Combined Short Foot and Three-Dimensional PNF Ankle Exercises Improve Plantar Pressure, Ground Reaction Forces, and Postural Sway in Female Karate Athletes with Flexible Flatfoot

Aims: Flexible flatfoot in athletes alters plantar pressure distribution, impairs postural control, and modifies ground reaction forces, elevating injury risk. This study compared SFE+۳DAE versus SFE alone on these outcomes in female karate athletes with flexible flatfoot. Method and Materials: Randomized controlled trial of ۳۴ female karate athletes aged ۱۷۲۵ years with flexible flatfoot, randomly assigned ۱:۱ to ۸ weeks of Short Foot Exercises (SFE) alone or combined with three-Dimensional Ankle Exercises (۳DAE). Plantar pressure distribution, postural control, and ground reaction forces were assessed pre- and postintervention using pressure platforms. Within-group changes were analyzed using paired ttests, while between-group differences were evaluated with ANCOVA, adjusting for baseline values. Findings: Both groups demonstrated improvements in plantar pressure distribution, postural control, and ground reaction forces; however, the SF-۳DAE group showed significantly greater reductions in first peak force and force depth (η² = ۰.۱۵۱, p < ۰.۰۵) and enhanced postural control, including major and minor axis lengths, COP path, and AP/ML sway (η² range: ۰.۱۷۶–۰.۷۳۴, p < ۰.۰۵). No significant changes were observed in symmetry indices between legs or forefoot-rearfoot distribution. Conclusion: Integrating SFE with ۳DAE provides a comprehensive rehabilitation approach for female karate athletes with flexible flatfoot, enhancing foot function, postural stability, and load distribution during dynamic activities. These results support the additive benefits of combining intrinsic foot muscle strengthening with ankle PNF exercises in athletic populations.

کلیدواژه ها:

Flatfoot ، Exercise Therapy ، Postural Balance ، Three-Dimensional Exercises ، Postural Control How