Physiotherapy and Rehabilitation in Melorheostosis: A Case Report (MELO-REHAB)

April 2, 2026 updated by: Yeditepe University

The Role of Physiotherapy and Rehabilitation in a Patient Diagnosed With Melorheostosis: A Case Report

The aim of this study is to evaluate the effects of a structured physiotherapy and rehabilitation-based exercise program on clinical and functional parameters in a patient diagnosed with melorheostosis.

This study specifically aims to assess the effects of a structured physiotherapy and rehabilitation-based intervention program, including patient education and therapeutic exercise, on lower extremity functional parameters, muscle strength, balance, and quality of life in a patient with melorheostosis.

The main hypotheses:

H0: A structured physiotherapy and rehabilitation-based exercise program has no effect on improvement in clinical and functional evaluation parameters in a patient with melorheostosis.

H1: A structured physiotherapy and rehabilitation-based exercise program leads to improvement in clinical and functional evaluation parameters in a patient with melorheostosis.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Melorheostosis is a rare, chronic, and progressive sclerosing bone disorder characterized by cortical bone thickening, pain, joint stiffness, restricted mobility, and functional impairment. Due to its low prevalence, the available literature is limited, and conservative management strategies, particularly physiotherapy interventions, remain insufficiently defined.

A patient diagnosed with melorheostosis who meets the inclusion criteria and is followed by an orthopedic specialist will be included in this prospective single-case study to investigate the effectiveness of a structured physiotherapy and rehabilitation-based exercise program.

The patient, who is under regular physician supervision and willing to participate in the rehabilitation program, will be included in the study. The intervention approach will be based on a non-invasive, exercise-oriented physiotherapy program.

The rehabilitation program will consist of patient education, diaphragmatic breathing training, and a structured exercise program including strength, flexibility, and balance components. The patient will participate in a total of 24 physiotherapy sessions, three days per week, for eight weeks.

Before starting the treatment program, the patient's sociodemographic characteristics, medical history, and disease-related clinical features will be recorded using a structured evaluation form. A baseline clinical evaluation will be performed prior to the intervention.

Following the baseline assessment, the individualized physiotherapy program will be implemented. Exercise intensity and progression will be adjusted according to the patient's pain level and functional capacity throughout the intervention period.

Clinical and functional parameters will be evaluated before the treatment, immediately after the 8-week intervention, and at a 6-month follow-up to assess both short-term and long-term effects.

Throughout the study, the patient will continue routine medical treatment and remain under physician supervision, and no changes will be made to the existing medical management.

Study Type

Interventional

Enrollment (Estimated)

1

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 Contact

Study Contact Backup

Study Locations

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

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosed with melorheostosis by a physician.
  • Voluntarily agreeing to participate in the study and providing written informed consent.
  • Being under physician follow-up for the disease.
  • Being 18 years of age or older.
  • Having the cognitive level, communication skills, and physical capacity to perform the planned exercise program.

Exclusion Criteria:

  • Presence of additional systemic, rheumatologic, or metabolic diseases that could affect bone metabolism, other than melorheostosis.
  • Presence of cardiovascular, pulmonary, or neurological disease at a level that may restrict exercising.
  • History of surgical intervention or severe trauma within the last six months.
  • Presence of psychiatric or cognitive disorders that could interfere with evaluation and exercise applications.
  • Failure to continue the 8-week exercise program.

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: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Structured Physiotherapy and Rehabilitation Program Group (SPTR-G)
The target population of the study consists of a 24-year-old female case diagnosed with melorheostosis by a relevant physician, who voluntarily meets the inclusion criteria. The study is designed as a single-case report and aims to evaluate the clinical and functional characteristics of the case. The participant is actively working as a physiotherapist in her professional life. Patient will receive patient education in addition to a structured exercise program. The exercise program will include progressive strengthening, flexibility, and balance-based exercises. Patient education will be delivered by targeting topics that encompass all components of the ICF framework. In addition, diaphragmatic breathing will be taught to patients prior to the exercise program.
Other: Assigned Interventions

Patient will receive patient education in addition to a structured exercise program. The exercise program will include progressive strengthening, flexibility, and balance-based exercises. Patient education will be delivered by targeting topics that encompass all components of the ICF framework. In addition, diaphragmatic breathing will be taught to patients prior to the exercise program.

