Foot Mobilization and Exercise Program Combined with Toe Separator Improves Outcomes in Women with Moderate Hallux Valgus at 1-Year Follow-up

Abstract

Background: Few studies have documented the outcome of conservative treatment of hallux valgus deformities on pain and muscle strength. We sought to determine the effects of foot mobilization and exercise, combined with a toe separator, on symptomatic moderate hallux valgus in female patients. Methods: As part of the randomized clinical trial, 56 women with moderate hallux valgus were randomly assigned to receive 36 sessions for 3 months or no intervention (waiting list). All patients in the treatment group had been treated with foot joint mobilization, strengthening exercises for hallux plantarflexion and abduction, toe grip strength, stretching for ankle dorsiflexion, plus use of a toe separator. Outcome measures were pain and American Orthopedic Foot and Ankle Society (AOFAS) scores. Objective measurements included ankle range of motion, plantarflexion and abduction strength, toe grip strength, and radiographic angular measurements. Outcome measures were assessed by comparing pretreatment, posttreatment, and 1-year follow-up after the intervention. Mixed-model analyses of variance were used for statistical assessment. Results: Patients who were treated with 3 months of foot mobilization and exercise combined with a toe separator experienced greater improvement in pain, AOFAS scores, ankle range of motion, hallux plantarflexion and abduction strength, toe grip strength, and radiographic angular measurements than those who did not receive an intervention 3 months and 1 year postintervention (P < .001 for all comparisons). Conclusions: These results support the use of a multifaceted conservative intervention to treat moderate hallux valgus, although more research is needed to study which aspects of the intervention were most effective.

Detailed analysis of the transverse arch of hallux valgus feet with and without pain using weightbearing ultrasound imaging and precise force sensors

“…In a deformity, the activity of the intrinsic muscles of the foot (the abductor hallucis muscle and the adductor hallucis muscle [47]) is imbalanced [47,49]. This malfunction is a factor of hallux valgus development [48]. From the relation between HVA and TAH seen in our results, we would suggest the same management methods in increased TAH by targeting the intrinsic muscles.…”

“…Past publications on interventions for hallux valgus depended on the severity and duration of the deformity, the level of pain, and the age of the individual [9,46], ranging from surgery to orthotics [7] and specific exercises [47]. One study mentioned foot mobilization such as: manual mobilization focusing on flexion and caudal sliding of the metatarsophalangeal joints, tarsals, subtalar and ankle joint and exercise (hallux plantar flexion strengthening exercises, hallux abduction strengthening exercises and towel curl exercise) to increase the foot's joints range of motion and toe grip strength and decrease pain [48]. Others mentioned toe-spreadout exercise [47,49] and short-foot exercise [49].…”

Comparison of the clinical outcomes of Scarf and Chevron Osteotomy for Hallux Valgus Deformity: a meta-analysis of randomized controlled trial

“…22,23 AOFAS((American Orthopaedic Foot and Ankle Society) scores have been described in previous reports which could be an effective tool to evaluated the foot function. 24,25 In our study there have only two researches reported preoperative and postoperative AOFAS data,and the result show that there have no significant difference between Scarf and Chevron osteotomy,but there is need more data to support this result in the future.…”

Effects of Iliotibial Band Flexibility and Tibial Torsion Angle on Improving Asymmetric Hallux Valgus Angle

“…Therefore, stretching of iliotibial band should be considered during rehabilitation of the hallux valgus. Abdalbary [22] reported that Bunion stretch increased the range of motion of greater toe and lengthened the surrounding tissue which helped in decrease the hallux valgus deformity. Again, Kim et al [23,24] opined that strengthening of the adductor halluces and abductor halluces could prevent a hallux valgus and could be helpful to correct the deformity.…”