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Effects of Foot Core Exercises in Patients With Total Hip Arthroplasty

17 de junho de 2026 atualizado por: Melike Naz Gürel, Hacettepe University

Investigation of the Effects of Foot Core Exercises on Lower Extremity Muscle Strength, Functional Parameters, and Morphological and Viscoelastic Properties of Foot and Ankle Periarticular Structures in Patients With Total Hip Arthroplasty

The goal of this clinical trial is to investigate the effects of foot core exercises on lower extremity muscle strength, viscoelastic properties, functional parameters, foot and ankle posture, balance, and the morphological characteristics of periarticular structures of the foot and ankle in individuals with total hip arthroplasty. The main questions it aims to answer are:

  • Does foot core exercises affect morphological characteristics of the periarticular structures surrounding the foot and ankle?
  • Does foot core exercises affect viscoelastic properties of the periarticular structures surrounding the foot and ankle?
  • Does foot core exercises affect lower extremity muscle strength?
  • Does foot core exercises affect lower extremity functional parameters and balance in individuals with total hip arthroplasty?

The researchers will compare the group performing foot core exercises with the group performing routine hip exercises that do not include foot core exercises.

Participitants will:

  • Participants will receive an exercise log after a specialist physiotherapist demonstrates the exercises in practice at the third postoperative mounth.
  • Visit the clinic every two months from postoperative mounth 3 to month 7 for routine follow-ups and progression of exercises.
  • Except for the control sessions held every two mounths, patients will be followed up through weekly phone calls.
  • Participants will complete an exercise diary indicating that they performed the exercises prescribed for each week, and they will bring their diaries with them to the follow-up sessions.

Visão geral do estudo

Status

Recrutamento

Condições

Intervenção / Tratamento

Tipo de estudo

Intervencional

Inscrição (Estimado)

50

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Estude backup de contato

Locais de estudo

  • Turquia (Türkiye)
    • Altındağ
      • Ankara, Altındağ, Turquia (Türkiye)
        • Recrutamento
        • Hacettepe University

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  • Being between 50 and 80 years old,
  • Having at least 2 months elapsed since total hip arthroplasty surgery,
  • Being willing to participate in the study,
  • Being literate.

Exclusion Criteria:

  • Having undergone revision total hip arthroplasty surgery,
  • Having a cognitive level below 21 on the MoCA scale, or having any neurological or rheumatological disease,
  • Inability to ambulate,
  • Having any history of lower extremity trauma or other surgical procedures,
  • Having toe-related pathologies that may affect pressure distribution and the course of exercise, such as hallux valgus or Morton's neuroma.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Triplo

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Comparador Ativo: Hip Exercise Only Group
Hip Rehabilitation Exercise Program
Outro: Hip Rehabilitation Exercise Program
5 days per week, 40 minutes per session, for 12 weeks.
Experimental: Hip exercise plus Foot Core exercise group
Hip Rehabilitation Exercise Program with Foot-Core Exercise Program
Outro: Hip Rehabilitation Exercise Program
5 days per week, 40 minutes per session, for 12 weeks.
Outro: Foot-Core Exercise Program
5 days per week, 40 minutes per session, for 12 weeks
Outros nomes:
  • Intervenção de exercício

