Immediate Effects of Plantar Fascia Release Combined With Foot Exercises on FMS Subscores in Young Adults With Pes Planus (FMS-PP)

Immediate Efeects of Plantar Facia Release Combined With Foot Exercises on Functional Movement Screen Subscores in Young Adults With Pes Planus: A Randomized Crossover Study

This randomized crossover clinical study aims to investigate the immediate effects of plantar fascia release combined with foot exercises on Functional Movement Screen sub-scores in physically active young adults with pes planus.

Participants aged 18-35 years with pes planus, determined by the Navicular Drop Test, will complete two different intervention protocols in a randomized order. Protocol A will include foot-core exercises combined with plantar fascia stretching. Protocol B will include the same foot-core exercises and plantar fascia stretching, with the addition of plantar fascia myofascial release. Each participant will receive both interventions on separate sessions, with a 24-hour wash-out period between sessions.

Functional movement quality will be assessed using two Functional Movement Screen subtests: Deep Squat and Hurdle Step. These tests will be performed before and after each intervention session to evaluate acute changes in movement performance.

The main hypothesis of the study is that plantar fascia myofascial release combined with foot-core exercises and plantar fascia stretching will produce greater immediate improvements in Functional Movement Screen Deep Squat and Hurdle Step scores compared with foot-core exercises and plantar fascia stretching alone.

Study Overview

• Status: Not yet recruiting
• Conditions: Pes Planus; FMS
• Intervention / Treatment: Other: Protocol A: Foot core Exercises and Plantar Facia Streching; Other: Protocol B: Foot Core Exercises, Plantar Fascia Stretching, and Myofascial Release

Detailed Description

This study is planned as a randomized crossover interventional clinical study designed to evaluate the acute effects of plantar fascia release combined with foot exercises on functional movement quality in young adults with pes planus.

Pes planus is associated with reduced medial longitudinal arch support and excessive pronation, which may influence lower extremity alignment, load transfer, postural control, and functional movement patterns. Foot-core exercises aim to activate and strengthen the intrinsic muscles of the foot that support the medial longitudinal arch. Plantar fascia stretching and myofascial release may improve the flexibility and mechanical properties of the plantar fascia and may contribute to improved ankle and lower extremity movement capacity. Therefore, combining active foot stabilization exercises with plantar fascia interventions may provide an immediate effect on movement quality.

The study will include physically active young adults aged 18-35 years with pes planus. Pes planus will be determined using the Navicular Drop Test. Physical activity level will be assessed using the International Physical Activity Questionnaire. After eligibility screening and written informed consent, participants will complete two different intervention protocols in a randomized order.

The crossover design will allow each participant to receive both intervention protocols and serve as his or her own control. A 24-hour wash-out period will be provided between the two intervention sessions to minimize possible carry-over effects. In each session, Functional Movement Screen subtests will be assessed before the intervention. The assigned intervention protocol will then be applied, followed by a one-hour waiting period. After this waiting period, the Functional Movement Screen subtests will be repeated to determine the immediate effect of the intervention.

Protocol A will consist of foot-core exercises combined with plantar fascia stretching. The foot-core exercise program will include short foot exercise, towel curl, toe spread, great toe extension, and reverse tandem walking. Plantar fascia stretching will be performed using a plantar fascia-specific stretching technique.

Protocol B will consist of the same foot-core exercises and plantar fascia stretching, with the addition of plantar fascia myofascial release. Myofascial release will be applied manually along the plantar fascia, from the calcaneal region toward the metatarsal heads, with controlled pressure and within the participant's tolerance.

Functional movement quality will be evaluated using the Deep Squat and Hurdle Step subtests of the Functional Movement Screen. These tests were selected because they reflect lower extremity mobility, stability, balance, and movement control, which may be influenced by foot posture and plantar fascia mobility.

The primary aim of the study is to compare the immediate effects of the two intervention protocols on Functional Movement Screen Deep Squat and Hurdle Step scores. The study hypothesis is that the protocol including plantar fascia myofascial release, plantar fascia stretching, and foot-core exercises will result in greater immediate improvement in Functional Movement Screen sub-scores compared with foot-core exercises and plantar fascia stretching alone.

All assessments and interventions will be performed face-to-face in a clinical/laboratory setting by trained physiotherapists. Procedures will be conducted according to standardized instructions, and participant safety and comfort will be monitored throughout the study.

• Study Type: Interventional
• Enrollment (Estimated): 29
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Emre S Atalay, PhD; Phone Number: +90 544 405 18 24; Email: emreserdar.atalay@sbu.edu.tr
• Study Contact Backup: Name: Büşra ERYİĞİT, PT; Phone Number: 905396570877; Email: busraeryigit00@gmail.com

Study Locations

• Turkey (Türkiye)
  • Osmaniye
    • Antakya, Osmaniye, Turkey (Türkiye), 06018
      • University of Healt Sciences, Gülhane Faculty ofHealth Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Being between 18 and 35 years of age
• Voluntarily agreeing to participate in the study and providing written informed consent
• Having pes planus according to the Navicular Drop Test result
• Having the cognitive ability to understand and perform the Functional Movement Screen (FMS) test instructions
• Being classified as sufficiently physically active according to the International Physical Activity Questionnaire (IPAQ), defined as at least 1500 MET-min/week of vigorous-intensity activity or at least 3000 MET-min/week of moderate-intensity activity
• Having no history of lower extremity surgery within the last 6 months
• Having no history of lower extremity injury/disability within the last 6 months
• Agreeing to complete the study protocol over two days

