Influence of proximal hip muscle strengthening on medial longitudinal arch alignment: A randomized trial comparing gluteus maximus and gluteus medius exercises

Abstract

Objective: To compare the effects of gluteus maximus (GMax) strengthening versus gluteus medius (GMed) strengthening on medial longitudinal arch (MLA) alignment in individuals with asymptomatic flexible flatfoot. Methods: Fifty-three individuals with asymptomatic flexible flatfoot were randomly assigned to two groups for this randomized comparative study. GMax strengthening activities were assigned to Group A, and GMed exercises to Group B. For two weeks, both therapies were administered. The navicular drop test (NDT) and foot posture index (FPI), evaluated before and after the intervention, were among the outcome measures. SPSS version 26.0 was used for statistical analysis, and p < 0.05 was used for both within-group and between-group comparisons. Results: After the intervention period, both groups showed statistically significant reductions in FPI scores and navicular decrease (p < 0.05). When comparing the GMed and GMax strengthening groups, the between-group analysis showed a considerably greater improvement in MLA alignment (p < 0.05). In individuals with asymptomatic flexible flatfoot, proximal hip muscle strengthening improves MLA alignment. The significance of focused hip abductor strengthening in the treatment of flexible flatfoot is evident, as GMed strengthening appears more successful than GMax strengthening in improving foot posture and reducing navicular drop. Conclusion: Gluteus maximus and gluteus medius strengthening improved the medial longitudinal arch and foot posture in asymptomatic flexible flatfoot; however, gluteus medius strengthening was more effective, emphasizing the importance of hip abductor-focused protocols in physiotherapy. Level of Evidence II; Randomized trial, Comparative study