Effects of Foot Core Exercises in Patients With Total Hip Arthroplasty

Condition(s) studied

Investigational drug(s) / intervention(s)

Hip Rehabilitation Exercise Program: 5 days per week, 40 minutes per session, for 12 weeks.

Foot-Core Exercise Program: 5 days per week, 40 minutes per session, for 12 weeks

Study summary

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.

Eligibility

Primary outcome measure(s)

• Ultrasonographic muscle thickness of foot and ankle periarticular structures — 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.
• Ultrasonographic cross-sectional area of foot and ankle periarticular structures — 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.
• Tone (frequency) of foot and ankle periarticular structures — 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
• Ultrasonographic tendon morphology of foot and ankle segments — 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.
• Stiffness of foot and ankle periarticular structures — 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
• The damping coefficient of foot and ankle periaticular structures — 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
• Relaxation time of foot and ankle periarticular structures — 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
• Creep parameters of foot and ankle periarticular structures — 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

Trial sites (1)

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