Pronated FootNCT06955039
Effects of Sand Exercise Program On Foot Posture , Navicular Drop and Dynamic Balance in Children With Pronated Foot
A study testing Sand Activites, Towel Curl Exercises and (TCE) in people with Pronated Foot, run by Riphah International University at 1 site in Pakistan.
Trial summary
This randomized controlled trial investigates the effects of combining sand training with navicular drop interventions on foot posture and dynamic balance in children aged 6-11 with pronated feet. Pronated foot posture, marked by inward foot rolling and a lowered arch, can impair gait and balance. Read more about this study
- Who is it for?
- Ages 6 to 11 yearsHealthy volunteers can take part
- Conditions the study is for
- Pronated Foot
- What is being tested?
- Sand Activites, Towel Curl Exercises and (TCE)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 1 sitePakistan
- Study dates
- 17 Apr 2025to 18 Jun 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 6 to 11 years
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Children aged [6-11] years with bilateral pronated feet.
- Both gender
- No recent foot injury or lower extremity pain from last six months
- Has no history of foot and ankle surgery lifetime
- All eligible children were assessed with the Feiss line method
Who cannot join
- the presence of pain in the foot at the time of physical examination
- injury to the lower limbs, such as musculoskeletal injuries, during the previous 6 months congenital structural abnormalities, cerebral palsy, motor dysfunction prior surgery affecting the foot
Trial locations and contacts
1 site in 1 country.
About this study
This randomized controlled trial investigates the effects of combining sand training with navicular drop interventions on foot posture and dynamic balance in children aged 6-11 with pronated feet. Pronated foot posture, marked by inward foot rolling and a lowered arch, can impair gait and balance. Early intervention is key to preventing long-term issues. Twenty participants will be divided into experimental and control groups. Over eight weeks, the experimental group will perform sand and towel curl exercises, while the control group will do towel curls only. Foot posture, navicular drop, and balance will be assessed using the FPI-6, Navicular Drop Test, Y Balance Test, and Feiss Line Test at baseline, 4 weeks, and 8 weeks. The study aims to evaluate the added benefits of sand training in improving pediatric foot health.
Read the detailed description
The effects of sand training exercises combined with navicular drop interventions on dynamic balance and foot posture in children aged 6 to 11 years with pronated feet. Pronated foot posture, characterized by the inward rolling of the foot and a lowered medial arch, is prevalent in pediatric populations and can lead to altered gait mechanics and reduced dynamic balance. Early intervention is crucial to prevent long-term deformities and improve overall foot health. The study aims to provide evidence-based insights into the benefits of integrating proprioceptive training with specific sand exercises program targeting the navicular bone, thereby enhancing foot posture and dynamic balance in affected children.
This randomized controlled trial (RCT) will involve 20 participants divided into an experimental group and a control group to assess the effects of an 8-week exercise program on foot health in children with pronated feet. The experimental group will perform sand activities and towel curl exercises three times a week, while the control group will only perform towel curl exercises. The study will measure foot posture, navicular drop, and dynamic balance using the Foot Posture Index (FPI-6), Navicular Drop Test, Y Balance Test, and Feiss Line Test, with assessments conducted at baseline, 4 weeks, and 8 weeks post-intervention. This study aims to provide evidence on the effects of combining sand training with towel curl exercises for determining foot posture.
- Conditions
- Pronated Foot
- Being tested
- Sand Activites, Towel Curl Exercises, (TCE)
- Keywords
- Pronated foot, sand exercise program, navicular drop, foot posture
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Sand ActivitesOther
Exercises included walking, jogging, striding, bounding, galloping, and short sprints.Exercise intensity (running speed) was controlled using a stopwatch and predefined running distances on the sand-based exercise court.
Towel Curl ExercisesOther
The experimental group will perform Towel Curl Exercises Sand .In Week 1-4 the exercises will conducted without weights while in weeks 5-8 the exercise included the use of dumbbells weighing 2kg.this exercises will conducted in a sitting position on a slick surface.
(TCE)Other
The control group will only perform towel curl exercises In Week 1-4 the exercises will conducted without weights while in weeks 5-8 the exercise included the use of dumbbells weighing 2kg.this exercises will conducted in a sitting position on a slick surface.
| Study group | Role | What they receive |
|---|---|---|
| Group A | Experimental | Clinical experimental: For group A each session last 50 minutes daily for 8 weeks 3 times per week during a 8-week period Receives: Other: Sand Activites; Other: Towel Curl Exercises |
| Group B | Active comparator | Clinical experimental: For group B each session lasted for 5 minutes. The exercise was performed in three sets per week, with each set lasting 5 minutes. Participants performed the exercise 20-25 times for 8 weeks Receives: Other: Sand Activites; Other: (TCE) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Feiss line Test
The Feiss Line Test assesses the medial longitudinal arch by drawing a line from the medial malleolus to the first metatarsophalangeal joint. The navicular tuberosity should lie on or near this line; displacement below indicates arch lowering. A perpendicular distance from the navicular to this line is measured-positive if above, negative if below. The test shows high reliability, with inter-tester ICC of 0.94 and intra-tester ICC of 0.91, indicating consistent measurements across and within testers.
Measured: base line ,4th week ,8th week
Foot Posture Index (FPI -6 )
Foot posture is assessed using the Foot Posture Index (FPI-6) with the subject barefoot in a relaxed standing position. It evaluates six criteria across the forefoot, midfoot, and hindfoot, including talar head palpation, malleolar curvature, calcaneal position, talonavicular prominence, medial arch height, and forefoot alignment. Scores range from -12 (highly supinated) to +12 (highly pronated). The FPI-6 is a quick, simple, and reliable tool, showing strong intra-rater reliability (ICC 0.81-0.92) and good inter-rater reliability (ICC 0.69), especially in pediatric assessments.
Measured: base line ,4th week ,8th week
Navicular Drop Measurement
The Navicular Drop Test (NDT) measures foot pronation by comparing navicular height in a seated subtalar neutral position to its height in relaxed standing. It shows moderate to good intra-rater reliability, with ICC values ranging from 0.61 to 0.79, making it a useful clinical tool for assessing pronation
Measured: base line ,4th week ,8th week
Dynamic Balance Assessment
The Star Balance Test (or Y-Balance Test) assesses dynamic balance by having participants reach in three directions-anterior, posteromedial, and posterolateral-while balancing on one foot. The test is performed clockwise for the right foot and counterclockwise for the left. Reach distance is recorded, and errors require a retest. It shows good interrater reliability with ICC values of 0.80-0.85 and a standard error of 3.1-4.2 cm.
Measured: base line ,4th week ,8th week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 May 2025
- Study start17 Apr 2025
- Primary completion17 Jun 2025
- Study completion18 Jun 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 Pronated FootStudies of the same condition, open and under way.
- 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
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- A randomized controlled trial (RCT) perfomed in which 20 participants divided into 2 groups an experimental group and a control group to assess the effects of an 8-week exercise program on foot health in children with pronated feet. The experimental group will perform sand activities and towel curl exercises three times a week, while the control group will only perform towel curl exercises. Pre values were taken at 1st week and then after 4th week mid values of interventions will be taken and post values of intervention will be taken after 8th week of intervention to measure foot posture, navicular drop, and dynamic balance using the Foot Posture Index (FPI-6), Navicular Drop Test, Y Balance Test, and Feiss Line Test.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 20 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Eishah M Saeed, MS-PPT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06955039
- Sponsor's protocol ID
- REC//RER/AHS/24/0733
- Status last verified
- Feb 2026
- First submitted
- 24 Apr 2025
- Last updated
- 25 Feb 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Alam F, Raza S, Moiz JA, Bhati P, Anwer S, Alghadir A. Effects of selective strengthening of tibialis posterior and stretching of iliopsoas on navicular drop, dynamic balance, and lower limb muscle activity in pronated feet: A randomized clinical trial. Phys Sportsmed. 2019 Sep;47(3):301-311. doi: 10.1080/00913847.2018.1553466. Epub 2018 Dec 5.
