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The central nervous system (CNS) coordinates balance through the visual, vestibular, and somatoproprioceptive systems, which produce muscle activation for postural control. Among the important muscle activations for postural control are those produced in the ankle joint, which is crucial for maintaining postural control in sports settings, along with the gastrocnemius and soleus muscles. Studies show that children who practice sports improve their postural stability and accelerate sensory maturation, which can affect the development of the lower limb extremity, specifically the insertional musculature of the ankle and foot. The present study aims to analyze postural control in school-aged children with triceps suralis retraction and assess the effectiveness of treatment with stretching versus a heel pad for 3 and 6 months. Additionally, the study will analyze whether the physical activity the children engage in influences their stability
A randomized controlled trial will be conducted to evaluate the effectiveness of using a heel pad and a gastrocnemius and soleus stretching protocol. The outcomes of both interventions will be evaluated and compared, including pre-intervention and post-intervention assessments at 3 months and 6 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Stretching Group | Active Comparator | The pattern will be performed 3 times per day (10 repetitions, 30 seconds each repetition). A daily control diary will be filled in when performing the exercise. |
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| Heel Cup Group | Active Comparator | The heel cup will be 5mm high (Eva Shore 65) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Streching Group | Procedure | The Streching group will perform a conventional stretching exercise. |
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| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline of Physical Activity Questionnaire for Children (PAQ-C) at 6 months | The data on the type and amount of physical activity performed by the participants will be collected using the Spanish version of the Physical Activity Questionnaire for Children (PAQ-C) (Appendix 3). The PAQ-C has been validated by Manchola-González, Bagur-Calafat, and Girabent-Farrésby Manchola-González, Bagur-Calafat, and Girabent-Farrés will be used to collect data on the type and amount of physical activity performed by the participants. | At baseline; post 1 (3 months) and post 2 (6 months) |
| Measure | Description | Time Frame |
|---|---|---|
| Stabilometry | For collecting stabilometry data, an inertial measurement instrument called Gyko® (Janusz Jaworski et al., 2020) (Figure 5) will be used. It is a state-of-the-art device that allows for objective assessment of acceleration, angular velocity, and with an acquisition frequency of 100Hz | At baseline; post 1 (3 months) and post 2 (6 months) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Javier Ferrer Torregrosa | Torrent | Valencia | 46900 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32927763 | Background | Garcia-Soidan JL, Garcia-Lineira J, Leiros-Rodriguez R, Soto-Rodriguez A. Physical Activity Practice and Optimal Development of Postural Control in School Children: Are They Related? J Clin Med. 2020 Sep 10;9(9):2919. doi: 10.3390/jcm9092919. | |
| 30870009 | Background | Vallandingham RA, Gaven SL, Powden CJ. Changes in Dorsiflexion and Dynamic Postural Control After Mobilizations in Individuals With Chronic Ankle Instability: A Systematic Review and Meta-Analysis. J Athl Train. 2019 Apr;54(4):403-417. doi: 10.4085/1062-6050-380-17. Epub 2019 Mar 14. |
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| ID | Term |
|---|---|
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| Heel group | Procedure | The heel pad group will be applied a plantar support during the months of the study. |
|
| Instability test | The instability test will be performed using a foam rubber pad model Balance _Pand Elite ® with dimensions of 50 x 41 x 6cm, a weight of 0.7kg, and a density of 55kg/m (Figure 6). The foam has a nominal density of 40kg/m3 and a vertical compressive strength of 0.45N mm2 and a vertical compressive elasticity of 34N mm2 according to the manufacturer | At baseline; post 1 (3 months) and post 2 (6 months) |
| Lunge Test | he Lunge Test will be used to determine the dorsal flexion of the ankle (Figure 10) using the Leg MOtion® system | At baseline; post 1 (3 months) and post 2 (6 months) |
| 35366430 | Background | Martinez-Corcoles V, Nieto-Gil P, Ramos-Petersen L, Ferrer-Torregrosa J. Balance performance analysis after the COVID-19 quarantine in children aged between 8 and 12 years old: Longitudinal study. Gait Posture. 2022 May;94:203-209. doi: 10.1016/j.gaitpost.2022.03.019. Epub 2022 Mar 27. |
| 19232750 | Background | Hsu YS, Kuan CC, Young YH. Assessing the development of balance function in children using stabilometry. Int J Pediatr Otorhinolaryngol. 2009 May;73(5):737-40. doi: 10.1016/j.ijporl.2009.01.016. Epub 2009 Feb 20. |
| 20843744 | Background | Hoch MC, Staton GS, McKeon PO. Dorsiflexion range of motion significantly influences dynamic balance. J Sci Med Sport. 2011 Jan;14(1):90-2. doi: 10.1016/j.jsams.2010.08.001. Epub 2010 Sep 16. |
| 26583139 | Background | Han J, Anson J, Waddington G, Adams R, Liu Y. The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury. Biomed Res Int. 2015;2015:842804. doi: 10.1155/2015/842804. Epub 2015 Oct 25. |
| 27662790 | Background | Grindstaff TL, Dolan N, Morton SK. Ankle dorsiflexion range of motion influences Lateral Step Down Test scores in individuals with chronic ankle instability. Phys Ther Sport. 2017 Jan;23:75-81. doi: 10.1016/j.ptsp.2016.07.008. Epub 2016 Jul 29. |
| 40253482 | Derived | Martinez-Corcoles V, Garcia-Campos J, Vicente-Mampel J, Chicharro-Luna E, Jimenez EMM, Ferrer-Torregrosa J. Postural analysis of children with muscle retraction after six-month exercise or heel cup interventions in a randomized trial. Sci Rep. 2025 Apr 19;15(1):13578. doi: 10.1038/s41598-025-98527-6. |