): e0218387. doi: 10.1371/journal.pone.0218387.
Sullivan GM, Feinn R. Using effect size-or why the p value is not enough. J Grad Med Educ. 2012; 4(3): 279-82. doi: 10.4300/JGME-D-12-00156.1.
Iaquinto JM, Wayne JS. Computational model of the lower leg and foot/ankle complex: Application to arch stability. J Biomech Eng. 2010; 132(2): 021009. doi: 10.1115/1.4000939.
Headlee DL, Leonard JL, Hart JM, Ingersoll CD, Hertel J. Fatigue of the plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol. 2008; 18(3): 420-5. doi: 10.1016/j.jelekin.2006.11.004.
Kalbouneh HM, Alkhawaldah AO, Alajoulin OA, Alsalem MI. The patellofemoral joint alignment in patients with symptomatic accessory navicular bone. Ital J Anat Embryol [Internet]. 2016; 121(2): 148-5. Available from: https://oajournals.fupress.net/index. php/ijae/article/view/1459.
Loudon JK. Biomechanics and pathomechanics of the patellofemoral joint. Int J Sports Phys Ther. 2016; 11(6): 820-30.
Shantanu K, Singh S, Kumar D, Singh A, Tewari PG, Gupta P. Anatomical variation in quadriceps angle with regard to different anthropometric parameters in a tertiary care center in Northern India: A descriptive study. Cureus. 2023; 15(1): e34224. doi: 10.7759/cureus.34224.
Piva SR, Fitzgerald GK, Irrgang JJ, Fritz JM, Wisniewski S, McGinty GT, et al. Associates of physical function and pain in patients with patellofemoral pain syndrome. Arch Phys Med Rehabil. 2009; 90(2): 285- 95. doi: 10.1016/j.apmr.2008.08.214.