Immediate and short-term radiological changes after combining static stretching and transcutaneous electrical stimulation in adults with cavus foot

Abstract

Background: Cavus foot is a deformity represented by an increased and rigid medial longitudinal arch, and it is often associated with persistent pain and gait disturbances. None of the conservative conventional treatments for cavus foot have shown conclusive evidence of effectiveness, and so further is research needed to understand how to manage this condition better. This study aimed to assess the immediate and short-term radiological changes after combining static stretching and transcutaneous electrical stimulation of the plantar fascia in adults with idiopathic cavus foot. Methods: A randomized, single-blinded clinical trial was conducted. Sixty-eight participants with idiopathic cavus foot, as determined by an internal Moreau–Costa–Bertani angle (MCBA) less than 125° in a lateral weight-bearing foot radiograph, were equally distributed into a neuromuscular stretching group (NSG) or a control group (no intervention). The NSG underwent a single session, combining transcutaneous electrical nerve stimulation with static stretching of the plantar fascia. Primary measurements of 3 angles were taken using a lateral weight-bearing foot radiograph: the internal MCBA; the calcaneal pitch angle (CPA); and the first metatarsal declination angle (FMDA). Outcomes were collected at baseline, immediately postintervention, and 1 week after intervention. Results: Analysis of variance revealed a significant group effect for all angles (all, P < .05). NSG participants showed a significant increase in the internal MCBA (P = .03), and a significant decrease in the CPA (P = .01) and FMDA (P = .04) from baseline to immediately postintervention. These changes remained statistically significant 1 week after the intervention (all, P < .05). Conclusion: The combination of static stretching and transcutaneous electrical stimulation of the plantar fascia, compared with no treatment, achieved immediate and short-term changes in the internal MCBA, the CPA, and the FMDA, which resulted in flattening the medial longitudinal plantar arch in adults with idiopathic cavus foot.

Is Morton's neuroma in a pes planus or pes cavus foot lead to differences in pressure distribution and gait parameters?

“…Patients were included if they had pain symptoms during gait (above 3/10 with Visual Analog Scale) due to unilateral MN for at least 6 months, had a painful Mulder's click sign, had been confirmed MN diagnosis with magnetic resonance imaging, had bilateral pes planus determined with navicular drop test (greater than 10 mm drop of navicula) [ 19 ], had bilateral pes cavus determined with Moreau-Costa-Bertani angle below 125° measured via a weight-bearing foot radiography [ 20 ] and had not received previous steroid injection, alcohol injection, and facial manipulation treatment. The exclusion criteria for both groups were: peripheral nervous system disease, preexisting musculoskeletal disease within the lower extremities, history of surgery within the lower extremity, history of trauma within the forefoot, preexisting of rigid finger deformity, and participation in a physical therapy program 3 months before the study.…”

Evaluation and Management of Cavus Foot in Adults: A Narrative Review

“…Nonoperative treatment of both neuromuscular and non-neuromuscular cavus foo should be tried first in order to prevent or slow down the further development of the deformity, although in many cases the effect is often not satisfactory. Since cavus foot is usually progressive, the deformity is already severe when the symptoms begin to appear Patients should be treated with medical and physical therapy, including activity modifi cation, anti-inflammatory medications, and shoe modification, which helps to maintain the flexibility of the arch of the foot [38][39][40][41]. Although there are no high-level studies prov ing that conservative treatment is effective, it is still reasonable to undergo nonoperative treatment in an attempt to avoid operative intervention.…”