PubMed 30517043
Study at a glance
From the registry record, last updated by the sponsor on 25 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Sand Exercise Program On Foot Posture , Navicular Drop and Dynamic Balance in Children With Pronated Foot
- ClinicalTrials.gov ID
- NCT06955039
- Acronym / sponsor ID
- REC//RER/AHS/24/0733
- Conditions
- Pronated Foot
- Keywords
- Pronated foot, sand exercise program, navicular drop, foot posture
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 20 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 17 Apr 2025 (actual)
- Primary completion
- 17 Jun 2025 (actual)
- Study completion
- 18 Jun 2025 (actual)
- First posted
- 2 May 2025 (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.
This randomized controlled trial investigates the effects of combining sand training with navicular drop interventions on foot posture and dynamic balance in children aged 6-11 with pronated feet. Pronated foot posture, marked by inward foot rolling and a lowered arch, can impair gait and balance. Early intervention is key to preventing long-term issues. Twenty participants will be divided into experimental and control groups. Over eight weeks, the experimental group will perform sand and towel curl exercises, while the control group will do towel curls only. Foot posture, navicular drop, and balance will be assessed using the FPI-6, Navicular Drop Test, Y Balance Test, and Feiss Line Test at baseline, 4 weeks, and 8 weeks. The study aims to evaluate the added benefits of sand training in improving pediatric foot health.
Detailed description
The effects of sand training exercises combined with navicular drop interventions on dynamic balance and foot posture in children aged 6 to 11 years with pronated feet. Pronated foot posture, characterized by the inward rolling of the foot and a lowered medial arch, is prevalent in pediatric populations and can lead to altered gait mechanics and reduced dynamic balance. Early intervention is crucial to prevent long-term deformities and improve overall foot health. The study aims to provide evidence-based insights into the benefits of integrating proprioceptive training with specific sand exercises program targeting the navicular bone, thereby enhancing foot posture and dynamic balance in affected children.
This randomized controlled trial (RCT) will involve 20 participants divided into an experimental group and a control group to assess the effects of an 8-week exercise program on foot health in children with pronated feet. The experimental group will perform sand activities and towel curl exercises three times a week, while the control group will only perform towel curl exercises. The study will measure foot posture, navicular drop, and dynamic balance using the Foot Posture Index (FPI-6), Navicular Drop Test, Y Balance Test, and Feiss Line Test, with assessments conducted at baseline, 4 weeks, and 8 weeks post-intervention. This study aims to provide evidence on the effects of combining sand training with towel curl exercises for determining foot posture.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- A randomized controlled trial (RCT) perfomed in which 20 participants divided into 2 groups an experimental group and a control group to assess the effects of an 8-week exercise program on foot health in children with pronated feet. The experimental group will perform sand activities and towel curl exercises three times a week, while the control group will only perform towel curl exercises. Pre values were taken at 1st week and then after 4th week mid values of interventions will be taken and post values of intervention will be taken after 8th week of intervention to measure foot posture, navicular drop, and dynamic balance using the Foot Posture Index (FPI-6), Navicular Drop Test, Y Balance Test, and Feiss Line Test.
| Arm | Type | Receives |
|---|---|---|
| Group A | Experimental | Other: Sand Activites, Other: Towel Curl ExercisesClinical experimental: For group A each session last 50 minutes daily for 8 weeks 3 times per week during a 8-week period |
| Group B | Active comparator | Other: Sand Activites, Other: (TCE)Clinical experimental: For group B each session lasted for 5 minutes. The exercise was performed in three sets per week, with each set lasting 5 minutes. Participants performed the exercise 20-25 times for 8 weeks |
Who may qualify
- Ages
- 6 to 11 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (5 listed)
- Children aged [6-11] years with bilateral pronated feet.
- Both gender
- No recent foot injury or lower extremity pain from last six months
- Has no history of foot and ankle surgery lifetime
- All eligible children were assessed with the Feiss line method
Key exclusion criteria (2 listed)
- the presence of pain in the foot at the time of physical examination
- injury to the lower limbs, such as musculoskeletal injuries, during the previous 6 months congenital structural abnormalities, cerebral palsy, motor dysfunction prior surgery affecting the foot
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 |
|---|---|---|
| Sand ActivitesExercises included walking, jogging, striding, bounding, galloping, and short sprints.Exercise intensity (running speed) was controlled using a stopwatch and predefined running distances on the sand-based exercise court. | Other | Group A, Group B |
| Towel Curl ExercisesThe experimental group will perform Towel Curl Exercises Sand .In Week 1-4 the exercises will conducted without weights while in weeks 5-8 the exercise included the use of dumbbells weighing 2kg.this exercises will conducted in a sitting position on a slick surface. | Other | Group A |
| (TCE)The control group will only perform towel curl exercises In Week 1-4 the exercises will conducted without weights while in weeks 5-8 the exercise included the use of dumbbells weighing 2kg.this exercises will conducted in a sitting position on a slick surface. | Other | Group B |
Primary outcome
Feiss line Test
Time frame: base line ,4th week ,8th week
The Feiss Line Test assesses the medial longitudinal arch by drawing a line from the medial malleolus to the first metatarsophalangeal joint. The navicular tuberosity should lie on or near this line; displacement below indicates arch lowering. A perpendicular distance from the navicular to this line is measured-positive if above, negative if below. The test shows high reliability, with inter-tester ICC of 0.94 and intra-tester ICC of 0.91, indicating consistent measurements across and within testers.
Foot Posture Index (FPI -6 )
Time frame: base line ,4th week ,8th week
Foot posture is assessed using the Foot Posture Index (FPI-6) with the subject barefoot in a relaxed standing position. It evaluates six criteria across the forefoot, midfoot, and hindfoot, including talar head palpation, malleolar curvature, calcaneal position, talonavicular prominence, medial arch height, and forefoot alignment. Scores range from -12 (highly supinated) to +12 (highly pronated). The FPI-6 is a quick, simple, and reliable tool, showing strong intra-rater reliability (ICC 0.81-0.92) and good inter-rater reliability (ICC 0.69), especially in pediatric assessments.
Navicular Drop Measurement
Time frame: base line ,4th week ,8th week
The Navicular Drop Test (NDT) measures foot pronation by comparing navicular height in a seated subtalar neutral position to its height in relaxed standing. It shows moderate to good intra-rater reliability, with ICC values ranging from 0.61 to 0.79, making it a useful clinical tool for assessing pronation
Dynamic Balance Assessment
Time frame: base line ,4th week ,8th week
The Star Balance Test (or Y-Balance Test) assesses dynamic balance by having participants reach in three directions-anterior, posteromedial, and posterolateral-while balancing on one foot. The test is performed clockwise for the right foot and counterclockwise for the left. Reach distance is recorded, and errors require a retest. It shows good interrater reliability with ICC values of 0.80-0.85 and a standard error of 3.1-4.2 cm.
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 25 Feb 2026.
- Background: PubMed 30517043Alam F, Raza S, Moiz JA, Bhati P, Anwer S, Alghadir A. Effects of selective strengthening of tibialis posterior and stretching of iliopsoas on navicular drop, dynamic balance, and lower limb muscle activity in pronated feet: A randomized clinical trial. Phys Sportsmed. 2019 Sep;47(3):301-311. doi: 10.1080/00913847.2018.1553466. Epub 2018 Dec 5.
- 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.
Eishah M Saeed, MS-PPT 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 Sand Activites, Towel Curl Exercises and (TCE) in people with Pronated Foot, 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 2 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 25 Feb 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?
Feiss line Test (time frame: base line ,4th week ,8th week). The study lists 4 primary outcomes in all. 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 NCT06955039, 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 25 Feb 2026.