Evidence-based exercise therapy for flexible flatfoot: a narrative review.

Abstrakt

Starting point: Flexible flatfoot (FFF) is a common musculoskeletal condition, particularly in children, characterized by a decreased medial longitudinal arch that dynamically collapses under load. While often asymptomatic, FFF can contribute to pain, altered biomechanics, and functional limitations. Exercise therapy is frequently recommended as a conservative intervention, but the level of evidence supporting specific exercise strategies remains unclear.

Objective: This narrative review aims to summarize the current evidence on exercise-based interventions for FFF, focusing on their efficacy in improving foot structure, function, and symptomatology.

Methods: A comprehensive literature search was conducted in PubMed, Scopus and Web of Science to identify randomized controlled trials examining exercise therapy for FFF. Studies were analyzed based on intervention types, outcome measures, and overall effectiveness.

Results: The findings suggest that short foot exercise, toe exercises, foot supination exercises, sensorimotor training, plantar and dorsal flexion exercises, general lower limb exercises and core exercises may contribute to improved arch height, foot posture, and functional outcomes. Conclusions: Exercise therapy appears to be a promising conservative approach for managing FFF, with potential benefits for foot function and posture. However, further high-quality randomized controlled trials with standardized protocols and long-term follow-up are needed to establish optimal exercise regimens and their long-term effects.