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Examination of Balance-Gait Parameters and Fall Effect of Flexor Hallucis Longus Muscle Strengthening Training in Geriatric Group It has been demonstrated that the reduction in the strength of the toe flexor muscles is an independent indicator of falls in geriatric individuals. However, the extent of this strength loss and the effects of strengthening training programs on balance, gait parameters, and falls are not well understood.
Objective: The aim is to investigate whether a progressive resistance exercise program, focusing specifically on the flexor hallucis longus (FHL) muscle, can improve toe flexor strength and influence gait, balance, and falls in geriatric individuals.
Materials and Methods: Individuals over the age of 65 who are willing to participate in the study will be included. The participants will be divided into three groups: individual exercise group, home exercise group, and control group. Individuals who are unable to walk independently, have severe musculoskeletal disorders, have hallux rigidus deformity, suffer from orthostatic hypotension, have difficulty understanding instructions, or have diabetic neuropathy will be excluded from the study. After obtaining socio-demographic information from the participants, anthropometric measurements will be taken. Toe grip strength will be assessed using a digital dynamometer, and the strength of the intrinsic foot muscles and lower extremity antigravity muscles will also be measured using a digital dynamometer. Balance parameters will be evaluated using the Berg Balance Scale, Functional Reach Test, Timed Up and Go Test, while gait parameters will be assessed using the 10-meter walk test and Tinetti Gait Scale. Fall parameters will be assessed by the Falls Efficacy Scale and fall frequency.
The collected data will be analyzed using SPSS (Statistical Package for Social Sciences) software.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Physiotherapist-Assisted Isolated FHL Strengthening Exercise Group | Experimental | The intervention for the "Physiotherapist-Assisted Isolated FHL Strengthening Exercise Group (FHL-SET)" will consist of physiotherapist-guided, isolated strengthening exercises specifically targeting the Flexor Hallucis Longus (FHL) muscle. Participants will engage in exercises designed to isolate and strengthen the FHL muscle through controlled and progressive resistance. Sessions will occur three times a week for 8 weeks, with the physiotherapist providing individualized adjustments and ensuring proper technique and progression. |
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| Home-Based Foot and Ankle Strengthening Exercise Training Group | Experimental | After the initial assessments, the participants in this group will receive home-based foot and ankle strengthening exercises three times a week for 8 weeks. They will be monitored weekly using an exercise log. The Home-Based Exercise Group (EvT-KE) will be taught general foot exercises without progression in resistance. These exercises include ankle rotations, toe raises, toe lifts, rolling a ball under the foot for 2 minutes, picking up marbles with toes, towel collection exercises, and foot shortening exercises. |
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| Control Group | No Intervention | For the Control Group, initial and final assessments will be conducted at the beginning of the study and at the end of 8 weeks. No exercise program will be provided during this period. After the study, necessary exercises and recommendations will be given. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exercise | Other | A progressive resistance exercise program focusing on strengthening the flexor hallucis longus (FHL) muscle in elderly participants. |
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| Measure | Description | Time Frame |
|---|---|---|
| Muscle Strength Measurement | Flexor hallucis longus strength and toe grip strength will be assessed using Dynamo by Vald branded dynamometer. The results will be reported in Newtons. | pre-intervention, immediately after the intervention |
| balance assessment | berg balance scale | pre-intervention, immediately after the intervention |
| gait | gait speed, cadence | pre-intervention, immediately after the intervention |
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Inclusion Criteria:
Exclusion Criteria:
over 65 years old
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Atakum Nursing Home, Elderly Care and Rehabilitation Center | Samsun | Samsun | 55200 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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