CAN WHOLE BODY VIBRATION TRAINING ALONG WITH SHORT FOOT EXERCISES IMPROVE FOOT FUNCTION IN PARTICIPANTS WITH FLEXIBLE FLATFEET?

R. Desai¹, M. Rathi², T. Palekar¹

¹Dr. D. Y. Patil College of Physiotherapy, Musculoskeletal Sciences, Pune, India, ²Dr. D. Y. Patil College of Physiotherapy, Community Based Rehabilitation Department, Pune, India

Background: The influence of new technology on Physiotherapy practice continues to challenge our ability to scientifically test the efficacy of products designed to enhance the physical performance. Whole body vibration (WBV) is one example of this emerging technique. Flexible Flatfeet (FF) can present correlated postural changes that disturbs the normal kinetic chain, producing unstable position which are at risk of lower extremity injuries. Literature supports the efficacy of intrinsic foot training on participants with FF. Numerous studies utilize WBV in elderly population, cerebral palsy, stroke, post ACL reconstruction. Evidence regarding the effectiveness of short foot exercises (SFE) on WBV is lacking. This study explored whether SFE on WBV can have an impact on foot function.

Purpose: To compare the effects of WBV along with SFE and SFE alone on Navicular Drop, Arch Height, Foot Posture and Surface Electromyography (sEMG) of Abductor Hallucis (AH) in participants with flexible flatfeet (FF).

Methods: Twenty-five young adults with FF aged 18 to 35 years, were allocated into 2 groups by Computer generated random allocation method. Group A (n=13) (feet=26), performed SFE on Crazy fit massage (KAMACHI) WBV, at frequency range from 50-60Hz, amplitude of 0-10mm. Group B (n=12) (feet=24) performed SFE. Intervention was given for 4 weeks, 3 alternate days in a week, in sitting position for 6 minutes/session during initial 2 weeks and standing for 12 minutes/session during last two weeks in both the groups. Outcome measures were Navicular drop test (NDT), Arch Height Index (AHI), Foot Posture Index (FPI) and sEMG of AH. Participants were assessed at baseline and completion of 1^st, 2^nd ,3^rd and 4^th week of intervention. Data was analyzed using IBM SPSS Statistics version 25.0. Significance was tested using Friedman test within the groups for all variables. Mann Whitney’s test was used between the groups. The significance level was set at p<0.05.

Results: Participants with FF significantly improved in all variables in both the groups over a period of 4 weeks (p≤0.05). On intergroup comparison, significant difference with ND in WBV was 5.80±1.82 mm and SFE was 4.59±2.035mm (p=0.02). AHI showed significant difference as 0.12±0.01 for WBV and 0.04±0.02 for SFE (p=0.00). FPI showed greater statistical difference as 4.68±1.96 for WBV and 3.04±1.71 for SFE (p=0.011).Differences in sEMG of AH showed no statistically significant difference between both the groups with 477.74±161µV for WBV and 419.97± 19.71 µV for SFE (p=.121).

Conclusions: Addition of WBV with SFE shows beneficial effects on improved characteristics of medial longitudinal arch height, navicular depth and foot posture. The extent of influencing electromyographic activity was found to be equal. Further studies can be done to find efficacy of insoles to retain the gains achieved in MLA after 4 weeks of intervention.

Implications: WBV along with SFE can prevent future musculoskeletal complications of foot, knee, low back which are consequences of untreated flatfeet in later stages of life, thus promoting health, improving efficacy and reducing the risk of injuries among young population.

Funding acknowledgements:Funding, Acknowledgements: None

Keywords:
Medial longitudinal arch
Abductor Hallucis
Electromyography

Topics:
Musculoskeletal: lower limb

Did this work require ethics approval? Yes

Institution: Dr. D. Y. Patil College of Physiotherapy, Pimpri, Pune, India

Committee: The Ethics Committee, Dr. D. Y. Patil Vidyapeeth, Pune

Ethics number: DYPCPT/ ISEC/01/2018 dated 9/04/2018