Analysing The Impact of Foot Arch Height on Leg Muscle Tone and Balance in Young Adults.
Analysing The Effects of Different Foot Arch Heights on The Leg Muscle Tone and Balance in Young Adults.
- Registry ID
- NCT07764393
- Source registry
- NCT
- Status
- COMPLETED
- Study type
- OBSERVATIONAL
- Sponsor
- Istinye University
- Enrollment
- 60
- Start date
- 2025-07-02
- Completion date
- 2026-04-29
- Last update
- 2026-08-13
Conditions
- Pes Cavus
- Muscle Strength
- Balance Assessment
- Muscle Tone
- Static Balance
- Dynamic Balance
- Pes Planus
Summary
The goal of this observational study is to explore how the shape of the foot arch affects muscle tone, strength, and balance in healthy young adults aged 18-25, of all genders.
The main questions it aims to answer are:
1. Does foot postures as Pes Planus, Pes Cavus, and Normal arch has significant effect on static and dynamic balance performance, lower limb muscle tone, or muscle strength in young adults?
2. What is the functional impact of foot posture on stability, movement efficiency, and injury risk?
Participants will be grouped based on foot arch type: flat (pes planus), high (pes cavus), or normal using Arch Height Index (AHI).
The investigators will compare groups to see if differences in foot arch affect postural stability, muscle tone, and strength. Participants will:
* Complete a sociodemographic questionnaire (Age, gender, physical activity level, dominant leg, and footwear habits), and anthropometric measurements (Height, weight, and BMI).
* Undergo static balance test for both legs:
Single Leg Stance, counting the errors made in 30 seconds for 3 trials.
\- Undergo dynamic balance tests for both legs: Star Excursion Balance Test (SEBT) by reaching in 8 directions while balancing on one foot, and Single-Leg Hop for Distance by hopping forward on one leg.
* Have muscle tone and stiffness assessed using the MyotonPRO device on specified lower limb muscles.
* Have muscle strength measured using a handheld dynamometer (MicroFET2) across major specified leg muscles.
People have different types of foot arches. Some have flat feet (pes planus), some have high arches (pes cavus), and others have normal arches. These variations affect how the body aligns during movement and balance. Flat feet may cause inward rolling (overpronation), fatigue, and pain. High arches may cause stiffness, poor shock absorption, and a higher risk of ankle injuries.
Both arch types can reduce postural control and increase the risk of imbalance. Since lower body muscles are critical for maintaining posture, weak or poorly coordinated muscles can worsen these effects. However, no previous study has comprehensively explored the combination of foot arch structure, muscle tone, muscle strength, and both static and dynamic balance. This study aims to fill that gap.
The results may help healthcare professionals develop better screening and treatment strategies, such as exercise programs, rehabilitation approaches, and shoe recommendations for individuals with flat or high arches. By understanding these factors, the investigators can improve movement efficiency, prevent injuries, and support better quality of life.
All participants will be informed of the study procedures and will provide both written and verbal consent. The study will be conducted in compliance with ethical standards.
Detailed description
Foot posture abnormalities due to high or low arches, such as pes planus (flatfoot) and pes cavus (high-arched foot), significantly impact daily activities, particularly among young adults engaged in prolonged standing, walking, or physical activities. Pes planus is commonly associated with ligamentous laxity, muscle weakness, or genetic predisposition, leading to diminished medial, lateral, and transverse arches, resulting in excessive pronation, instability, and compromised shock absorption. This has been linked to knee pain and altered lower extremity alignment, and individuals with pes planus often experience foot pain, fatigue, and reduced physical performance.
Conversely, pes cavus is characterized by an exaggerated medial and lateral arch and diminished transverse arch, often linked to neuromuscular disorders, tight plantar fascia, or congenital factors. This condition leads to reduced shock absorption and uneven weight distribution, increasing the risk of recurrent ankle sprains, calluses, and metatarsalgia. Individuals with pes cavus frequently encounter discomfort during weight-bearing tasks and difficulties maintaining balance, which can hinder participation in physical and social activities.
Pes planus is linked to excessive pronation, while pes cavus is associated with excessive supination and rigidity, limiting adaptive responses to uneven surfaces. Both conditions have been associated with deficits in static and dynamic balance due to altered foot and lower limb alignment, leading to postural instability and increased sway during quiet standing and movement tasks. These balance deficits highlight the need for comprehensive assessments to identify individuals at greater risk of mobility impairments.
