Skip to main content
SpringerLink
Log in

Is there any additional effect of foot core training on dynamic function and balance in women with patellofemoral pain? A randomized controlled study

  • Research
  • Published:
Sport Sciences for Health Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to investigate the effects of foot core training (FCT) on dynamic function and balance, in addition to exercises for strengthening and stretching of hip and knee muscles in females with patellofemoral pain (PFP).

Methods

Twenty-eight females with PFP were randomized into foot core training (FCT, n = 13) and standardized exercise groups (EXE, n = 15). The Timed-Up&Go Test (TUG) was used for dynamic function and balance, and Y-Balance Test (YBT) was used for dynamic balance; performed at baseline and after 6 weeks of the exercise program. For the EXE exercise program, routine and widely used exercises for strengthening and stretching of hip and knee muscles were selected. For patients assigned to the FCT, a similar program was performed with the addition of FCT. Physiotherapist-supervised exercise sessions were scheduled 2 times per week for 6 weeks and performed as a home program on the other days of the week.

Results

Both groups displayed decreases in TUG scores, whereas YBT scores increased in both groups. No significant group by time interaction and no between-group differences were found (P > 0.05).

Conclusion

In conclusion, the results from this study indicate that the dynamic balance impairment is due to not only foot pronation but also the malalignment of knee biomechanics and pain in PFP patients. We believe that there may be a need for a longer training period to achieve improvements in PFP patients.

Trail Registration

clinicaltrials.gov NCT03099512.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Data sharing not applicable – no new data generated, or the article describes entirely theoretical research : Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Abbreviations

PFP:

Patellofemoral pain

FC:

Foot core

SFE:

Short Foot Exercises

VAS:

The Visual Analogue Scale

FCT:

Foot Core Training Group

EXE:

Standardized Exercise Group

TUG:

The Timed-Up&Go Test

YBT:

The Y-Balance Test

ant:

Anterior

PL:

Posterolateral

PM:

Posteromedial

ANOVA:

A two-way (group by time) mixed-model analysis of variance

ηp 2 :

Partial eta-squared

References

  1. Smith BE et al (2018) Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis. PLoS ONE 13(1):e0190892

    Article  MathSciNet  PubMed  PubMed Central  Google Scholar 

  2. Powers CM et al (2012) Patellofemoral pain: proximal, distal, and local factors, 2nd international research retreat. J Orthop Sports Phys Ther 42(6):A1-54

    Article  ADS  PubMed  PubMed Central  Google Scholar 

  3. Arun B, Vakkachan T, Abraham B (2013) Comparison of dynamic postural control with and without patellofemoral pain syndrome using star excursion balance test. J Med Sci Technol 2:1–6

    Google Scholar 

  4. Mahmoud WSE-d, Kamel EM (2015) The effect of additional balance training program to gluteus medius strengthening exercises on patellofemoral pain syndrome. Int J Ther Rehabil Res 4(2):7

    Google Scholar 

  5. de Moura Campos Carvalho ESAP et al (2016) Dynamic postural stability and muscle strength in patellofemoral pain: is there a correlation? Knee 23(4):616–621

    Article  Google Scholar 

  6. de Vasconcelos GS et al (2021) Adding muscle power exercises to a strength training program for people with patellofemoral pain: protocol of a randomized controlled trial. Trials 22(1):1–11

    Article  Google Scholar 

  7. Nedelkou A et al (2021) Does somatosensory feedback from the plantar foot sole contribute to verticality perception? Somatosens Mot Res 38(3):214–222

    Article  CAS  PubMed  Google Scholar 

  8. Cobb SC et al (2014) The relationship among foot posture, core and lower extremity muscle function, and postural stability. J Athl Train 49(2):173–180

    Article  PubMed  PubMed Central  Google Scholar 

  9. Shrader JA et al (2005) Navicular drop measurement in people with rheumatoid arthritis: interrater and intrarater reliability. Phys Ther 85(7):656–664

    Article  PubMed  Google Scholar 

  10. Panjabi MM (1992) The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 5:383–383

    Article  CAS  PubMed  Google Scholar 

  11. McKeon PO et al (2015) The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med 49(5):290–290

    Article  PubMed  Google Scholar 

  12. Mulligan EP, Cook PG (2013) Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic function. Man Ther 18(5):425–430

    Article  PubMed  Google Scholar 

  13. Lynn SK, Padilla RA, Tsang KK (2012) Differences in static-and dynamic-balance task performance after 4 weeks of intrinsic-foot-muscle training: the short-foot exercise versus the towel-curl exercise. J Sport Rehabil 21(4):327–333