Exclusion Criteria:

• Having a history of ankle sprain, especially recurrent ankle sprains
• Presence of hallux valgus deformity
• Presence of hammer toe deformity
• Presence of generalized ligamentous laxity
• Having a history of systemic disease, such as rheumatic, neurological, or metabolic disorders
• Presence of ongoing lower extremity pain
• Having any orthopedic or neurological condition that may prevent the safe performance of the Functional Movement Screen tests

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Protocol A; Participants will receive Protocol A, which includes foot core exercises combined with plantar fascia stretching. In the randomized crossover design, Protocol A may be administered either in the first session or in the second session, depending on the randomized intervention order. FMS Deep Squat and Hurdle Step scores will be assessed before and after the intervention session.	Other: Protocol A: Foot core Exercises and Plantar Facia Streching; Protocol A consists of foot core exercises combined with plantar fascia stretching. Foot core exercises include short foot exercise, towel curl, toe spread, great toe extension, and reverse tandem walking. Plantar fascia stretching will be performed using a plantar fascia-specific stretching technique. This protocol may be administered in either the first or second session according to the randomized crossover order.
Experimental: Protocol B; Participants will receive Protocol B, which includes foot core exercises combined with plantar fascia stretching and plantar fascia myofascial release. In the randomized crossover design, Protocol B may be administered either in the first session or in the second session, depending on the randomized intervention order. FMS Deep Squat and Hurdle Step scores will be assessed before and after the intervention session.	Other: Protocol B: Foot Core Exercises, Plantar Fascia Stretching, and Myofascial Release; Protocol B consists of all components of Protocol A, including foot core exercises and plantar fascia stretching, with the addition of plantar fascia myofascial release. Myofascial release will be applied manually along the plantar fascia from the calcaneal region toward the metatarsal heads, with pressure adjusted according to participant tolerance. This protocol may be administered in either the first or second session according to the randomized crossover order.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Functional Movement Screen Hurdle Step Score	The Hurdle Step subtest of the Functional Movement Screen will be used to assess single-leg balance, hip stability, knee control, and ankle stability. The score ranges from 0 to 3, with higher scores indicating better movement quality. The change from pre-intervention to post-intervention will be compared between protocols.	Before intervention and 1 hour after intervention in each session
Change in Functional Movement Screen Deep Squat Score	The Deep Squat subtest of the Functional Movement Screen will be used to assess functional movement quality involving the lower extremity, trunk, shoulder, hip, knee, and ankle. The score ranges from 0 to 3, with higher scores indicating better movement quality. The change from pre-intervention to post-intervention will be compared between protocols	Before intervention and 1 hour after intervention in each session

Collaborators and Investigators

• Sponsor: Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey

Publications and helpful links

General Publications

• Richman ED, Tyo BM, Nicks CR. Combined Effects of Self-Myofascial Release and Dynamic Stretching on Range of Motion, Jump, Sprint, and Agility Performance. J Strength Cond Res. 2019 Jul;33(7):1795-1803. doi: 10.1519/JSC.0000000000002676.
• Sulowska I, Oleksy L, Mika A, Bylina D, Soltan J. The Influence of Plantar Short Foot Muscle Exercises on Foot Posture and Fundamental Movement Patterns in Long-Distance Runners, a Non-Randomized, Non-Blinded Clinical Trial. PLoS One. 2016 Jun 23;11(6):e0157917. doi: 10.1371/journal.pone.0157917. eCollection 2016.
• Soni J, Sawant S, Shah S. Efficacy of Core Stability Exercises and Intrinsic Foot Training on Patients With Flat Foot: A Comparative Study. Cureus. 2025 Oct 29;17(10):e95659. doi: 10.7759/cureus.95659. eCollection 2025 Oct.

Study record dates

Study Major Dates

• Study Start (Estimated): July 18, 2026
• Primary Completion (Estimated): August 14, 2026
• Study Completion (Estimated): August 14, 2026

Study Registration Dates

• First Submitted: June 17, 2026
• First Submitted That Met QC Criteria: June 17, 2026
• First Posted (Actual): June 24, 2026

Study Record Updates

• Last Update Posted (Actual): June 24, 2026
• Last Update Submitted That Met QC Criteria: June 17, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Functional Movement Screen; Pes Planus; Plantar Facia; Deep squat; Hurdle Step
• Additional Relevant MeSH Terms: Talipes; Musculoskeletal Diseases; Musculoskeletal Abnormalities; Congenital Abnormalities; Lower Extremity Deformities, Congenital; Limb Deformities, Congenital; Foot Deformities; Foot Deformities, Acquired; Foot Deformities, Congenital; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Flatfoot; Therapeutics; Complementary Therapies; Physical Therapy Modalities; Rehabilitation; Therapy, Soft Tissue; Musculoskeletal Manipulations; Massage; Myofascial Release Therapy
• Other Study ID Numbers: 2026-095

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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