Kinetic Control Versus Dynamic Taping on First Metatarsophalangeal Joint in Athletes With Functional Hallux Limitus

Official title

Kinetic Control Versus Dynamic Taping on First Metatarsophalangeal Joint Performance and Injury Prevention in Athletes With Functional Hallux Limitus: A Randomized Controlled Trial

Overview

This study is conducted to investigate and compare the effect of adding either kinetic control retraining or dynamic taping to the standard treatment program on first metatarsophalangeal joint dorsiflexion active range of motion, first metatarsophalangeal joint dorsiflexion strength, forefoot strike pattern running, vertical jump performance, and lower limb injury prevention in intermediate-professional level indoor sports athletes with functional hallux limitus.

Detailed description

this study will be conducted, using valid and reliable methods and instrumentations, to evaluate and compare the effect of adding either kinetic control retraining or dynamic taping to the standard treatment program on first metatarsophalangeal joint dorsiflexion active range of motion, first metatarsophalangeal joint dorsiflexion strength, forefoot strike pattern running, vertical jump performance and lower limb injury prevention in indoor sports athletes with functional hallux limitus. This may add a new hope to decrease the rate of injuries occurrence or recurrence which will diminish financial expenses and lengthen athletes' competitiveness time in courts.

Interventions

• Other the standard treatment
  The text details therapeutic techniques for managing first metatarsophalangeal joint (1stMTPJ) issues, including: 1) First MTPJ Manipulation with Grade IV mobilization and thrusts; 2) Subtalar Manipulation to improve mobility; 3) 1stMTPJ Mobilization through Grade III dorsal glides; 4) Sesamoid Mobilization involving rhythmic oscillations; 5) Strengthening Exercises conducted three times daily to enhance stability; 6) Flexibility Exercises for related muscle groups; and 7) Sham Taping to simulat
• Other Dynamic taping
  Athletes will receive a briefing on the taping procedure before it starts, with the option for private administration. The functional correction technique is to be applied to limit first metatarsophalangeal joint plantar flexion. This involves measuring and applying an I-shaped strip of tape from the plantar surface over the toenail to the first metatarsophalangeal joint, ensuring no tension at the joint's base. The athlete's toe should be positioned in maximum plantar flexion while severe tensi
• Other kinetic control
  kinetic control retraining emphasizes achieving ideal lower limb (LL) sagittal alignment to activate the kinetic chain from hip to foot. Key exercises include maintaining correct femur alignment, controlling knee movement, and focusing on eccentric control of various muscle groups. Specific routines target hip (glutes), knee (popliteus), and ankle/foot levels (tibialis posterior, anterior, soleus, peroneus brevis) to enhance stability and extensibility. Mobilization strategies address extensibil

Primary outcome measures

• Assessment of active range of motion of the First metatarsophalangeal joint dorsiflexion [Time frame: (pre-intervention) and after 4 weeks (post-intervention)]
• Assessment of muscle strength of the First metatarsophalangeal joint dorsiflexion [Time frame: (pre-intervention) and after 4 weeks (post-intervention)]
• Forefoot running (step length, speed and propulsion rate) [Time frame: (pre-intervention) and after 4 weeks (post-intervention)]
• Vertical jumping performance (flight time, vertical jump height, and takeoff velocity) [Time frame: (pre-intervention) and after 4 weeks (post-intervention)]

Eligibility criteria

Inclusion criteria

• Ninety male and female indoor sports' athletes at intermediate to professional level of indoor sports.
• Athletes aged from 18 to 35 years.
• Body Mass Index ranged from 22.5- 28 kg/cm2.
• Athletes with a habitual Fore Foot Strike Pattern by determining foot strike angle using Insole Pressure Sensors.
• Athletes with less than 37° of the first metatarsophalangeal joint dorsiflexion active range of motion using a Digital Goniometer (Positive Jack test).
• Athletes with less than 50° of the first metatarsophalangeal joint dorsiflexion active range of motion using a Digital Goniometer. (Positive flexor hallucis longus stretch text).
• Athletes with at least a 1.8-kg (4-lb) difference in first metatarsophalangeal joint dorsiflexion strength as compared to the opposite side using hand-held dynamometer.
• Athletes with pinch calluses, hyperkeratotic skin lesions identified by palpation on the medial surface of the affected first metatarsophalangeal joint (not the metatarsal head).
• Athlete's shoes must be with a minimal or no heel to toe drop design to facilitate Fore Foot Strike Pattern as Foot Strike Patterns may be facilitated partly by the shoe wear type.
• If any athlete changes the running shoes, it must be a safe transition for a few weeks to few months, to avoid injuries (stress fractures) or performance alteration.

Exclusion criteria

• Athletes with other habitual foot strike patterns rather than a forefoot strike pattern.
• Any limitation to the first metatarsophalangeal joint dorsiflexion active range of motion while resting plantar flexion position of the ankle.
• Athletes shoes that are cushioned with a high heel-to-toe drop which encourages Rearfoot Strike Pattern as foot strike patterns may be facilitated partly by the type of shoe wear.
• History of musculoskeletal system disorders (spine deformities, disc pathologies, orthopedic contractures, or osseous deformities such as: Sheperds fracture, Large steidas process, Ostrigonum Cysts and dorsal talar exostosis.
• History of surgeries in the last six months.
• History of neurological disorders.
• Any preexisting injury that may become exacerbated or made worse with participation.
• History of contact dermatitis or cutaneous adverse reaction to Dynamic Tape.
• Radiological signs as first metatarsophalangeal joint head alterations, dorsal or lateral spurs, and bunion formation, as mostly radiographs of Functional Hallux Limitus are normal and these signs are more relevant to hallux rigidus which will not be evaluated in this study.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Treatment

Study locations

Egypt · 1 center

• Fatemah M. Alboraei — Cairo

Identifiers

NCT: NCT07692113 · P.T.REC/012/006173

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