Comparing the efficacy of exercise, internal and external shoe modification in pes planus: A clinical and pedobarographic study

Abstract

Pes planus is a condition that can cause pain along the innerfoot due to the absence or abnormal depression of the longitudinal arch. There are few studies available that compare therapy modalities used in these patients. In our study, those treated with conservative therapies-internal and external shoe modifications and pes planus exercises -were compared clinically and pedobarographyically. 60 pes planus patients were included in the study. In the first group; internal modification was performed by placing a medial longitudinal arch support inside the shoe. In the second group, external shoe modification was performed using the Thomas heel. In the third group of patients however, only an exercise program was executed. The patients' foot pain levels, functional asssessment, satisfaction and quality of life were recorded. Pedobarography was used in measuring both static and dynamic plantar pressure. Assessments were carried out at baseline and at the end of the first and third months respectively where intra-and inter-group comparisons were performed. Each group was composed of 20 subjects. While improvement in terms of foot pain, foot function index and quality of life was observed in all the study groups (p < 0.05), the most improvement was observed in the group of patients treated with internal modification (p < 0.016). This was followed by the external modification and the exercise groups respectively. No difference was observed between the internal and external modification groups in terms of patient satisfaction. Cross-sectionally; clinical assessments, pedobarographic analysis were correlated. The changes observed after static and dynamic pedobarographic studies were not significantly different between the study groups. At the end of the study it was observed that internal modification yielded the most significant clinical improvement. In the literature, there are limited publications comparing the conservative treatments with each other. In this study we aimed to compare the conservative treatments for flatfoot.