Effect of Eight-Week Corrective Exercises on the activity of Involved Muscles in Ankle Balance Strategies in Girls with Lower Limb Pronation Syndrome

Document Type : Original article

Authors

1 PhD Candidate, School of Sport Corrective Exercise, Kharazmi Pardis University, Tehran, Iran

2 Associate Professor, School of Sport biomechanics and Corrective Exercise, Kharazmi University, Tehran, Iran.

3 Associate Professor, School of Sport biomechanics and Corrective Exercise, Rajaee shahid University, Tehran, Iran.

Abstract

Background and Aim: Thelower extremity pronation syndrome involves foot hyper pronation, knee internal rotation, and adduction. When sport exercises are properly designed and integrated, using a multifaceted training approach can help achieve goals without the need for other interventions. Ankle balance strategy restores balance by moving the body around the ankle joint. The aim of the present study was to investigate the effect of eight-weeks of combined corrective exercises on the activity of of involved muscles in girls’ ankle strategy with lower extremity pronation syndrome.
Materials and Method: In the current semi-experimental study with pretest-posttest design and control group, 30 students, aged 13-16 years old, with lower extremity pronation syndrome were randomly divided into two groups of experimental (n=15) and control (n=15). Prior to and after eight weeks of training for 60 to 80 minutes, three times a week, we evaluated flat foot using Navi drop test, knee valgus using tibiofemoral angle measurement, tibialis anterior and medial gastrocnemius muscles Electromyography (EMG) activity on Biodex Balance while standing on dominant.
Results: Covariance analysis showed a significant difference in tibialis anterior and medial gastrocnemius muscles EMG between the two groups in the posttests. Also, corrective exercises was found to be significantly different on tibialis anterior and medial gastrocnemius amount of muscles activity at posttest compared with pretest and had approximately 94% and 62%, respectively, effects on the EMG of these muscles in girls with lower extremity pronation syndrome (p=0,001) (p=0,026).
Conclusion: It seems that corrective mixed exercises led to changes such as increased muscles activity in those responsible for balance control such as increase in the tibialis anterior muscle activity and decrease in the gastrocnemius muscle activity, which are related to the ankle strategy. So it is recommended that specialists and researchers consider corrective exercises in order to improve balance strategies in people with pronation syndrome.