    Article  PubMed  Google Scholar 

  14. Moon DC, Kim K, Lee SK (2014) Immediate effect of short-foot exercise on dynamic balance of subjects with excessively pronated feet. J Phys Ther Sci 26(1):117–119

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lee E, Cho J, Lee S (2019) Short-foot exercise promotes quantitative somatosensory function in ankle instability: a randomized controlled trial. Med Sci Monit 25:618

    Article  PubMed  PubMed Central  Google Scholar 

  16. Janda V, VaVrova M (1996) Sensory motor stimulation. In: Liebenson C (ed) Rahabilitation of the spine. Williams&Wilkins, Baltimore, pp 319–328

    Google Scholar 

  17. Crossley KM et al (2016) 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med 50(14):839–843

    Article  PubMed  Google Scholar 

  18. Collins N et al (2008) Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. BMJ 337:a1735

    PubMed  PubMed Central  Google Scholar 

  19. Boonstra AM et al (2014) Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain 155(12):2545–2550

    Article  PubMed  Google Scholar 

  20. Selfe J et al (2013) Targeted interventions for patellofemoral pain syndrome (TIPPS): classification of clinical subgroups. BMJ Open 3(9):e003795

    Article  PubMed  PubMed Central  Google Scholar 

  21. Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148

    Article  CAS  PubMed  Google Scholar 

  22. Bohannon RW (2006) Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther 29(2):64–68

    Article  PubMed  Google Scholar 

  23. Hoglund LT et al (2015) Physical performance measurement in persons with patellofemoral osteoarthritis: a pilot study. J Back Musculoskelet Rehabil 28(2):335–342

    Article  MathSciNet  PubMed  Google Scholar 

  24. Chimera NJ, Smith CA, Warren M (2015) Injury history, sex, and performance on the functional movement screen and Y balance test. J Athl Train 50(5):475–485

    Article  PubMed  PubMed Central  Google Scholar 

  25. Crossley KM et al (2016) 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). Br J Sports Med 50(14):844–852

    Article  PubMed  Google Scholar 

  26. Peters JS, Tyson NL (2013) Proximal exercises are effective in treating patellofemoral pain syndrome: a systematic review. Int J Sports Phys Ther 8(5):689–700

    PubMed  PubMed Central  Google Scholar 

  27. Mascal CL, Landel R, Powers C (2003) Management of patellofemoral pain targeting hip, pelvis, and trunk muscle function: 2 case reports. J Orthop Sports Phys Ther 33(11):647–660

    Article  PubMed  Google Scholar 

  28. Myer GD et al (2015) High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: is PFP itself a predictor for subsequent ACL injury? Br J Sports Med 49(2):118–122

    Article  PubMed  Google Scholar 

  29. Menz HB, Morris ME, Lord SR (2005) Foot and ankle characteristics associated with impaired balance and functional ability in older people. J Gerontol A Biol Sci Med Sci 60(12):1546–1552

    Article  PubMed  Google Scholar 

  30. Newsham KR (2010) Strengthening the intrinsic foot muscles. Int J Athl Ther Train 15(1):32–35

    Google Scholar 

Download references

Acknowledgements

This study was supported by the Hacettepe University Scientific Research Project Coordination Unit (HUBAP) (TDK-2017-14658). Except these, there was no other financial support or other benefits from commercial sources for this study.

Author information

Authors and Affiliations

  1. Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey

    Pınar Kısacık & Volga Bayrakcı Tunay

  2. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey

    Nilgün Bek & Aynur Ayşe Karaduman

Authors
  1. Pınar Kısacık
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Volga Bayrakcı Tunay
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nilgün Bek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aynur Ayşe Karaduman
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: PK, AAK, NB. Methodology: PK, VBT, NB. Formal analysis and investigation: PK. Writing—original draft preparation: PK. Writing—review and editing: VBT, NB, AAK. Funding acquisition: PK, AAK. Resources: VBT. Supervision: NB, VBT.

Corresponding author

Correspondence to Pınar Kısacık.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interest.

Ethical approval

This study conforms to the principles outlined in the Declaration of Helsinki.

Informed consent

The Institutional Review Board approved the study and written informed consent was obtained from all participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kısacık, P., Bayrakcı Tunay, V., Bek, N. et al. Is there any additional effect of foot core training on dynamic function and balance in women with patellofemoral pain? A randomized controlled study. Sport Sci Health 20, 137–143 (2024). https://doi.org/10.1007/s11332-023-01076-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11332-023-01076-6

Keywords

Search

Navigation