An interventional study of Toe spread out exercise and Toe spread out exercises with walking surface training in Autism, sponsored by Riphah International University. Not yet recruiting at 1 site in Pakistan. Open to participants aged 7 Years to 12 Years. Per ClinicalTrials.gov, last updated 2026-02-27.
Sponsored by Riphah International University · Not applicable, Interventional, and Treatment
Flatfoot is a common postural deformity in children, characterized by the collapse of the medial longitudinal arch, leading to abnormal foot posture, gait disturbances, and postural instability. Arch collapse in flatfoot is also due to navicular drop a condition where the navicular bone, located in the midfoot, shifts downward excessively when bearing weight.
This excessive drop reflects poor structural support in the foot and is often linked to weakness in the intrinsic foot muscles. The intrinsic and extrinsic muscles of the foot, particularly the abductor hallucis (AbdH), play a vital role in maintaining arch stability.
Strengthening exercises like toe spread out movements are specifically designed to target these muscles by abducting and flexing the toes, helping to support and elevate the medial arch. This study aims to investigate the combined effect of toe spread out exercises and walking surface training on navicular drop and jumping performance in children with ASD, focusing on muscle strength and sensory-motor integration to support functional movement and postural control. This randomized controlled trial will be conducted over ten months at Step Up Autism Center and Rehab Care, Lahore, following ethical approval from the Research Ethical Committee of Riphah International University Islamabad (Lahore Campus). Children aged 7 to 12 years, clinically diagnosed with autism spectrum disorder, navicular drop, and poor locomotor skills will be recruited through non-probability convenient sampling. After obtaining informed consent from guardians, eligible participants will be randomly allocated into two groups. Group A will perform toe spread out exercises only, while Group B will perform toe spread out exercises combined with walking surface training. Both interventions will be carried out three times a week for eight weeks. This will be a single-blinded study, where the assessor will remain unaware of the group allocations. Data collection will involve pre- and post intervention assessment using the Navicular Drop Test, Wet Footprint Test (Clarke's Angle), Horizontal Jump Test, and the Test of Gross Motor Development-Second Edition (TGMD-2) to evaluate changes in foot posture, arch structure, lower limb power, and locomotor skills in participating children.
1,344 studies on the registry are indexed under Autistic Disorder; 334 are open to participants now.
This study's planned enrollment of 34 is below the median of 45 across 1,044 interventional studies indexed under Autistic Disorder.
Browse Autistic Disorder studies →Riphah International University is the lead sponsor of 2,133 studies on the registry; 633 are open to participants now.
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Exclusion Criteria:
Other: Toe spread out exercise
Other: Toe spread out exercise · Other: Toe spread out exercises with walking surface training
Partcipant will sit on the edge of chair with hips and knees at 90 degree flexion, with foot flat on the floor. This position makes sure that there is equal weight distibution across the calcaneus, metatarsals and phalanges. It is also made sure that the feet are hip width apart.Then the participant is asked to lift the toes off the ground(dorsiflexion) , keeping the heel and ball(metarsals) of foot on the ground. While maintaining dorsiflexion of toes, the participant will be asked to flex the first toe medially (bending downward and toward the midline), similarly the fifth toe will be flexed laterally (bending downward and away from the midline) .The position will be held for 3 to 5 seconds with 10 repetiotns.
Walking Surface • The participant will be barefoot and will be asked to walk in their usual manner and speed. • There will be three different surfaces i.e pile carpet (18mm thickness) for soft sensation, vinyl tile for flat smooth and loose gravel (average height of 14mm) for uneven sensation respectively. • The participant will be asked to walk on the 4 meter walking surface, taking 10 rounds on each
Navicular Drop by Navicular Drop Test
The Navicular Drop (ND) Test evaluates medial longitudinal arch stability by measuring the difference in navicular height between neutral/seated and weight-bearing positions. A drop of 5-9 mm is typical, while \> 10mm indicates excessive pronation (arch collapse) or instability, often linked to structural issues
Time frame: Baseline and 8th Week
Jumping Performance by using Horizontal Jump Test
Horizontal jump tests, particularly the Standing Long Jump (SLJ) or Broad Jump, measure lower-body explosive power by recording the furthest distance of three attempts from a takeoff line to the nearest heel landing. Elite men typically exceed 2.50 m, while women excel over 2.0 m , often aiming for a distance greater than their height.
Time frame: Baseline and 8th Week
Plan to share: No
This study is not yet recruiting, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.
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Riphah International University