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CTRI Number  CTRI/2025/09/095496 [Registered on: 30/09/2025] Trial Registered Prospectively
Last Modified On: 29/09/2025
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Physiotherapy (Not Including YOGA) 
Study Design  Randomized, Parallel Group Trial 
Public Title of Study   A 6-week foot exercise program to strengthen the feet and activation of hip muscles: How it helps people with flat feet to improve balance, and its effect on lower limb movement. 
Scientific Title of Study   The effect of 6 week of short foot exercises with isometric hip abduction on Navicular drop, dynamic balance and step up kinematics in adults with flexible flat foot: a randomized control trial 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Riddhi Prakash Sonaiya 
Designation  Postgraduate Student 
Affiliation  DY Patil deemed to be University 
Address  6th floor, Physiotherapy department, DY Patil deemed to be University, School of Physiotherapy, plot no-2, sector-5, Nerul, Navi Mumbai

Mumbai
MAHARASHTRA
400706
India 
Phone  9727830228  
Fax    
Email  dr.riddhirs20@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Riddhi Prakash Sonaiya 
Designation  Postgraduate Student 
Affiliation  D.Y Patil deemed to be University, School of Physiotherapy 
Address  6th floor, Physiotherapy department, DY Patil deemed to be University, School of Physiotherapy, plot no-2, sector-5, Nerul, Navi Mumbai

Mumbai
MAHARASHTRA
400706
India 
Phone  9727830228  
Fax    
Email  dr.riddhirs20@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Dr Twinkle Dabholkar 
Designation  Professor and Head of Musculoskeletal Department 
Affiliation  D.Y Patil deemed to be University, School of physiotherapy 
Address  6th floor, Physiotherapy department, DY Patil deemed to be University, School of Physiotherapy, plot no-2, sector-5, Nerul, Navi Mumbai

Mumbai
MAHARASHTRA
400706
India 
Phone  9819870821  
Fax    
Email  twinkle.dabholkar@dypatil.edu  
 
Source of Monetary or Material Support  
D.Y Patil deemed to be University, School of Physiotherapy, Navi Mumbai, 400706, India 
 
Primary Sponsor  
Name  DY Patil deemed to be University, School of Physiotherapy 
Address  DY Patil deemed to be University, School of Physiotherapy, 6th floor, Plot no-2, sector-5, Nerul, Navi Mumbai - 400706 
Type of Sponsor  Private medical college 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Riddhi Prakash Sonaiya  Dr. DY Patil deemed to be University, School of Physiotherapy  DY Patil deemed to be University, School of Physiotherapy, 6th floor, plot no-2, sector-5, Nerul, Navi Mumbai
Mumbai
MAHARASHTRA 
09727830228

dr.riddhirs20@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional Ethics commitee for Biomedical and Health Research  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: M214||Flat foot [pes planus] (acquired),  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Short Foot Exercise  3 session per week for 6 weeks- Lesser toe extension, toe spread, doming, and hallux extension, Marble pick up, toe towel curl, tibialis posterior strengthening, iliopsoas stretching, Rolling a tennis ball, Pulling the foot with a towel around the heel, Write the alphabet. Calf muscle stretching, Resistive inversion and eversion with an elastic band, Maintaining balance in a stable and unstable base. These exercise will be done in sitting position for week 1 and 2, in Standing position in week 3 and 4 and one leg standing position in week 5 and week 6 
Intervention  Short Foot Exercise with Isometric Hip Abduction  3 session per week for 6 weeks - Lesser toe extension, toe spread, doming, and hallux extension, Marble pick up, toe towel curl, tibialis posterior strengthening, iliopsoas stretching, Rolling a tennis ball, Pulling the foot with a towel around the heel, Write the alphabet. Calf muscle stretching, Resistive inversion and eversion with an elastic band, Maintaining balance on a stable and unstable base. All these exercise will be done with isometric hip abduction using Theraband in sitting position for first two weeks, followed by in standing in week 3 and week 4 and one leg standing in week 5 and 6.  
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  30.00 Year(s)
Gender  Both 
Details  1.Age- 18 to 30 years
2.Gender-male/female
3.Navicular Drop more than 10mm
3.BMI- 18 to 25
4.Arch Index – more than 0.28 cm²
5.Flexible flat foot
 
 
ExclusionCriteria 
Details  1.Any back or lower limb injury in last 6 months
2.History of hip and Ankle surgery
3.Neurological disability
4.Pregnancy
 
 
Method of Generating Random Sequence   Coin toss, Lottery, toss of dice, shuffling cards etc 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Participant Blinded 
Primary Outcome  
Outcome  TimePoints 
Star Excursion Balance Test to test dynamic balance,
Lower limb kinematics using Kinovea 
Baseline
after 6 weeks of training  
 
Secondary Outcome  
Outcome  TimePoints 
Navicular Drop,
Arch Index 
Baseline,
After 6 weeks 
 
Target Sample Size   Total Sample Size="36"
Sample Size from India="36" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   10/10/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="5"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

Flexible flat foot is characterized by a weakened medial longitudinal arch and compromised abductor halluces muscle function, which increases compensatory Tibialis anterior activity, leading to Hyperpronation of foot, tibial internal rotation, and altered lower-limb kinematics. Additionally, hip abductor and external rotator weakness contribute to dynamic knee valgus and hip adduction, further impairing lower-limb alignment. Short Foot Exercises (SFE) are commonly prescribed to strengthen intrinsic foot muscles, but evidence suggests that combining them with isometric hip abduction (IHA) may provide better outcomes. Prior studies have demonstrated improvements in static balance when SFE is combined with IHA, but their impact on dynamic balance and lower-limb kinematics remains unexplored. Therefore, this study seeks to investigate whether adding IHA to SFE enhances dynamic balance and lower-limb kinematics  in adults with flexible flat feet.

AIMS AND OBJECTIVES- 

The aim is to compare the effects of a 6-week program of SFE with IHA against SFE alone on Navicular drop, dynamic balance, step-up kinematics, and arch index 

PRIMARY OBJECTIVES

1.To compare the effect of 6 week of short foot exercises with isometric hip abduction treatment protocol with short foot exercise alone on Dynamic balance assessed by Star excursion Balance Test in adults with flexible flat foot.

 2. To compare the effect of 6 week of short foot exercises with isometric hip abduction treatment protocol with short foot exercise alone on Step up kinematics assessed by Kinovea software in adults with flexible flat foot. 

  •  SECONDARY OBJECTIVES: 

 1. To compare the effect of 6 week of short foot exercises with isometric hip abduction treatment protocol with short foot exercise alone on Navicular drop test in adults with flexible flat foot.

 2.To compare the effect of 6 week of short foot exercises with isometric hip abduction treatment protocol with short foot exercise alone on Arch index in adults with flexible flat foot.

MATERIALS AND METHODOLOGY- 

The Interventional study will be conducted for 6 weeks. 36 subjects with flexible flat foot based on inclusion and exclusion criteria will be recruited. Participants will be allocated into two groups: one receiving SFE alone, and the other SFE with IHA using resistance bands. After baseline assessment , participants will undergo a 6 week exercise protocol, performed three time a week under supervision. The intervention will last 6 weeks, with 3 sessions per week (45 minutes each) 

Outcome measures include Star Excursion Balance Test, step-up kinematics (hip abduction angle and dynamic knee valgus using Kinovea), Navicular drop test, and arch index . Data will be statistically analyzed using t-tests and ANOVA at the end of the study to determine the effectiveness of the training program.

 
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