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The aim of this study was to determine the effects of 8 weeks of supervised in addition to stretching exercise resisted concentric and eccentric contraction protocol of toe spread out exercise on the angular severity of hallux valgus deformity, changes in the cross-sectional area, stiffness and thickness of the abductor hallucis muscle, electromyographic activities, plantar pressure distribution, foot morphology and gait characteristics, balance and physical performance at the end of the medium and long term.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CG | Active Comparator | 8 weeks, stretching exercise |
|
| SEG | Active Comparator | 8 weeks, stretching exercise and toe spread out standart protocol |
|
| REG | Experimental | 8 weeks, stretching exercise and resisted concentric and eccentric contraction protocol of toe spread out exercise |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Resisted Toe Spread Out Exercise | Other | new resistance exercise phase in addition to the standard protocol |
|
| Measure | Description | Time Frame |
|---|---|---|
| Hallux Valgus Angle | A radiographic measurement (°) The angle created between the lines that longitudinally bisect the proximal phalanx and the first metatarsal. | Before treatment, after 6 months |
| Intermetatarsal angle | A radiographic measurement (°) The term intermetatarsal angle alone typically refers to assessment of the first and second metatarsals | Before treatment, after 6 months |
| Hallux Interphalangeal Angle | A radiographic measurement (°) The hallux interphalangeal angle is between the proximal and distal phalanx of the great toe and serves for the evaluation of toe deformity at the level of the first interphalangeal joint. | Before treatment, after 6 months |
| Distal Metatarsal Articular Angle | A radiographic measurement (°) The distal metatarsal articular angle (DMAA) evaluates the relationship between the longitudinal axis and the articular surface of the first metatarsophalangeal joint and thus metatarsophalangeal coverage or joint congruity on a weight-bearing dorsoplantar radiograph of the foot. | Before treatment, after 6 months |
| Sesamoid Position Classification | A radiographic measurement (1-7 grades) The medial sesamoid position would be classified into 7 grades by the respective circle as the position of the medial sesamoid. | Before treatment, after 6 months |
| Length of the First Metatarsal | A radiographic measurement Length of the first metarsal (centimeter) | Before treatment, after 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Bahar Anaforoğlu Anaforoğlu, Associate Professor | Contact | +90 505 742 1220 | anaforoglub@hotmail.com | |
| Mahmut Beşli, Master of Physical Therapy | Contact | +90 542 556 8617 | fzt.mahmutbesli@gmail.com |
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| ID | Term |
|---|---|
| D006215 | Hallux Valgus |
| ID | Term |
|---|---|
| D005530 | Foot Deformities |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D052580 | Muscle Stretching Exercises |
| ID | Term |
|---|---|
| D005081 | Exercise Therapy |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
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Randomised controlled
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| Toe Spread Out Exercise | Other | Standart protocol of toe spread out exercise |
|
| Stretching exercise | Other | Toe stretching |
|
| Surface Electromyography | Maximum volunteer isometric contarction (MVIC) of m. abductor hallucis | Before first treatment, after 8 weeks, and after 6 months |
| Cross Sectional Area | CSA of m. abductor hallucis with ultrasound (cm²) CSA: In muscle physiology, physiological cross-sectional area (PCSA) is the area of the cross section of a muscle perpendicular to its fibers, generally at its largest point | Before treatment, after 8 weeks, after 6 months |
| Dorsoplantar Thickness | Measurement muscle thickness (m. abductor hallucis) with ultrasound (cm) | Before treatment, after 8 weeks, after 6 months |
| Mediolateral Width | Measurement muslce width (m. abductor hallucis) with ultrasound (cm) | Before treatment, after 8 weeks, after 6 months |
| Shear Wave Elastography | Measurement SWE with ultrasound (m. abductor hallucis) (cm) | Before treatment, after 8 weeks, after 6 months |
| Plantar load | Measurement with plantar pressure distrubiton analysis (kg/cm²) | Before treatment, after 8 weeks, after 6 months |
| Loads per unit of plantar segments | Measurement with plantar pressure distrubiton analysis (kg/cm²) | Before treatment, after 8 weeks, after 6 months |
| Changes of loads during gait | Measurement with plantar pressure distrubiton analysis (kg/cm²) | Before treatment, after 8 weeks, after 6 months |
| Gait-time graph | Measurement with plantar pressure distrubiton analysis (%) | Before treatment, after 8 weeks, after 6 months |
| Maximum and average pressures | Measurement with plantar pressure distrubiton analysis (kg/cm²) | Before treatment, after 8 weeks, after 6 months |
| Plantar Contact area | Measurement with plantar pressure distrubiton analysis (cm²) | Before treatment, after 8 weeks, after 6 months |
| Plantar contact time | Measurement with plantar pressure distrubiton analysis (msn) | Before treatment, after 8 weeks, after 6 months |
| Balance measurement | Y-balance test | Before first treatment, after 8 weeks, and after 6 months |
| Physical performance tests | Gait speed (10 meter), Climbing stairs speed (10 meter) | Before first treatment, after 8 weeks, and after 6 months |
| Multidimensional Nil Hallux Valgus Scale | The scale has a score range of 0-60, with higher score indicating increased HV symptoms, complaints, and functional disorder. | Before first treatment, after 8 weeks, and after 6 months |
| D005791 |
| Patient Care |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D015444 | Exercise |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |