Combined Short Foot and Three-Dimensional PNF Ankle Exercises Improve Plantar Pressure, Ground Reaction Forces, and Postural Sway in Female Karate Athletes with Flexible Flatfoot

Ghadiri, Yasaman; Saki, Farzaneh; Gandomi, Farzaneh

doi:10.48311/ijmpp.2026.118709.82915

Combined Short Foot and Three-Dimensional PNF Ankle Exercises Improve Plantar Pressure, Ground Reaction Forces, and Postural Sway in Female Karate Athletes with Flexible Flatfoot

Document Type : Original Article

Authors

Yasaman Ghadiri ¹

farzaneh saki ²

Farzaneh Gandomi ³

¹ Department of Exercise Rehabilitation, Faculty of Sports Science, Bu-Ali Sina University, Hamedan, Iran

² Department of Exercise Rehabilitation, Faculty of Sports Science, Bu-Ali Sina University, Hamedan, Iran.

³ Department of Sports Injuries and Corrective Exercises, Faculty of Sports Science, Razi University, Kermanshah, Iran

10.48311/ijmpp.2026.118709.82915

Abstract

Aims: Flexible flatfoot in athletes alters plantar pressure distribution, impairs postural control, and modifies ground reaction forces, elevating injury risk. This study compared SFE+3DAE versus SFE alone on these outcomes in female karate athletes with flexible flatfoot. Method and Materials: Randomized controlled trial of 34 female karate athletes aged 1725 years with flexible flatfoot, randomly assigned 1:1 to 8 weeks of Short Foot Exercises (SFE) alone or combined with three-Dimensional Ankle Exercises (3DAE). Plantar pressure distribution, postural control, and ground reaction forces were assessed pre- and postintervention using pressure platforms. Within-group changes were analyzed using paired ttests, while between-group differences were evaluated with ANCOVA, adjusting for baseline values. Findings: Both groups demonstrated improvements in plantar pressure distribution, postural control, and ground reaction forces; however, the SF-3DAE group showed significantly greater reductions in first peak force and force depth (η² = 0.151, p < 0.05) and enhanced postural control, including major and minor axis lengths, COP path, and AP/ML sway (η² range: 0.176–0.734, p < 0.05). No significant changes were observed in symmetry indices between legs or forefoot-rearfoot distribution. Conclusion: Integrating SFE with 3DAE provides a comprehensive rehabilitation approach for female karate athletes with flexible flatfoot, enhancing foot function, postural stability, and load distribution during dynamic activities. These results support the additive benefits of combining intrinsic foot muscle strengthening with ankle PNF exercises in athletic populations.

Keywords

Flatfoot

Exercise Therapy

Postural Balance

Three-Dimensional Exercises

Postural Control How

Subjects