Hallux Valgus Manual Therapy Based on Global Postural Reeducation. (HVMT)

Effects of Global Postural Reeducation on Hallux Valgus

Manual approach of Hallux Valgus with global postural reeducation.

Study Overview

• Status: Completed
• Conditions: Foot Deformities; Hallux Valgus; Hallux Deformity
• Intervention / Treatment: Other: Global postural reeducation

Detailed Description

Hallux Abducto Valgus is a frequent pathology with a prevalence of 30% in women and 13% in men. The tendency is to increase with age.

Usually, the elected treatment is surgery, as the conservative orthopedic methods are used at the early stages of the pathology. Global Postural Re-Education is a manual therapy treatment method through which we can treat lots of pathologies. Some investigations demonstrate Postural Re-Education is effective for the treatment of temporomandibular disorders, urinary incontinence, and spine disorders, but there is no scientific evidence that defends the improvement of the symptoms and correction of the angle of the Hallux Abducto Valgus using Postural Re-Education.

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Jaen, Spain, 23071
    • University of Jaén

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• hallux abducto valgus with an angle between 15 - 39º
• pain on the medial or plantar face of the forefoot
• Physical independence to take part in the study.

Exclusion Criteria:

• Being under hallux abducto valgus treatment.
• Lower limb surgery.
• Fracture or disfunction on the lower limb other than hallux valgus which may affect the studied variables.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control group; Patients allocated to the control group did not receive any treatment.
Experimental: Global postural reeducation; Patients completed 3 sessions of global postural reeducation for 3 weeks.	Other: Global postural reeducation; It consisted of Global Postural Re-Education sessions divided into 3 sessions and performed with a frequency of 1 per week for 3 weeks. The sessions were performed individually, with an approximate duration of 40 minutes and all of them were assessed by the same physiotherapist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postural control	Postural control was evaluated by means of a stabilometric platform of resistive pressure sensors (Sensor Medica, Rome, Italy). There will be performed two tests: open eyes Romberg and closed eyes Romberg.	From baseline to 3 weeks and 8 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dynamic balance	Dynamic balance has been measured by a simplified version of the Star Excursion Balance Test where the anterior, posteromedial and posterolateral reach directions were collected for statistical analysis.	From baseline to 3 weeks and 8 weeks.
Ankle range of motion	Ankle dorsiflexion range of motion was assessed by the weight-bearing lunge test. The patient is positioned in a standing position facing a wall with the involved foot parallel with a tape measure which has been attached to the floor and the opposite leg placed behind in a tandem stance. A forward lunge is performed until the anterior knee tries to make contact with the wall with the heel firmly planted on the ground.	From baseline to 3 weeks and 8 weeks.
Self-reported instability	To determine the severity of ankle instability the Cumberland ankle instability tool was used. The total score of the nine items ranges from 0 (severe instability) to 30 (normal stability).	From baseline to 3 weeks and 8 weeks.
Assessment of the grade of hallux valgus	With the Manchester Scale the examiners grade the feet of the participants in: A: no hallux valgus; B: mild hallux valgus; C: moderate hallux valgus; D: severe hallux valgus.	From baseline to 3 weeks and 8 weeks.
Foot posture	it will be performed the Foot Posture Index 6-items for evaluating the general foot position. It is graded as pronated, neutral or supinated depending on the punctuation	From baseline to 3 weeks and 8 weeks.
Passive and active dorsiflexion range of motion of the 1st metatarsophalangeal joint	it will be assessed by the Jack test, in which the phalangeal bone is passively dorsiflexed and the plantar arch is observed. The aim is classified the Windlass Mechanism in: intact; limited; absent. The active range of motion will be assessed by kinovea software.	From baseline to 3 weeks and 8 weeks.
Gait parameters	Gait parameters after treatment with optogait system including gait cycle, contact time, flight time, and pre-swing phase during walking and running.	From baseline to 3 weeks and 8 weeks.
Functional status	Function in daily living and sport activities were assessed by the Foot and Ankle Ability Measure. This questionnaire Is divided by two subscales of 21 items (daily living subscale) and 8 items (sports subscale). The obtained score is expressed as a percentage calculated by dividing the patient's score by max score and the lower percentage is related to the lower level of function.	From baseline to 3 weeks and 8 weeks.

Collaborators and Investigators

• Sponsor: University of Jaen
• Investigators: Study Director: David Cruz-Diaz, PhD, University of Jaén

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2019
• Primary Completion (Actual): February 20, 2020
• Study Completion (Actual): February 26, 2020

Study Registration Dates

• First Submitted: July 4, 2020
• First Submitted That Met QC Criteria: July 10, 2020
• First Posted (Actual): July 13, 2020

Study Record Updates

• Last Update Posted (Actual): July 13, 2020
• Last Update Submitted That Met QC Criteria: July 10, 2020
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Musculoskeletal Abnormalities; Limb Deformities, Congenital; Foot Deformities, Acquired; Lower Extremity Deformities, Congenital; Congenital Abnormalities; Hallux Valgus; Bunion; Foot Deformities; Foot Deformities, Congenital
• Other Study ID Numbers: HVUJA

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No