Effects of the Short Foot Exercise With Neuromuscular Electrical Stimulation on Navicular Height in Flexible Flatfoot in Thailand: A Randomized Controlled Trial

Abstract

Objectives Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. Methods Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. Results No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups (SFE=73.9±11.0% of maximal voluntary isometric contraction [MVIC]; SFE with NMES=81.4±8.3% of MVIC; p <0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group (pre-treatment=218.6±53.2 mm 2 ; post-treatment=256.9±70.5 mm 2 ; p <0.05). Conclusions SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

Adult flatfoot

“…Explain to the patient that the symptoms are caused by loss of normal foot shape, which leads to pressure overloading the medial side of the foot over the arch. Explain that it can be treated with non-surgical options which can decrease symptoms, but these won’t restore the decreased medial arch height 13. There are surgical options available which have a longer recovery time but can correct the deformity.…”

The Effects of Electrical Stimulation Program on Navicular Height, Balance, and Fear of Falling in Community-Dwelling Elderly

“…Nowadays, strengthening of the AbdH muscle can be performed in many ways; however, neuromuscular electrical stimulation (NMES) is an especially effective method for directly stimulating the targeted muscle during training compared with traditional techniques, such as the short foot exercise [15]. Symmetrical biphasic squared pulses directly generate impulses and sends them to the nerve supply of the targeted muscle for better contraction [16].…”

Randomized Clinical Trial: The Effect of Exercise of the Intrinsic Muscle on Foot Pronation

“…Recently, Namsawang et al [38] investigated the effects of the SFE alone and after adding neuromuscular electrical stimulation in healthy people diagnosed with flexible flat feet. The navicular height using radiography and the cross-sectional area of the abductor hallucis (AbdH) muscle obtained by ultrasound machine and its activity with surface electromyography were evaluated.…”