Pes PlanusNCT06707844
TF and MFR on Calf Muscles in Patients With Pes Planus
A study testing Conventional treatment, Myofascial release and Tissue flossing in people with Pes Planus, run by Riphah International University at 1 site in Pakistan.
Trial summary
Pes planus, commonly known as flat feet, is a condition characterized by a reduced or absent arch in the foot, which often leads to pain and functional limitations. This study aims to evaluate the effectiveness of two therapeutic interventions-tissue flossing and myofascial release-in improving balance, arch height… Read more about this study
- Who is it for?
- Ages 18 to 25 years
- Conditions the study is for
- Pes Planus
- What is being tested?
- Conventional treatment, Myofascial release and Tissue flossing
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Jan 2025to 29 Aug 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 25 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age 18-25 years.
- Having normal BMI ranging from 18.5 to 24.9 kg/m²
- Having flexible flat feet, defined as a navicular drop test value of ≥10 mm
- Must have pain in the calf muscles or ankle joint, with a NPRS score of ≥3
- Must have limited ankle dorsiflexion ROM, defined as ≤10° of dorsiflexion
Who cannot join
- Patients with rigid flatfoot
- History of ankle or calf muscle injury or surgery within the last 6 months
- Individuals with latex allergy
- Individuals having any lumbo-pelvic, hip, knee and ankle pathologies such as fractures, dislocations, degenerative diseases etc.
- Any neurological disease
- Pregnant females
Show all 9Show fewer
- Individuals with BMI greater than or equal to 25.0 kg/m²
- Ongoing use of medications such as muscle relaxants or anti-inflammatory drugs
- Involved in athletic training
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
Margalla Rehabilitation Center
Rawalpindi, Punjab Province, 46000
About this study
Official title: Comparison of Tissue Flossing and Myofascial Release on Calf Muscles in Patients With Pes Planus
Pes planus, commonly known as flat feet, is a condition characterized by a reduced or absent arch in the foot, which often leads to pain and functional limitations. This study aims to evaluate the effectiveness of two therapeutic interventions-tissue flossing and myofascial release-in improving balance, arch height, and range of motion (ROM) in patients with flexible flatfoot. The research will be conducted at the Margalla Rehabilitation Center over a duration of six months, involving a total of 44 participants divided into two equal groups. One group will receive tissue flossing as the intervention, while the other group will undergo myofascial release. Participants will be selected using non-probability convenience sampling. Eligible individuals will be adults aged 18-25 years with flexible pes planus and limited ankle dorsiflexion. The study seeks to provide valuable insights into the comparative effectiveness of these interventions for managing symptoms associated with flat feet. Data was be analyzed through SPSS version 25.
Read the detailed description
Pes planus, or flat feet, is characterized by a reduced or absent arch, causing the entire sole to contact the ground. It is categorized into flexible and rigid types, with flexible pes planus being more common. In this form, the arch is visible in non-weight-bearing positions but flattens during standing or walking, while rigid pes planus remains flat irrespective of weight-bearing. The condition often results in foot instability, excessive eversion, and midfoot abduction, leading to pain, fatigue, and reduced shock absorption during activities.
Flexible flatfoot is prevalent in children but can persist into adulthood, affecting 2% to 23% of adults in the U.S. and 13.6% in India. It disrupts gait mechanics, shifting weight medially, impairing balance, and increasing injury risk. Management ranges from conservative treatments like physical therapy to surgical interventions in severe cases.
Emerging therapies include tissue flossing and myofascial release (MFR). Tissue flossing uses compression bands to improve blood flow, reduce pain, and enhance range of motion (ROM). In contrast, MFR applies sustained pressure to relieve fascial tension, promoting flexibility and reducing discomfort. Both techniques show promise for addressing the biomechanical and functional impairments associated with pes planus.
