Flexor Hallucis Longus Training and Balance-Gait in Geriatrics

March 13, 2025 updated by: Hüseyin Gerdan, Lokman Hekim Üniversitesi

Examination of Balance-Gait Parameters and Fall Effect of Flexor Hallucis Longus Muscle Strengthening Training in Geriatric Group

Examination of Balance-Gait Parameters and Fall Effect of Flexor Hallucis Longus Muscle Strengthening Training in Geriatric Group It has been demonstrated that the reduction in the strength of the toe flexor muscles is an independent indicator of falls in geriatric individuals. However, the extent of this strength loss and the effects of strengthening training programs on balance, gait parameters, and falls are not well understood.

Objective: The aim is to investigate whether a progressive resistance exercise program, focusing specifically on the flexor hallucis longus (FHL) muscle, can improve toe flexor strength and influence gait, balance, and falls in geriatric individuals.

Materials and Methods: Individuals over the age of 65 who are willing to participate in the study will be included. The participants will be divided into three groups: individual exercise group, home exercise group, and control group. Individuals who are unable to walk independently, have severe musculoskeletal disorders, have hallux rigidus deformity, suffer from orthostatic hypotension, have difficulty understanding instructions, or have diabetic neuropathy will be excluded from the study. After obtaining socio-demographic information from the participants, anthropometric measurements will be taken. Toe grip strength will be assessed using a digital dynamometer, and the strength of the intrinsic foot muscles and lower extremity antigravity muscles will also be measured using a digital dynamometer. Balance parameters will be evaluated using the Berg Balance Scale, Functional Reach Test, Timed Up and Go Test, while gait parameters will be assessed using the 10-meter walk test and Tinetti Gait Scale. Fall parameters will be assessed by the Falls Efficacy Scale and fall frequency.

The collected data will be analyzed using SPSS (Statistical Package for Social Sciences) software.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

66

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Samsun, Turkey, 55200
        • Atakum Nursing Home, Elderly Care and Rehabilitation Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Individuals over the age of 65,
  • Individuals who do not have hearing or speech problems,
  • Individuals who do not have any neurological, orthopedic or visual problems that would prevent walking (can walk 10 meters independently)
  • Individuals who score 24 points and above in the Mini Mental Test evaluation.

Exclusion Criteria:

  • Those who cannot walk independently,
  • Those with serious musculoskeletal system disorders,
  • Those with hallux rigidus deformity,
  • Those with orthostatic hypotension,
  • Those who have difficulty understanding instructions and those with diabetic neuropathy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Physiotherapist-Assisted Isolated FHL Strengthening Exercise Group
The intervention for the "Physiotherapist-Assisted Isolated FHL Strengthening Exercise Group (FHL-SET)" will consist of physiotherapist-guided, isolated strengthening exercises specifically targeting the Flexor Hallucis Longus (FHL) muscle. Participants will engage in exercises designed to isolate and strengthen the FHL muscle through controlled and progressive resistance. Sessions will occur three times a week for 8 weeks, with the physiotherapist providing individualized adjustments and ensuring proper technique and progression.
Other: Exercise
A progressive resistance exercise program focusing on strengthening the flexor hallucis longus (FHL) muscle in elderly participants.
Experimental: Home-Based Foot and Ankle Strengthening Exercise Training Group
After the initial assessments, the participants in this group will receive home-based foot and ankle strengthening exercises three times a week for 8 weeks. They will be monitored weekly using an exercise log. The Home-Based Exercise Group (EvT-KE) will be taught general foot exercises without progression in resistance. These exercises include ankle rotations, toe raises, toe lifts, rolling a ball under the foot for 2 minutes, picking up marbles with toes, towel collection exercises, and foot shortening exercises.
Other: Exercise
A progressive resistance exercise program focusing on strengthening the flexor hallucis longus (FHL) muscle in elderly participants.
No Intervention: Control Group
For the Control Group, initial and final assessments will be conducted at the beginning of the study and at the end of 8 weeks. No exercise program will be provided during this period. After the study, necessary exercises and recommendations will be given.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Muscle Strength Measurement
Time Frame: pre-intervention, immediately after the intervention
Flexor hallucis longus strength and toe grip strength will be assessed using Dynamo by Vald branded dynamometer. The results will be reported in Newtons.
pre-intervention, immediately after the intervention
balance assessment
Time Frame: pre-intervention, immediately after the intervention
berg balance scale
pre-intervention, immediately after the intervention
gait
Time Frame: pre-intervention, immediately after the intervention
gait speed, cadence
pre-intervention, immediately after the intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Lokman Hekim Üniversitesi

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 10, 2025

Primary Completion (Estimated)

April 1, 2025

Study Completion (Estimated)

April 1, 2025

Study Registration Dates

First Submitted

March 8, 2025

First Submitted That Met QC Criteria

March 13, 2025

First Posted (Actual)

March 25, 2025

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 13, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2024049 (Registry Identifier: Milk Temperature and NEC)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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