Enhancing Athletes' Foot Stability: A Comparative Analysis of Gluteus Maximus and Gluteus Medius Muscle Strengthening Effects on Navicular Drop, Balance, and Foot Posture Index in Over-Pronated Foot

Year 2024, , 59 - 72, 29.04.2024

Uma Raghav , Bharti Sharma , Harsirjan Kaur , Charu Chhabra

https://doi.org/10.54141/psbd.1328500

Abstract

This study aimed to determine the effectiveness of gluteus maximus versus gluteus medius muscle strengthening exercises on the navicular drop (ND), balance, and foot posture index (FPI 6) among athletes with over-pronated feet. A pre-post experimental study design with a total of 54 athletes with bilateral over-pronated feet were randomly assigned into group A (n=18), group B (n=18), and group C (n=18). Medial longitudinal arch height (MLA) was assessed with the Navicular Drop Test, the static and dynamic balance was determined with the stork stance test (SST) and modified Star Excursion Balance Test, and Foot Posture was assessed with Foot Posture Index 6. Multivariate Repeated measures ANOVA was used to analyze the effects of gluteus maximus versus gluteus medius muscle strengthening and short foot exercises. At four weeks, the gluteus medius along with short foot exercises (group B) showed significantly less ND and FPI 6 while showing more excellent SST and modified SEBT than the gluteus maximus muscle strengthening along with short foot exercises (group A) and control group (group C). These results suggest that adding gluteus medius muscle strengthening exercises to short foot exercises (SFE) was more effective in supporting the medial longitudinal arch and improving balance than performing SFE alone.

Keywords

Foot Posture Index, Gluteus Maximus, Gluteus Medius, Medial Longitudinal Arch, Navicular drop, Overpronation