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Ultrasonographic muscle thickness of foot and ankle periarticular structures
Prazo: From enrollment to the end of treatment at 12 weeks
The muscle thickness of the foot and ankle periarticular structures will be evaluated using ultrasonography. Ultrasonographic examinations will be performed in accordance with the EURO-MUSCULUS/USPRM foot and ankle protocols (26, 27), using a Clarius ultrasound system (Clarius Mobile Health, 205-2980 Virtual Way, Vancouver, British Columbia, Canada) and a 4-13 MHz linear transducer. All measurements will be conducted by researchers who have received training in ultrasonographic imaging.
From enrollment to the end of treatment at 12 weeks
Ultrasonographic cross-sectional area of foot and ankle periarticular structures
Prazo: From enrollment to the end of treatment at 12 weeks
The muscle cross-sectional area of the foot and ankle periarticular structures will be evaluated using ultrasonography. Ultrasonographic examinations will be performed in accordance with the EURO-MUSCULUS/USPRM foot and ankle protocols (26, 27), using a Clarius ultrasound system (Clarius Mobile Health, 205-2980 Virtual Way, Vancouver, British Columbia, Canada) and a 4-13 MHz linear transducer. All measurements will be conducted by researchers who have received training in ultrasonographic imaging.
From enrollment to the end of treatment at 12 weeks
Tone (frequency) of foot and ankle periarticular structures
Prazo: From enrollment to the end of treatment at 12 weeks
The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the muscle tone (frequency) (F) of the gastrocnemius medialis (GM),gastrocnemius lateralis (GL) , tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). Frequency (F) characterizes muscle tone and is reffered as Hz (Hertz). All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement
From enrollment to the end of treatment at 12 weeks
Ultrasonographic tendon morphology of foot and ankle segments
Prazo: From enrollment to the end of treatment at 12 weeks
The tendon morphology of the foot and ankle muscles will be evaluated using ultrasonography. Ultrasonographic examinations will be performed in accordance with the EURO-MUSCULUS/USPRM foot and ankle protocols (26, 27), using a Clarius ultrasound system (Clarius Mobile Health, 205-2980 Virtual Way, Vancouver, British Columbia, Canada) and a 4-13 MHz linear transducer. All measurements will be conducted by researchers who have received training in ultrasonographic imaging.
From enrollment to the end of treatment at 12 weeks
Stiffness of foot and ankle periarticular structures
Prazo: From enrollment to the end of treatment at 12 weeks
The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the stiffness (S) of the gastrocnemius medialis (GM),gastrocnemius lateralis (GL) , tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). Stiffness (S) reflects the resistance of tissue to an external force that changes its shape and is reffered as N/m (Newton/metre). All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement
From enrollment to the end of treatment at 12 weeks
The damping coefficient of foot and ankle periaticular structures
Prazo: From enrollment to the end of treatment at 12 weeks
The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the the damping coefficient (D) of gastrocnemius, tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). The damping coefficient (D) characterizes elasticity. All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement
From enrollment to the end of treatment at 12 weeks
Relaxation time of foot and ankle periarticular structures
Prazo: From enrollment to the end of treatment at 12 weeks
The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the Rr relaxation time of the gastrocnemius, tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). The relaxation time (R) of is reffered as mechanical stress and is shown as ms (milliseconds). All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement
From enrollment to the end of treatment at 12 weeks
Creep parameters of foot and ankle periarticular structures
Prazo: From enrollment to the end of treatment at 12 weeks
The MyotonPro device (Myoton AS, Estonia) will be used to evaluate the creep (C) parameters of the gastrocnemius, tibialis anterior (TA), peroneus longus (PL) muscles, the Achilles tendon (AT), and the plantar fascia (PF). Creep (C) is defined by the ratio of relaxation time to deformation time. All measurements will be performed on both extremities. To ensure standardization, appropriate anatomical reference points for each structure will be marked prior to measurement
From enrollment to the end of treatment at 12 weeks

