The Effect of Physiotherapy on Lower Extremity Function and Gait in Children with Isolated Gastrocnemius Muscle Tightness

Bezmialem Vakif University

Status

Completed

Conditions

Lower Extremity Biomechanics

Gastrocnemius Tightness

Pes Planovalgus

Treatments

Other: physiotherapy

Study type

Interventional

Funder types

Other

Identifiers

NCT06678139

12.10.2024-168536

Details and patient eligibility

About

Since the gastrocnemius muscle crosses both joints, the joint kinematics of the ankle are affected by knee flexion. According to the Kendall & McCreary assessment of normal joint motion angles, the generally accepted normal range of motion for ankle dorsiflexion is 20° when the knee joint is in extension and can approach 30° when the knee joint is flexed due to relaxation of the gastrocnemius. In the mid-stance phase of gait, it is observed that the ankle joint allows 8-10° dorsi flexion movement.

In this study, a minimum 13° increase in dorsiflexion with knee flexion compared to dorsiflexion with knee extension will be considered as isolated gastrocnemius muscle tightness. Isolated gastrocnemius muscle tightness has been associated with many biomechanical changes such as pes planus, talar equinus, hindfoot pronation and symptoms such as plantar fasciitis, leg pain, metatarsalgia, achilles tendinopathy by compensatory effects on the lower extremity and foot during gait. The association of increased hindfoot pronation with isolated gastrocnemius tightness has been shown in many studies. Regardless of the etiology of pronation of the hindfoot, there will be adaptive isolated gastrocnemius tightness with talar plantar flexion. Isolated gastrocnemius tightness, which causes plantar flexion in the ankle joint and pronation in the subtalar joint, also prevents the distribution of the load to the base of the foot within normal limits during weight bearing. However, no study investigating the effect of physiotherapy program on function and gait has been encountered. The aim of this study was to investigate the effect of a physiotherapy program on lower extremity function and gait in children with isolated gastrocnemius muscle tightness.

Enrollment

30 patients

Sex

All

Ages

4 to 10 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Presence of bilateral pes planovalgus due to the isolated gastrocneius tightness
Being the ages between 4-10 years old
Having body mass index between within normal limits

Exclusion criteria

Presence of high femoral anteversion (Craig test > 30 degrees) and/or internal tibial torsion and/or metatursus adductus
Having of leg length discrepancy
Accompanying any neurological, rheumatologic, musculoskeletal, metabolic and connective tissue disease
Presence of pain associated with the vertebral column and lower extremities
Presence of any lower extremity and/or vertebral column deformity or history of surgery
Cognitive, mental, serious psychiatric illness
Participation in any exercise program and/or sportive activity in the last six months