OBJECTIVES: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. METHODS: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. RESULTS: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups (SFE=73.9±11.0% of maximal voluntary isometric contraction [MVIC]; SFE with NMES=81.4±8.3% of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group (pre-treatment=218.6±53.2 mm²; post-treatment=256.9±70.5 mm²; p<0.05). CONCLUSIONS: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.
Electric Stimulation ; Flatfoot ; Foot ; Humans ; Isometric Contraction ; Lower Extremity ; Muscles ; Patient Care Team ; Physical Therapists ; Thailand

OBJECTIVES: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. METHODS: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. RESULTS: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups (SFE=73.9±11.0% of maximal voluntary isometric contraction [MVIC]; SFE with NMES=81.4±8.3% of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group (pre-treatment=218.6±53.2 mm²; post-treatment=256.9±70.5 mm²; p<0.05). CONCLUSIONS SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

OBJECTIVES: This study evaluated the immediate effects and acceptability of a smartphone application named NeckProtector to promote neck pain self-management through stretching incorporating deep slow breathing, among smartphone users with neck pain. METHODS: One-hundred participants were recruited in the study. Participants were divided into two groups by block randomized allocation. The researchers gave the NeckProtector application to all participants for acceptability testing by navigation of the application for 20–30 minutes. Next, the treatment group (n = 50) conducted the exercise program via smartphone application for 15–20 minutes, while the control group (n = 50) rested for 20 minutes. Evaluations were performed at baseline and after intervention for pain intensity, muscle tension, pressure pain threshold (PPT), and cervical range of motion (CROM). Quantitative and qualitative feedback was then obtained by an acceptability survey and open-ended questionnaires. RESULTS: The immediate effects showed statistically significant improvements in pain intensity, muscle tension, PPT, and CROM in the treatment group in comparison to the control group. Participants reported a high level of acceptability through ratings on a Likert scale. The qualitative questionnaires received positive responses that the application was easy to use and the exercise program was useful to cope with neck pain. CONCLUSIONS NeckProtector can be an alternative treatment for neck pain self-management via smartphone application among smartphone users with neck pain. Further studies should examine the long-term effectiveness (Clinical trials registry: TCTR20160523001).