Comparison of the effects on foot function, walking distance, pain when standing and pain during walking after low load versus high load exercise in hallux valgus : a pilot randomized controlled trial

Sammanfattning

Background: Hallux valgus (HV) is a common foot deformity. Conservative treatments with a multidisciplinary approach including exercise are recommended. However, there is no consensus regarding the training regimen. This study aims to evaluate the design of an upcoming RCT comparing foot function, walking distance, pain when standing, and pain during walking after a training period with digitally supervised high-load versus low-load exercise for individuals with mild to moderate hallux valgus. Method: Twenty-one participants with mild or moderate HV were randomly assigned to a low-load exercise group (LLEG) or a high-load exercise group (HLEG). Both groups received supervised follow-up via video calls once a week. The LLEG performed exercises twice per day for eight weeks. The HLEG started performing exercises twice daily for four weeks. With increased intensity, they switched to training three times per week for the remaining four weeks. Study design evaluation included training compliance and participant feedback from evaluation questionnaire. Further, the 6-minute walk test, pain when standing and walking, and the self-reported Foot and Ankle Score were compared between groups before and after the training period. The study is conducted in collaboration with another physiotherapist evaluating additional outcomes in a parallel study. Results: Participant feedback was positive, indicating contentment with the study design, and training compliance was satisfactory in both groups. Preliminary results suggest that digitally supervised exercise may reduce pain and improve self-reported foot function in individuals with hallux valgus, although no significant differences were observed between the LLEG and HLEG. Conclusion: This study design provides a foundation for a larger RCT. Although no significant differences between the training intensities were found, the findings indicate that digitally supervised exercise could be a promising approach for managing hallux valgus. Given the ceiling effects of the 6MWT in this population, a more challenging test may be preferable. Future studies with a more impaired participants and a placebo control group, could clarify the results and identify the most effective exercise regimen for hallux valgus.