Literature review: According to literature, Galis et al. (2022) performed a study that aimed to examine the effects of applying tissue flossing band at different pressure levels on ankle ROM, strength and power performance in university students. The results showed an increase in dorsiflexion ROM and power. Furthermore, the author concluded that this can aid injury prevention, performance enhancement, and functional ability.
In another study, Driller et al. (2016) conducted a study on the effects of tissue flossing on ankle ROM and jump performance in recreational athletes. The study concluded that applying floss bands to the ankle effectively increased both dorsiflexion and plantarflexion ROM and enhances single-leg jump performance in recreational athletes.
Similarly, Choi et al. (2022) conducted a study aimed at investigating the impact of myofascial release of the peroneus longus muscle on the activity of the abductor hallucis muscle and the medial longitudinal arch in individuals with flexible pes planus. The results showed an increase in abductor hallucis muscle activity and elevation of the medial longitudinal arch.
A study conducted by Chang et al. (2021) examined the effect of a single session of tissue flossing on the knee joint in female college students. The results showed a significant improvement with a medium-to-large effect in the Y-Balance test assessment immediately postintervention. He concluded that tissue flossing can indeed enhance dynamic balance.
- Conditions
- Pes Planus
- Being tested
- Conventional treatment, Myofascial release, Tissue flossing
- Keywords
- tissue flossing, Flatfeet, myofascial release, balance, arch height, range of motion
- Medical subject headings
- Flatfoot
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Conventional treatmentOther
Conventional treatment will include:
- Stretching exercises (5Reps with 15sec hold): Gastrocnemius-soleus stretch, TA stretch.
- Strengthening exercises (5Sets, 5Reps, 5sec hold): Weight-bearing lunges, Short-foot exercise.
- Maitland mobilization Grade 2 \& 3 (3 Sets, 20Reps) at Talonavicular joint.
Myofascial releaseOther
- Myofascial release is a manual therapy applying sustained pressure on the calf muscles to release fascial restrictions.
- Protocol: 3 sets of 2-minute pressure applications with a 1-minute break between sets
- Performed twice weekly for 3 weeks
Tissue flossingOther
Tissue flossing involves wrapping a latex band around the calf muscles with 50-75% elongation, followed by active ankle movements (dorsiflexion, plantarflexion, circles, heel raises).
Protocol: 4 sets of 8 repetitions, 10-second rest between sets Performed twice weekly for 3 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Tissue flossing | Experimental | * Tissue flossing involves wrapping a latex band around the calf muscles with 50-75% elongation, followed by active ankle movements (dorsiflexion, plantarflexion, circles, heel raises).
* Protocol: 4 sets of 8 repetitions, 10-second rest between sets
* Performed twice weekly for 3 weeks.
Conventional Treatment Receives: Other: Conventional treatment; Other: Tissue flossing |
| Myofascial release | Active comparator | * Myofascial release is a manual therapy applying sustained pressure on the calf muscles to release fascial restrictions.
* Protocol: 3 sets of 2-minute pressure applications with a 1-minute break between sets
* Performed twice weekly for 3 weeks
Conventional Treatment Receives: Other: Conventional treatment; Other: Myofascial release |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale (NPRS)
This tool will be used to assess pain intensity, at baseline, 2nd week and 3rd week post treatment
Measured: 3 weeks
Secondary outcomes (4)
Digital Goniometer
It will be used for the measurement of ankle range of motion. Changes from baseline, 2nd week and 3rd week will be taken.
Measured: 3 weeks
Brody's Navicular Drop Test
It will be used for the measurement of navicular drop. It is the one of the static foot assessment tools and is intended to represent the displacement of the navicular tuberosity from a neutral position. Measurements taken at baseline, 2nd week and 3rd week
Measured: 3 weeks
Single-Leg Stance Test
It will be used to assess each patient's static balance with their eyes open and arms on hips. Good static balance is indicated by participant's ability to maintain position for atleast 30 seconds. Test will be repeated 3 times and average will be taken. measurements will be taken at baseline, 2nd week and 3rd week.