Keywords

Main Subjects


  1. Clark MC, Lucett SC. NASM Essentials of Corrective Exercise Training. Baltimore, MD. Lippincott, Williams and Wilkins 2011; 170-172.##
  2. Bell Dr, Pauda Da, Clark Ma. Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement. mArch physical Med Rehabil 2008; 89:1323-8. ##
  3. Claeys K, Brumagne S, Dankaerts W, Kiers H, Janssens L. Decreased variability in postural control strategies in young people with non-specific low back pain is associated with altered proprioceptive reweighting. European journal of applied physiology 2011;111(1):115-23. ##
  4. Gross Mt. Lower quarter screening for skeletal malalignment: Sggestions for orthotics and shoewear. J Orthop Sport Phys Ther 1995; 21: 405-389. ##
  5. Hertel J, Gay MR, Denegar CR. Differences in postural control during single-leg stance among healthy individuals with different foot types. J Athl Train 2002;37(2): 129-132. ##
  6. Cote KP, Brunet ME, Gansneder BM, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. J Ath Train 2005;40:41-46. ##
  7. Nashner LM. Physiology of balance, with special reference to healthy elderly". In Gait disor of aging: falls and therapeutic sterategies. Eds: Masdeu JC, Sudardky L and Wolfson L. Philadelphia, Lippincott-Raven 1997;37-53. ##
  8. Colby LA, Kisner C, Exercise T. Foundations and Techniques”: FA Davis Company 2007. ##
  9. Hewett TE, Zazulak BT, Myer GD, Ford KR. A review of electromyographic activation levels, timing differences, and increased anterior cruciate ligament injury incidence in female athletes. Br J Sports Med 2005; 39: 347-350##
  10. Horak FB, Henry SM, Shumway-Cook A. Postural perturbations: new insights for treatment of balance disorders. J Phys Ther 1997; 77(5): 517-33. ##
  11. Horak FB, Henry SM, Shumway-Cook A. Postural perturbations: new insights for treatment of balance disorders. Phys Ther 1997;77(5):517–33. ##
  12. Chen C, Lou S, Wu H-W, Wu S, Yeung K, Su F. Effects of the type and direction of support surface perturbation on postural responses. Journal of NeuroEngineering and Rehabilitation 2014;11(50): 2-12. ##
  13. Lloyd DG, Buchanan TS, J Biomech. Strategies of muscular support of varus and valgus isometric loads at the human knee. J Biomech 2001;34(10):1257-67. ##
  14. Murley GS, L.K., Menz HB, Bird AR, Effect of foot posture, foot orthoses and footwear on lower limb muscle activity during walking and running: a systematic review. Gait and Posture 2009; 29:172-187. ##
  15. Moon D, Kim K, Lee S. Immediate Effect of Short-foot Exercise on Dynamic Balance of Subjects with Excessively Pronated Feet. J. Phys. Ther. Sci 2014; 26: 117-119##
  16. Listyorini I, Shanti M, Prabowo T. Effectiveness in Dynamic Balance: a Comparison between Foot Muscle Strengthening Using Elastic Band and without Elastic Band in Children Aged 8-12 with Flexible Flatfeet. IJIHS 2015;3(1): 26-32##
  17. Hrysomallis C, Goodman C. A review of resistance exercise and posture realignment. J Strength Cond Res 2001; 15(3): 385-390. ##
  18. Garakhanloo R, Alizadeh MH, Daneshmandi H. Corrective exercises. 3 ed. Tehran: Jahad Daneshgahi Pub2002. ##
  19. Walker M, Fan H. Relation between foot pressure pattern and foot type. Foot and ankle international 1998;19(6): 379-83. ##
  20. Chougala A, P.V., Khanna E, Panda S. Screening of body mass index and functional flatfoot in adult: an observational study International Journal of Physiotherapy and Research 2015;3(3):1037-41. ##
  21. Mathew S E, Madhuri V. Clinical tibiofemoral angle in south Indian children. Bone Joint Res 2013;2(8): 155-61. ##
  22. Singh O, Maheshwari T P, Hasan S, Ghatak S and Ramphal S K. Study of Tibiofemoral angle among Healthy Male Maharashtrian population. International Journal of Biomedical Research 2013; 4(7) :321-329. ##
  23. Winter D A, Yack HJ. EMG profiles during normal human walking: stride - to - stride and inter - subject variability. Electroencephalography and clinical 1987; 67: 402-411. ##
  24. Arnold BL, S.R., Examination of balance measures produced by the biodex stability system. J Athl Train 1998. 33(4): 323-327. ##
  25. Mansouri R, R.R., Minoonejad H, Comparing the amount of EMG activity of the selected involved muscles in ankle strategy in female athletes while standing on one leg on shuttle balance and wobble board. Arak Medical University Journal (AMUJ) 2015; 18(95): 70-79. [In Persian] ##
  26. Goss K., The ultimate guide to FixingFlat Feet. TRAINING & EQUIPMENT 2008; 48-51. ##
  27. Junga DY, Kohb E, Kwonc OY. Effect of foot orthoses and short-foot exercise on the cross-sectional area of the abductor hallucis muscle in subjects with pes planus. Journal of Back and Musculoskeletal Rehabilitation 2011; 24:225-31. ##
  28. Listyorini,I. Shanti,M. Prabowo,T. Effectiveness in Dynamic Balance: a Comparison between Foot Muscle Strengthening Using Elastic Band and without Elastic Band in Children Aged 8–12 with Flexible Flatfeet. IJIHS 2015; 3(1):26–32. ##
  29. Oatis CA. Kinsiology the mechanics and pathomechanics of human: Human kinetics. Champaign, 2ed 2009; 121-124##
  30. Daneshmandi H, Saki F, Shahheidari S, Khoori A. Lower extremity Malalignment and its linear relation with Q angle in female athletes. Procedia - Social and Behavioral Sciences 2011; 15:3349.-3359. [In Persian] ##
  31. Marsh E, Sale DG, McComas AJ, Quinlan J. Influence of joint position on ankle dorsiflexion in humans. J Appl physiol 1981; 51(1): 160-167. ##
  32. Namavarian N, Rezasoltani A, Rekabizadeh M. A study on the function of the knee muscles in genu varum and genu valgum. Scientific Journal of Novin Tavanbakhsi 2014; 8(3):1-9. ##
  33. Welch TDJ, Ting LH. A Feedback Model Reproduces Muscle Activity During Human Postural Responses to Support-Surface Translations. J Neurophysiol 2008; 99: 1032-8. ##
  34. Horak FB, Nashner LM. Central programming of postural movement: adaptation to altered support surface configurations. Journal of Neurophysiology1986; 35:1369-81. ##
  35. Lee, JH, Cynn HS, Yoon TL, Choi SH, Kang TW. Differences in the angle of the medial longitudinal arch and muscle activity of the abductor hallucis and tibialis anterior during sitting short-foot exercises between subjects with pes planus and subjects with neutral foot Journal of Back and Musculoskeletal Rehabilitation 2016;29(4):809-815. ##
  36. Oliveira DC Santos PA, etal. Electromyographic analysis of lower limb muscles in proprioceptive exercise performed with eyes open and close Rev Bras Med Esporte 2012;18(4): 261-66. ##
  37. Vittore D, Patella V. Petrera M, et al, Extensor deficiency: first cause of childhood flexible flat foot. Orthopedics 2009; 32(1):28. ##
  38. Nyland J, Smith S, Beickman K, Armsey TH, Caborn DNM. Frontal plane knee angle affects dynamic postural control strategy during unilateral stance. Med Sci Sports Exerc 2002;34(7): 1150-57. ##
  39. Azizpour S, Anbarian M. Effect of a pronate and supinat foot on surface electromyography activity in leg select muscles during walking. spot teb researches2011;10:123-138. [In Persian]. ##
  40. Rabiei M. afarnejhad-Gre, Binabaji H, Hosseininejad E, Anbarian M. Assessment of postural response after sudden perturbation in subjects with genu valgum. Journal of Shahrekord University of Medical Sciences 2012; 14(2):90-100. [In Persian]. ##
  41. Khodaveisi H, Sadeghi H, Memar R, Anbarian M. Comparison of selected muscular activity of trunk and lower extremities in young women’s walking on supinated, pronated and normal foot . Apunts Med Esport 2016; 51(189):13-19. [In Persian]. ##
  42. Fayiz F. El-Shamy, Anees S. Effect of Flexible Pes Planus on Postural Stability in Adolescent Females. International Journal of Science and Research (IJSR) 2012; 3(7): 653-656. [In Persian]. ##
  43. Payton D, Richard P, Di Fabio. Manual of physical therapy. New York: Churchill Livingstone 1989. ##
Volume 7, Issue 1
March and April 2018
Pages 77-87
  • Receive Date: 07 February 2017
  • Revise Date: 31 March 2017
  • Accept Date: 01 May 2017
  • First Publish Date: 21 March 2018