The exercise program will be conducted three times per week for 8 weeks. Baseline assessments will be performed before the intervention, and post-intervention assessments will be repeated after completion of the program. Furthermore, evaluations will be conducted again during a 6-month follow-up period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Assessment
Time Frame: Baseline (Week 0), Post-intervention (Week 8), and Follow-up (Month 6)
The Visual Analog Scale (VAS) was used to evaluate pain intensity. The location and severity of the pain will be questioned. The individual's resting, activity, and nighttime pain levels were evaluated on a 10 cm horizontal line with the extremes of "0: no pain" and "10: unbearable pain". Higher values indicate severe pain. In this study, it is planned to be used to evaluate the pain intensity of the case.
Baseline (Week 0), Post-intervention (Week 8), and Follow-up (Month 6)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
SF-12 Quality of Life Scale
Time Frame: Baseline (Week 0), Week 8, and Month 6.
The SF-12 is a self-reported questionnaire used to assess health-related quality of life. It evaluates both physical and mental health components, yielding two summary measures: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Scores range from 0 to 100, where higher scores indicate a better level of health and a higher quality of life.
Baseline (Week 0), Week 8, and Month 6.
Passive Knee Extension (PKE) Test
Time Frame: Baseline (Week 0), Week 8, and Month 6.
The PKE test is used to assess hamstring muscle flexibility. The participant is positioned supine, with the non-tested limb stabilized and the tested hip fixed at 90 degrees of flexion. As the knee is extended, the angle between the tibia and the vertical vector is measured using an inclinometer placed 15 cm distal to the tibial tuberosity. The measurement is recorded in degrees (°). A smaller angle relative to the vertical line indicates greater knee extension and better hamstring flexibility.
Baseline (Week 0), Week 8, and Month 6.
Ankle Active Range of Motion
Time Frame: Baseline (Week 0), Week 8, and Month 6.
Ankle AROM (dorsiflexion, plantarflexion, inversion, and eversion) is evaluated using a goniometer in standard anatomical positions. For dorsiflexion and plantarflexion, the participant is seated with knees slightly flexed; the axis of the goniometer is placed over the lateral malleolus, the stationary arm parallel to the fibular line, and the moving arm parallel to the lateral aspect of the 5th metatarsal. For inversion and eversion, the participant sits with legs hanging off the edge of the table; the axis is placed at the midpoint between the two malleoli, the stationary arm on the anterior surface of the tibia, and the moving arm parallel to the longitudinal axis of the 2nd metatarsal. All measurements are recorded in degrees (°), with higher values indicating a greater active range of motion.
Baseline (Week 0), Week 8, and Month 6.
Quadriceps Flexibility / Ely's Test
Time Frame: Baseline (Week 0), Week 8, and Month 6.
The Ely's test is used to assess the flexibility of the rectus femoris muscle. With the participant in a prone position and the pelvis stabilized, the examiner passively flexes the knee to its maximal limit just before compensatory pelvic flexion occurs. The maximum knee flexion angle is measured using a goniometer and recorded in degrees (°). A higher degree of knee flexion indicates greater quadriceps flexibility.
Baseline (Week 0), Week 8, and Month 6.
Gastrocnemius-Soleus Muscle Flexibility Tests
Time Frame: Baseline (Week 0), Week 8, and Month 6.
Flexibility of the calf muscles is assessed by measuring ankle dorsiflexion range of motion using a goniometer in standing positions. For the gastrocnemius, the participant stands facing a wall, keeps the tested knee fully extended, and shifts weight forward. For the soleus, the participant assumes a weight-bearing lunge position with the tested knee flexed, keeping both heels firmly on the floor. Measurements are recorded in degrees (°), with higher values representing greater muscle flexibility.
Baseline (Week 0), Week 8, and Month 6.
Weight-Bearing Lunge Test - WBLT
Time Frame: Baseline (Week 0), Week 8, and Month 6.
The WBLT evaluates closed kinetic chain ankle dorsiflexion under a loaded, functional condition. The participant performs a maximal forward lunge toward a wall, maintaining heel contact with the floor. The angle between the tibia and the vertical axis is measured using a digital inclinometer placed 15 cm distal to the tibial tuberosity. The measurement is recorded in degrees (°). Higher angle values indicate greater dorsiflexion mobility.