Measured: 3 weeks
Y-Balance test
It will be used for dynamic balance assessment. Patient is asked to stand on one leg while reaching out in 3 different directions (anterior, posteromedial and posterolateral) with the other lower extremity.
Measured: 3 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Nov 2024
- Study start1 Jan 2025
- Primary completion28 Aug 2025
- Study completion29 Aug 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Pes PlanusStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 44 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Aneela Zia, MsOMPT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06707844
- Sponsor's protocol ID
- REC/MS-PT/02019 Arfa Zafar
- Status last verified
- Aug 2026
- First submitted
- 25 Nov 2024
- Last updated
- 7 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
1. R A, Malar A, J H, G S. The cause and frequency of PES Planus (Flat Foot) problems among young adults. Asian Journal of Medical Sciences. 2021;12(7):107-11.
Study at a glance
From the registry record, last updated by the sponsor on 7 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Tissue Flossing and Myofascial Release on Calf Muscles in Patients With Pes Planus
- ClinicalTrials.gov ID
- NCT06707844
- Acronym / sponsor ID
- REC/MS-PT/02019 Arfa Zafar
- Conditions
- Pes Planus
- Keywords
- tissue flossing, Flatfeet, myofascial release, balance, arch height, range of motion
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 44 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 1 Jan 2025 (actual)
- Primary completion
- 28 Aug 2025 (actual)
- Study completion
- 29 Aug 2025 (actual)
- First posted
- 27 Nov 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Pes planus, commonly known as flat feet, is a condition characterized by a reduced or absent arch in the foot, which often leads to pain and functional limitations. This study aims to evaluate the effectiveness of two therapeutic interventions-tissue flossing and myofascial release-in improving balance, arch height, and range of motion (ROM) in patients with flexible flatfoot. The research will be conducted at the Margalla Rehabilitation Center over a duration of six months, involving a total of 44 participants divided into two equal groups. One group will receive tissue flossing as the intervention, while the other group will undergo myofascial release. Participants will be selected using non-probability convenience sampling. Eligible individuals will be adults aged 18-25 years with flexible pes planus and limited ankle dorsiflexion. The study seeks to provide valuable insights into the comparative effectiveness of these interventions for managing symptoms associated with flat feet. Data was be analyzed through SPSS version 25.
Detailed description
Pes planus, or flat feet, is characterized by a reduced or absent arch, causing the entire sole to contact the ground. It is categorized into flexible and rigid types, with flexible pes planus being more common. In this form, the arch is visible in non-weight-bearing positions but flattens during standing or walking, while rigid pes planus remains flat irrespective of weight-bearing. The condition often results in foot instability, excessive eversion, and midfoot abduction, leading to pain, fatigue, and reduced shock absorption during activities.
Flexible flatfoot is prevalent in children but can persist into adulthood, affecting 2% to 23% of adults in the U.S. and 13.6% in India. It disrupts gait mechanics, shifting weight medially, impairing balance, and increasing injury risk. Management ranges from conservative treatments like physical therapy to surgical interventions in severe cases.
Emerging therapies include tissue flossing and myofascial release (MFR). Tissue flossing uses compression bands to improve blood flow, reduce pain, and enhance range of motion (ROM). In contrast, MFR applies sustained pressure to relieve fascial tension, promoting flexibility and reducing discomfort. Both techniques show promise for addressing the biomechanical and functional impairments associated with pes planus.
Literature review: According to literature, Galis et al. (2022) performed a study that aimed to examine the effects of applying tissue flossing band at different pressure levels on ankle ROM, strength and power performance in university students. The results showed an increase in dorsiflexion ROM and power. Furthermore, the author concluded that this can aid injury prevention, performance enhancement, and functional ability.
In another study, Driller et al. (2016) conducted a study on the effects of tissue flossing on ankle ROM and jump performance in recreational athletes. The study concluded that applying floss bands to the ankle effectively increased both dorsiflexion and plantarflexion ROM and enhances single-leg jump performance in recreational athletes.