Lower extremity muscle tone plays a critical role in postural stability and overall functional movement, contributing to joint stabilization, shock absorption, and postural control during both static and dynamic activities. Individuals with lower muscle tone and stiffness have been shown to exhibit greater postural sway, indicating reduced postural control. Myotonometry provides reliable, repeatable, and non-invasive measurement of muscle tone, stiffness, and elasticity. Muscle strength and power also play a crucial role in foot function, balance, and postural stability by providing the necessary force for efficient movement and weight-bearing. Deficiencies in muscle power can lead to compensatory movement patterns that increase the risk of falls and injuries, particularly in individuals with foot posture abnormalities.
Prior research has examined dynamic balance, static balance, and muscle tone across different foot arch types separately, but no study has integrated foot posture, static and dynamic balance, muscle tone, and muscle strength within a single framework. This study addresses that gap by evaluating these factors together to provide a more comprehensive understanding of how foot posture abnormalities influence postural stability across genders.
Aim of Study
This study aims to examine how different foot arch types (pes planus, pes cavus, and normal arch) affect lower extremity muscle tone, muscle strength, and static and dynamic balance, in order to better understand their impact on postural stability and movement efficiency. The primary goals are to examine the relationship between foot posture abnormalities and muscle tone, balance performance, and strength in young adults; to identify differences in these factors based on gender; and to determine the functional impact of foot posture on stability, movement efficiency, and injury risk.
Hypotheses
The null hypothesis states that foot posture (pes planus, pes cavus, and normal arch) has no significant effect on static and dynamic balance performance, lower limb muscle tone, or muscle strength. The alternative hypothesis states that foot posture significantly affects static and dynamic balance performance, lower limb muscle tone, and muscle strength, with variations in arch structure influencing postural stability and muscle function, and that this effect differs between male and female participants.
Overview of Procedures
Participants will be classified into one of three foot arch groups using the Arch Height Index and confirmed with the Foot Posture Index-6. Each participant will complete a sociodemographic questionnaire and anthropometric measurements, followed by static balance assessment (Single Leg Stance), dynamic balance assessment (Star Excursion Balance Test and Single-Leg Hop for Distance), muscle tone assessment using a myometer, and muscle strength assessment using a handheld dynamometer. Assessments will be conducted in a standardized order for all participants to minimize order-related bias. Detailed eligibility thresholds and outcome measure definitions are provided in the corresponding registration modules.
Interventions
- OTHER: Single-Leg Hop for Distance
- OTHER: Height
- OTHER: Dynamometer
- OTHER: Weight
- OTHER: Body Mass Index
- OTHER: Single Leg Stance
- OTHER: Star Excrusion Blance Test (SEBT)
- OTHER: Arch Height Index
- OTHER: Myometer Device
- OTHER: Foot Posture Index
Inclusion criteria
Inclusion Criteria:
* Aged 18-25 years old-
* Not diagnosed with other medical conditions, fractures, or deformities
* No prior foot or lower limb surgeries affecting musculoskeletal health
* Wears sport shoes majority of the time
Exclusion criteria
Exclusion Criteria:
* Neurological Disorders: Conditions affecting balance or muscle tone
* Balance Disorders like vestibular or inner ear conditions
* Women that wears high heels majority of the time
* Men that wear stiff and hard material shoes majority of the time
Primary outcomes
[{"measure":"Lower Extremity Muscle Tone","timeFrame":"At baseline (single session)"},{"measure":"Lower Extremity Muscle Strength","timeFrame":"At baseline (single session)"},{"measure":"Single Leg Stance (Static Balance)","timeFrame":"At baseline (single session)"},{"measure":"Star Excursion Balance Test (Dynamic Balance)","timeFrame":"At baseline (single session)"},{"measure":"Height","timeFrame":"At baseline (single session)"},{"measure":"Weight","timeFrame":"At baseline (single session)"},{"measure":"Body Mass Index (BMI)","timeFrame":"At baseline (single session)"}]
Locations
- Fizyoterapi ve Rehabilitasyon Uygulama ve Araştırma Merkezi (İSÜFİZYOTEM)., Istanbul, Turkey (Türkiye)
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