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Evaluation of lower extremity alignment
Prazo: From enrollment to the end of treatment at 12 weeks
Lower extremity alignment will be assessed by calculating the Q angle. To evaluate the Q angle, participants will be asked to lie in the supine position with the knee joint in full extension. The Q angle will be measured using a goniometer as the angle formed between a line drawn from the anterior superior iliac spine (ASIS) to the midpoint of the patella and a line drawn from the midpoint of the patella to the tibial tuberosity, and the values will be recorded
From enrollment to the end of treatment at 12 weeks
Navicular height during weight-bearing condition
Prazo: From enrollment to the end of treatment at 12 weeks
It is a widely used test for evaluating foot biomechanics disorders and related musculoskeletal problems, used to assess foot arch structure and pronation level (38). The navicular height will be measured in a barefoot full weight-bearing position. The vertical distance between the navicular tuberosity and the ground will be assessed.
From enrollment to the end of treatment at 12 weeks
Assessment of Hip Flexor Muscle Strength
Prazo: From enrollment to the end of treatment at 12 weeks
Hip flexion muscle strength will be assessed using a hand-held dynamometer (Lafayette Instrument, Lafayette, IN). The maximal isometric strength will be recorded as Newton (N)
From enrollment to the end of treatment at 12 weeks
Assessment of Balance
Prazo: From enrollment to the end of treatment at 12 weeks
Functional mobility and dynamic balance will be assessed using the Timed Up and Go (TUG) test. It is a simple and reliable test that is frequently used in older adults to assess an individual's mobility, balance, walking ability, and risk of falling. The Time Up Go test is commonly used in individuals who have undergone total hip arthroplasty, and it has been shown to have high test-retest reliability and good construct validity in this population
From enrollment to the end of treatment at 12 weeks
Assessment of Hip Functional Status
Prazo: From enrollment to the end of treatment at 12 weeks
Hip functional status will be assessed using the Hip Outcome Score. This questionnaire consists of four main parameters assessing pain, functional status in various activities (limping, use of support, walking distance, stair climbing, putting on/taking off socks, sitting, and using public transportation), absence of deformity, and range of motion. Each parameter includes items that evaluate the respective domain, and each response option is assigned a corresponding score. At the end of the questionnaire, these scores are summed to obtain a total score. The questionnaire is scored on a scale from 0 to 100, where 90-100 is classified as excellent, 80-89 as good, 70-79 as moderate, and scores below 70 as poor.
From enrollment to the end of treatment at 12 weeks
Ankle Mobility Measurement
Prazo: From enrollment to the end of treatment at 12 weeks
Ankle mobility will be measured using a fluid-filled inclinometer and the weight-bearing lunge test (knee-to-wall test). The knee-to-wall test is a valid and reliable test that assesses joint range of motion in the closed kinetic chain of the lower extremity and provides a passive measure of ankle dorsiflexion range of motion
From enrollment to the end of treatment at 12 weeks
Assessment of Foot Posture
Prazo: From enrollment to the end of treatment at 12 weeks
Foot posture will be assessed using the Foot Posture Index in a relaxed standing position, based on six criteria related to the rearfoot and forefoot. Each criterion will be scored on a scale from -2 to +2. Negative values indicate supination, while positive values indicate pronation. Total score represents overall foot posture
From enrollment to the end of treatment at 12 weeks
Assessment of Kinesiophobia
Prazo: From enrollment to the end of treatment at 12 weeks
The individuals' fear of movement or avoidance will be assessed using the Tampa Scale for Kinesiophobia (TSK). The TSK is a valid and reliable measure used to evaluate fear of physical activity and fear-avoidance beliefs related to movement. The scale is appropriate for use in individuals who have undergone total hip arthroplasty. This scale consists of 17 items rated on a 4-point Likert scale ranging from "strongly disagree" to "strongly agree." During scoring, items 4, 8, 12, and 16 are reverse scored, and a total score is then calculated. The total score ranges from 17 to 68. A score of 17 indicates no kinesiophobia, while a score of 68 indicates severe fear of movement. The cut-off value of the scale is 37; scores above 37 are considered to indicate high levels of kinesiophobia.
From enrollment to the end of treatment at 12 weeks
Assessment of the Ability to Forget the Artificial Joint
Prazo: From enrollment to the end of treatment at 12 weeks
The validated Forgotten Joint Score Questionnaire (FJS-12) will be used to evaluate patients' return to daily life activities following treatment. The FJS-12 is a questionnaire consisting of 12 items that assesses joint awareness during activities of daily living using a 5-point Likert scale. For scoring, all responses are summed and divided by the total number of answered items. The resulting mean value is multiplied by 25 to transform the score to a 0-100 scale, and then subtracted from 100. Higher scores indicate the extent to which the patient is able to forget the operated side (%), reflecting better adaptation to activities of daily living.
From enrollment to the end of treatment at 12 weeks
Assessment of Fear of Falling and Confidence in Avoiding Falls
Prazo: From enrollment to the end of treatment at 12 weeks
The International Falls Efficacy Scale (FES-I) will be used to measure the participants' confidence in performing activities of daily living without fear of falling.The FES-I consists of 16 items that assess individuals' confidence in their ability to perform activities. Participants rate each item on a scale from 1 ("no concern at all") to 4 ("very concerned"), resulting in a total score ranging from 16 to 64. Higher scores indicate lower self-confidence in performing daily activities without falling