Similarly, Choi et al. (2022) conducted a study aimed at investigating the impact of myofascial release of the peroneus longus muscle on the activity of the abductor hallucis muscle and the medial longitudinal arch in individuals with flexible pes planus. The results showed an increase in abductor hallucis muscle activity and elevation of the medial longitudinal arch.
A study conducted by Chang et al. (2021) examined the effect of a single session of tissue flossing on the knee joint in female college students. The results showed a significant improvement with a medium-to-large effect in the Y-Balance test assessment immediately postintervention. He concluded that tissue flossing can indeed enhance dynamic balance.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Tissue flossing | Experimental | Other: Conventional treatment, Other: Tissue flossing* Tissue flossing involves wrapping a latex band around the calf muscles with 50-75% elongation, followed by active ankle movements (dorsiflexion, plantarflexion, circles, heel raises). * Protocol: 4 sets of 8 repetitions, 10-second rest between sets * Performed twice weekly for 3 weeks. Conventional Treatment |
| Myofascial release | Active comparator | Other: Conventional treatment, Other: Myofascial release* Myofascial release is a manual therapy applying sustained pressure on the calf muscles to release fascial restrictions. * Protocol: 3 sets of 2-minute pressure applications with a 1-minute break between sets * Performed twice weekly for 3 weeks Conventional Treatment |
Who may qualify
- Ages
- 18 to 25 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Age 18-25 years.
- Having normal BMI ranging from 18.5 to 24.9 kg/m²
- Having flexible flat feet, defined as a navicular drop test value of ≥10 mm
- Must have pain in the calf muscles or ankle joint, with a NPRS score of ≥3
- Must have limited ankle dorsiflexion ROM, defined as ≤10° of dorsiflexion
Key exclusion criteria (9 listed)
- Patients with rigid flatfoot
- History of ankle or calf muscle injury or surgery within the last 6 months
- Individuals with latex allergy
- Individuals having any lumbo-pelvic, hip, knee and ankle pathologies such as fractures, dislocations, degenerative diseases etc.
- Any neurological disease
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Conventional treatmentConventional treatment will include: * Stretching exercises (5Reps with 15sec hold): Gastrocnemius-soleus stretch, TA stretch. * Strengthening exercises (5Sets, 5Reps, 5sec hold): Weight-bearing lunges, Short-foot exercise. * Maitland mobilization Grade 2 \& 3 (3 Sets, 20Reps) at Talonavicular joint. | Other | Myofascial release, Tissue flossing |
| Myofascial release* Myofascial release is a manual therapy applying sustained pressure on the calf muscles to release fascial restrictions. * Protocol: 3 sets of 2-minute pressure applications with a 1-minute break between sets * Performed twice weekly for 3 weeks | Other | Myofascial release |
| Tissue flossingTissue flossing involves wrapping a latex band around the calf muscles with 50-75% elongation, followed by active ankle movements (dorsiflexion, plantarflexion, circles, heel raises). Protocol: 4 sets of 8 repetitions, 10-second rest between sets Performed twice weekly for 3 weeks. | Other | Tissue flossing |
Primary outcome
Numeric Pain Rating Scale (NPRS)
Time frame: 3 weeks
This tool will be used to assess pain intensity, at baseline, 2nd week and 3rd week post treatment
4 secondary outcomes
Digital Goniometer
Time frame: 3 weeks
Brody's Navicular Drop Test
Time frame: 3 weeks
Single-Leg Stance Test
Time frame: 3 weeks
Y-Balance test
Time frame: 3 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Aug 2026.
- Background1. R A, Malar A, J H, G S. The cause and frequency of PES Planus (Flat Foot) problems among young adults. Asian Journal of Medical Sciences. 2021;12(7):107-11.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Aneela Zia, MsOMPT principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Conventional treatment, Myofascial release and Tissue flossing in people with Pes Planus, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale (NPRS) (time frame: 3 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06707844, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Aug 2026.