Baseline (Week 0), Week 8, and Month 6.
Quadriceps Muscle Strength Measurement
Time Frame: Baseline (Week 0), Week 8, and Month 6.
Quadriceps strength is evaluated using a digital handheld myometer (dynamometer). The participant is seated with legs hanging from the edge of the table, with both hip and knee positioned at 90 degrees of flexion. The myometer is placed on the anterior surface of the tibia, approximately 5 cm proximal to the lateral malleolus. The participant performs a maximal isometric knee extension for 5 seconds. The peak force is recorded. Higher values indicate greater quadriceps muscle strength.
Baseline (Week 0), Week 8, and Month 6.
Hamstring Muscle Strength Measurement
Time Frame: Baseline (Week 0), Week 8, and Month 6.
Hamstring strength is evaluated using a digital handheld myometer (dynamometer). The participant is in a prone position, and the tested knee is passively brought to an angle of 30° to 45° of flexion. The myometer is placed on the posterior surface of the tibia, just proximal to the heel (calcaneus). The peak force is recorded. Higher values indicate greater hamstring muscle strength.
Baseline (Week 0), Week 8, and Month 6.
Hip External Rotator Muscle Strength Measurement
Time Frame: Baseline (Week 0), Week 8, and Month 6.
Hip external rotator strength is evaluated using a digital handheld myometer. The participant is assessed in a side-lying position with the knees flexed at 90 degrees. The myometer is placed on the medial aspect of the leg, just proximal to the medial malleolus of the tested limb. The peak force is recorded. Higher values indicate greater hip external rotator muscle strength.
Baseline (Week 0), Week 8, and Month 6.
Y-Balance Test
Time Frame: Baseline (Week 0), Week 8, and Month 6.
The Y-Balance Test evaluates dynamic balance. The participant stands on one leg and reaches as far as possible with the contralateral leg in three directions: anterior, posteromedial, and posterolateral. To standardize the measurements, the reach distances are normalized to the participant's lower limb length, measured from the anterior superior iliac spine (ASIS) to the medial malleolus. Higher normalized composite scores indicate better dynamic balance and stability.
Baseline (Week 0), Week 8, and Month 6.
Feiss Line Test
Time Frame: Baseline (Week 0), Week 8, and Month 6.
The Feiss Line Test evaluates the height of the medial longitudinal arch and static foot posture. While the participant is seated (non-weight bearing) and then standing, the medial malleolus, navicular tubercle, and the center of the first metatarsophalangeal (MTP) joint are marked. An imaginary line (Feiss Line) is drawn between the medial malleolus and the first MTP joint. The position of the navicular tubercle relative to this line is examined to grade the arch height.
Baseline (Week 0), Week 8, and Month 6.
Navicular Drop Test
Time Frame: Baseline (Week 0), Week 8, and Month 6.
The Navicular Drop Test assesses excessive foot pronation and the dynamic stability of the medial longitudinal arch under load. With the participant seated (non-weight bearing) and the subtalar joint in a neutral position, the height of the navicular tubercle from the floor is measured in millimeters. The participant then stands with weight distributed evenly on both feet (weight-bearing position), and the measurement is repeated. The difference between the two measurements is recorded as the navicular drop (in mm). A higher drop value indicates greater dynamic foot pronation and reduced arch stability.
Baseline (Week 0), Week 8, and Month 6.

Collaborators and Investigators

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

Sponsor

Yeditepe University

Investigators

  • Study Chair: Aslı Yeral, Asst. Prof. Dr., Yeditepe University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 (Estimated)

March 17, 2026

Primary Completion (Estimated)

May 19, 2026

Study Completion (Estimated)

September 22, 2026

Study Registration Dates

First Submitted

March 16, 2026

First Submitted That Met QC Criteria

April 2, 2026

First Posted (Actual)

April 9, 2026

Study Record Updates

Last Update Posted (Actual)

April 9, 2026

Last Update Submitted That Met QC Criteria

April 2, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • yeditepe01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared to protect the privacy of the single participant involved in this case report.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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