References

• Adhikari, U., Arul Singh, W., Pai, G., & Raj, J. O. (2014). Normative values of navicular drop test and the effect of demographic parameters cross-sectional study. Annals of Biological Research, 5(7), 40-48.
• Brijwasi, T., & Borkar, P. (2023). A comprehensive exercise program improves foot alignment in people with the flexible flat foot: a randomized trial. Journal of Physiotherapy, 69(1), 42-46. https://doi.org/10.1016/j.jphys.2022.11.011
• Choi, J. H., Cynn, H. S., Yi, C. H., Yoon, T. L., & Baik, S. M. (2020). Effect of isometric hip abduction on foot and ankle muscle activity and medial longitudinal arch during short-foot exercise in individuals with pes planus. Journal of sport rehabilitation, 30(3), 368-374. https://doi.org/10.1123/jsr.2019-0310
• Chuter, V. H., & de Jonge, X. A. J. (2012). Proximal and distal contributions to lower extremity injury: a review of the literature. Gait & posture, 36(1), 7-15. https://doi.org/10.1016/j.gaitpost.2012.02.001
• Engkananuwat, P., & Kanlayanaphotporn, R. (2023). Gluteus medius muscle strengthening exercise effects on medial longitudinal arch height in individuals with flexible flatfoot: a randomized controlled trial. Journal of Exercise Rehabilitation, 19(1), 57. https://doi.org/10.12965/jer.2244572.286
• Ferber, R., Hreljac, A., & Kendall, K. D. (2009). Suspected mechanisms in the cause of overuse running injuries: a clinical review. Sports health, 1(3), 242-246. https://doi.org/10.1177/1941738109334272.
• Friel, K., McLean, N., Myers, C., & Caceres, M. (2006). Ipsilateral hip abductor weakness after inversion ankle sprain. Journal of athletic training, 41(1), 74.
• Goo, Y. M., Kim, T. H., & Lim, J. Y. (2016). The effects of gluteus maximus and abductor hallucis strengthening exercises for four weeks on navicular drop and lower extremity muscle activity during gait with flatfoot. Journal of Physical Therapy Science, 28(3), 911-915. https://doi.org/10.1589/jpts.28.911
• Hintermann, B., & Nigg, B. M. (1998). Pronation in runners: Implications for injuries. Sports medicine, 26, 169-176. https://doi.org/10.2165/00007256-199826030-00003
• Kant, K. K., Saharan, A. K., Saharan, M., Singh, T., & Kumar, A. A Study to Find Out the Effectiveness of Hip Muscle Strengthening On Static and Dynamic Balance In Chronic Ankle Instability. https://doi.org/10.9790/6737-08041822
• Kernozek, T. W., & Ricard, M. D. (1990). Foot placement angle and arch type: effect on rearfoot motion. Arch Phys Med Rehabil, 71(12), 988-91.
• Khisty, A., Kulkarni, R., Desai, P., & Palekar, T. J. Effect of Short Foot Exercises on Patients with Flexible Flat Foot: A Pre-Post Experimental Study. https://doi.org/10.52403/ijhsr.20220115
• Krivickas, L. S. (1997). Anatomical factors associated with overuse sports injuries. Sports medicine, 24, 132-146. DOI: https://doi.org/10.2165/00007256-199724020-00005
• Kranti Panta, B. P. T. (2015). A study to associate the Flamingo Test and the Stork Test in measuring static balance in healthy adults. Foot Ankle Online J, 8(4). https://doi.org/10.3827/faoj.2015.0803.0004
• Koh, E. K., Weon, J. H., & Jung, D. Y. (2013). Effects of activation of gluteus maximus and abdominal muscle using EMG Biofeedback on lumbosacral and tibiocalcaneal angles in standing position. Journal of Korean Physical Therapy, 25(6), 411-416.
• Mitchell, A., Dyson, R., Hale, T., & Abraham, C. (2008). Biomechanics of ankle instability. Part 2: Postural sway-reaction time relationship. Medicine and science in sports and exercise, 40(8), 1522-1528. http://dx.doi.org/10.1249/MSS.0b013e31817356d6
• Mulligan, E. P., & Cook, P. G. (2013). Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic function. Manual therapy, 18(5), 425-430. https://doi.org/10.1016/j.math.2013.02.007
• Mulchandani, P. O. O. J. A., Warude, T. R. U. P. T. I., & Pawar, A. M. R. U. T. K. U. V. A. R. (2017). Effectiveness of gluteal muscle strengthening on flat foot. Asian J Pharm Clin Res, 10(6), 219-221. http://dx.doi.org/10.22159/ajpcr.2017.v10i6.17719
• Nicholas, J. A., & Marino, M. (1987). The relationship of injuries of the leg, foot, and ankle to proximal thigh strength in athletes. Foot & ankle, 7(4), 218-228. https://doi.org/10.1177/107110078700700404
• Nur Saibah, G. (2020). Biomechanical investigation of individuals with over-pronation and over-supination foot during walking/Nur Saibah Ghani (Doctoral dissertation, University of Malaya).
• Picot, B., Terrier, R., Forestier, N., Fourchet, F., & McKeon, P. O. (2021). The star excursion balance test: an updated review and practical guidelines. International Journal of Athletic Therapy and Training, 26(6), 285-293. https://doi.org/10.1123/ijatt.2020-0106.
• Riskowski, J. L., Dufour, A. B., Hagedorn, T. J., Hillstrom, H. J., Casey, V. A., & Hannan, M. T. (2013). Associations of foot posture and function to lower extremity pain: results from a population‐based foot study. Arthritis care & research, 65(11), 1804-1812. https://doi.org/10.1002/acr.22049
• Robbins, S., & Waked, E. (1998). Factors associated with ankle injuries: preventive measures. Sports Medicine, 25, 63-72. https://doi.org/10.2165/00007256-199825010-00005
• Seshan, J., Selvam, P. S., Sundaram, M. S., & Kokila, K. B. (2021). The Effectiveness Of Flat Foot With Intrinsic Gluteal Muscle Strengthening And Stretching Combined With Talonavicular Mobilization Among Adult Population. https://doi.org/10.20959/wjpr20217-20753
• Snyder, K. R., Earl, J. E., O’Connor, K. M., & Ebersole, K. T. (2009). Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. Clinical biomechanics, 24(1), 26-34. https://doi.org/10.1016/j.clinbiomech.2008.09.009