Effectiveness of osteopathic manipulative treatment with home based exercises on progressed flexible pes planus

Abstract

Background: Flexible pes planus presents under the age of 10 years and may progress leading to various lower-limb symptoms later in life. To date, there is little evidence for non-orthotic rehabilitative strategies. Objectives: The objectives of this study were to determine the impact of an osteopathic and exercise intervention on objective measures of navicular heights and positions, navicular drop, and self-report measures of pain using a short-form McGill’s pain questionnaire in participants with progressed flexible pes planus. Methods: Fourteen participants with pre-diagnosed or examined progressed flexible pes planus were randomly allocated into either the immediate start group (one week of baseline, three weeks of intervention, four weeks follow-up) or the delayed start group (four weeks baseline, three weeks intervention, one week follow-up). Navicular heights, positions, and drop were recorded weekly using sagittal photographs taken with an infrared-filter and analysed using AutoCAD 2010. Pain change was monitored by a short-form McGill’s pain questionnaire. Results: Welch’s t-test indicated a statistically significant (left feet p = 0.05) improvement of sitting navicular heights at the follow-up between the two groups. Pain sensitivity (p < 0.01) and present pain intensity (p < 0.01) exhibited a significant difference between baseline and follow-up with both measures improving by at least 30%. Conclusion: The results of this mixed research study ( a randomised controlled trial and single cohort) found the osteopathic manipulative treatment with home based exercise to be beneficial in reducing the pain sensitivity and intensity experienced in individuals with progressed flexible pes planus.