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Instrument-assisted soft tissue mobilization technique versus static stretching in patients with pronated dominant foot: a comparison in effectiveness on flexibility, foot posture, foot function index, and dynamic balance
Gupta U, Sharma A, Rizvi MR, Alqahtani MM, Ahmad F, Kashoo FZ, Miraj M, Asad MR, Uddin S, Ahamed WM, Nanjan S, Hussain SA, Ahmad I
Healthcare 2023 Mar;11(6):785
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Pronated foot is a deformity with various degrees of physical impact. Patients with a pronated foot experience issues such as foot pain, ankle pain, heel pain, shin splints, impaired balance, plantar fasciitis, etc. METHODS: Seventy-two participants between the ages of 18 to 25 years with a flexible pronated foot were included and allocated into three groups: Control, stretching, and IASTM group using single-blinded randomization. Range of motion (ROM) measuring ankle flexibility, foot posture index (FPI), foot function index (FFI), and dynamic balance was measured at baseline and after 4 weeks of intervention. Soft tissue mobilization was applied on to the IASTM group, while the stretching group was directed in static stretching of the gastrocnemius-soleus complex, tibialis anterior, and Achilles tendon in addition to the foot exercises. The control group received only foot exercises for 4 weeks. RESULTS: The result shows the significant improvement of the right dominant foot in ROM plantar flexion, (F = 3.94, p = 0.03), dorsiflexion (F = 3.15, p = 0.05), inversion (F = 8.54, p = 0.001) and eversion (F = 5.93, p = 0.005), FFI (control versus IASTM, mean difference (MD) = 5.9, p < 0.001), FPI (right foot, control versus IASTM MD = 0.88, p = 0.004), and in dynamic balance of the right-leg stance (anterior, pre versus post = 88.55 +/- 2.28 versus 94.65 +/- 2.28; anteromedial, pre versus post = 80.65 +/- 2.3 versus 85.55 +/- 2.93; posterior, pre versus post = 83 +/- 3.52 versus 87 +/- 2.99 and lateral, pre versus post = 73.2 +/- 5.02 versus 78.05 +/- 4.29) in the IASTM group. The FFI was increased remarkably in the stretching group as compared to the control group. CONCLUSIONS: Myofascial release technique, ie, IASTM with foot exercises, significantly improves flexibility, foot posture, foot function, and dynamic balance as compared to stretching, making it a choice of treatment for patients with a flexible pronated foot.

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