From enrollment to the end of treatment at 12 weeks
Assessment of Quality of Life
Prazo: From enrollment to the end of treatment at 12 weeks
The SF-12 questionnaire will be used to assess participants' quality of life. In the literature, it has been used to measure the quality of life in patients who have undergone hip arthroplasty. The SF-12 consists of 12 items in total, covering questions related to two main domains: physical health and mental health. The questionnaire is scored using computer-based scoring algorithms, and higher scores indicate better health status. With this algorithm, physical health and mental health scores are calculated separately
From enrollment to the end of treatment at 12 weeks
Navicular height during non-weight-bearing condition
Prazo: From enrollment to the end of treatment at 12 weeks
It is a widely used test for evaluating foot biomechanics disorders and related musculoskeletal problems, used to assess foot arch structure and pronation level (38). The navicular height will be measured in a non-weight-bearing position. The vertical distance between the navicular tuberosity and the ground will be assessed.
From enrollment to the end of treatment at 12 weeks
Navicular drop
Prazo: From enrollment to the end of treatment at 12 weeks
It is a widely used test for evaluating foot biomechanics disorders and related musculoskeletal problems, used to assess foot arch structure and pronation level (38). Navicular drop will be calculated by subtracting the navicular height measured during weight-bearing from the navicular height measured during non-weight-bearing condition.
From enrollment to the end of treatment at 12 weeks
Assessment of Hip Extensor Muscle Strength
Prazo: From enrollment to the end of treatment at 12 weeks
Hip extensor muscle strength will be assessed using a hand-held dynamometer (Lafayette Instrument, Lafayette, IN). The maximal isometric strength will be recorded as Newton (N)
From enrollment to the end of treatment at 12 weeks
Assessment of Hip Abductor Muscle Strength
Prazo: From enrollment to the end of treatment at 12 weeks
Hip abductor muscle strength will be assessed using a hand-held dynamometer (Lafayette Instrument, Lafayette, IN). The maximal isometric strength will be recorded as Newton (N)
From enrollment to the end of treatment at 12 weeks
Assessment of Hip Adductor Muscle Strength
Prazo: From enrollment to the end of treatment at 12 weeks
Hip a dductor muscle strength will be assessed using a hand-held dynamometer (Lafayette Instrument, Lafayette, IN). The maximal isometric strength will be recorded as Newton (N)
From enrollment to the end of treatment at 12 weeks
Assessment of Knee Flexor Muscle Strength
Prazo: From enrollment to the end of treatment at 12 weeks
Knee flexor muscle strength will be assessed using a hand-held dynamometer (Lafayette Instrument, Lafayette, IN). The maximal isometric strength will be recorded as Newton (N)
From enrollment to the end of treatment at 12 weeks
Assessment of Knee Extensor Muscle Strength
Prazo: From enrollment to the end of treatment at 12 weeks
Knee extensor muscle strength will be assessed using a hand-held dynamometer (Lafayette Instrument, Lafayette, IN). The maximal isometric strength will be recorded as Newton (N)
From enrollment to the end of treatment at 12 weeks
Assessment of Ankle Dorsiflexor Muscle Strength
Prazo: From enrollment to the end of treatment at 12 weeks
Ankle Dorsiflexor muscle strength will be assessed using a hand-held dynamometer (Lafayette Instrument, Lafayette, IN). The maximal isometric strength will be recorded as Newton (N)
From enrollment to the end of treatment at 12 weeks
Assessment of Ankle Plantar Flexor Muscle Strength
Prazo: From enrollment to the end of treatment at 12 weeks
Ankle plantar flexor muscle strength will be assessed using a hand-held dynamometer (Lafayette Instrument, Lafayette, IN). The maximal isometric strength will be recorded as Newton (N)
From enrollment to the end of treatment at 12 weeks
Assessment of Intrinsic Foot Muscle Strength
Prazo: From enrollment to the end of treatment at 12 weeks
Intrinsic foot muscle muscle strength will be assessed using a hand-held dynamometer (Lafayette Instrument, Lafayette, IN). The maximal isometric strength will be recorded as Newton (N)
From enrollment to the end of treatment at 12 weeks
Assessment of Lower Extremity Function
Prazo: From enrollment to the end of treatment at 12 weeks
Lower extremity function will be assessed using the Lower Extremity Function Score (LEFS). It consists of 20 questions related to activities of daily living. It is used by clinicians to assess patients' baseline, progressive, and final functional status. It allows evaluation of deteriorating functional capacity in patients. For each row, the degree of ability to perform the specified function is scored from 0 to 4 across columns (0 = extreme difficulty or inability to perform the activity, 4 = no difficulty at all). The maximum possible score is 80. In our study, the LEFS (%) was calculated as: (LEFS score / 80) × 100. A low score indicates severe functional limitation, whereas a high score indicates good functional status. The minimal clinically important difference for the scale score is 9.
From enrollment to the end of treatment at 12 weeks

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Hacettepe University

Investigadores

  • Diretor de estudo: Gürsoy Coşkun, PT, PhD, Prof., Hacettepe University

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

23 de março de 2026

Conclusão Primária (Estimado)

3 de maio de 2027

Conclusão do estudo (Estimado)

31 de maio de 2027

Datas de inscrição no estudo

Enviado pela primeira vez

7 de junho de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

17 de junho de 2026

Primeira postagem (Real)

24 de junho de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

24 de junho de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

17 de junho de 2026

Última verificação

1 de junho de 2026

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Outros números de identificação do estudo

  • FTREK26/20

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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