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pronation distortion syndrome is a common postural distortion of the lower extremity, involving the anterior part of the leg. It may cause pain in the leg and disturbances in the tarsal part, in addition to distal and proximal parts. In this deformity, the head of the talus and navicular bones are rotated inward and downward, and the body's center of gravity shifts inward, resulting in flat feet. It is also associated with a union and increased pressure on the medial parts of the first and second metatarso phalangeal joints. The characteristics of pronation distortion syndrome due to excessive foot pronation include inward rotation of the tibia, internal rotation of the thighs associated with flat feet, genu valgum (knock-knee), and increased lordosis in case of hyperpronation. The randomized clinical trial study design will be used with the sample of 48 womens. The data will be collected from ganga ram hospital and mukhtara rafique welfare hospital by using convenient sampling technique.The inclusion criteria Ages 30-35 years, Female gender, BMI of overweight women (25-29.9). Foot pronation on observation, Navicular Drop Test more than 10mm (measured in weight bearing and non-weight bearing positions distance between ground and navicular tuberosity and difference calculated), Increased Q angle :females 15-18. The exclusion criteria is Other deformities such as tarsal coalition and vertical talus, BMI under weight,normal,obese.Any history of surgery involving both lower extremities.and Neuromuscular disorder(GBS,MG,Muscular dystrophies extremities)|.The tools used is Numeric Pain Rating Scale (NPRS), Navicular drop test, Goniometer for Q angle measurement, and Lower extremity functional scale (LEFS). Data will be analyzed by using SPSS version 26,0.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intrinsic foot muscle training | Experimental | Technique In intrinsic foot muscle training, there are following exercises:
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| hip abductor muscle training with intrinsic foot muscle training. | Active Comparator | Hip abductor muscle training consists of the following two exercise using
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intrinsic foot muscle training | Other | Technique In intrinsic foot muscle training, there are following exercises:
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| Measure | Description | Time Frame |
|---|---|---|
| Goniometer | universal goniometer has been shown to have good to excellent reliability, and is more reliable than visual estimation especially with inexperienced examiners.The Q angle is formed between a line representing the resultant line of force of the quadriceps (connecting a point near the anterior superior iliac spine (ASIS) to the mid-point of the patella) and a line from the center of the patella to the center of the tibial tubercle. In women, the Q angle should be less than 22 degrees with the knee in extension and less than 9 degrees with the knee in 90 degrees of flexion.normal 14 to 16. In female 15 degree. | baseline and fourth week |
| Numeric Pain Rating Scale | The Numeric Pain Rating Scale (NPRS) that is a unidimensional measure of pain intensity in adults,including those with chronic pain due to rheumatic diseases. The NPRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of his/her pain. | baseline and fourth week |
| Navicular Drop Test: | The ND test was performed to confirm whether subjects had flexibility flatfoot.The examiner measured the height of the navicular tuberosity from the ground with the subject being non-weight bearing.Subject then stood,with weight bearing equally on both feet,as the examinar remeasured the height of the navicular tuberosity.The difference in the height of the navicular tuberosity between weight bearing and non weight bearing situation was determined.A difference of 10>mm was considered as flexibal flat foot.ND test have proven valid and reliable for the assessment of the medial arch. | baseline and fourth week |
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Inclusion Criteria:
Exclusion Criteria:
• Other deformities such as tarsal coalition and vertical talus.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| IQBAL TARIQ, PHD | Contact | 03338236752 | iqbal.tariq@riphah.edu.pk | |
| IMRAN AMJAD, PHD | Contact | 03324390125 | Imran.amjad@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Rabiya Noor, PHD | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ganga Ram Hospital | Recruiting | Lahore | Punjab Province | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23632367 | Background | Mulligan EP, Cook PG. Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic function. Man Ther. 2013 Oct;18(5):425-30. doi: 10.1016/j.math.2013.02.007. Epub 2013 Apr 28. | |
| 32645830 | Background | Pabon-Carrasco M, Castro-Mendez A, Vilar-Palomo S, Jimenez-Cebrian AM, Garcia-Paya I, Palomo-Toucedo IC. Randomized Clinical Trial: The Effect of Exercise of the Intrinsic Muscle on Foot Pronation. Int J Environ Res Public Health. 2020 Jul 7;17(13):4882. doi: 10.3390/ijerph17134882. |
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| hip abductor muscle training with intrinsic foot muscle training | Other | Hip abductor muscle training consists of the following two exercise
Standard treatment
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| 31723561 | Background | Lee DR, Choi YE. Effects of a 6-week intrinsic foot muscle exercise program on the functions of intrinsic foot muscle and dynamic balance in patients with chronic ankle instability. J Exerc Rehabil. 2019 Oct 28;15(5):709-714. doi: 10.12965/jer.1938488.244. eCollection 2019 Oct. |