Background: The longitudinal arch is important for individuals with pes planus. The toe spread out exercise (TSO) has been widely used to continuously support the longitudinal arch by increasing the abductor hallucis (AbdH) muscle activation. However, the AbdH muscle is commonly lack of the sufficient activation during the TSO especially in individuals with pes planus. Objects: This study was performed to investigate the effect of arch support on the muscle activity and strength of the AbdH during TSO in standing position in individuals with pes planus. Methods: Twenty subjects with pes planus between 20 and 30 years of age participated in this study. The muscle activity and strength of the AbdH were measured using surface EMG system and the Smart KEMA tensiometer system. The AbdH muscle was evaluated during TSO between individuals with and without longitudinal arch support in standing position. The longitudinal arch was supported by using the insole. The paired t-test was used. The level of statistical significance was set at α = 0.05. Results: The muscle activity and strength of the AbdH during TSO with arch support in standing position was significantly greater than that without arch support. Conclusion: The muscle activity and strength of the AbdH during TSO in standing position can be influenced by the longitudinal arch support in individuals with pes planus. The AbdH strengthening during TSO in standing with arch support can be recommended especially in individuals with pes planus in the clinical settings.

Background: In previous studies regarding flexible pes planus, Foot orthosis, special shoes have been used as interventions for correcting malalignment and intrinsic muscles strengthening exercise have been regarded as interventions for foot function and supporting medial longitudinal arch during walking. However, some recent studies reported that strengthening extrinsic muscles as well as intrinsic muscles is more effective and active intervention for flexible pes planus. In particular, the tibialis posterior muscle of foot extrinsic muscles plays essential roles in maintaining the medial longitudinal arch during dynamic weight bearing and balance. In addition this muscle acts longer than other supination muscles during the stance phase in the gait cycle. Objects: This study aimed to investigate the effect of foot intrinsic muscle and tibialis posterior muscle strengthening exercise for plantar pressure and dynamic balance in adults with flexible pes planus. Methods: 16 young flexible pes planus adults (7 males, 9 females) were recruited and were randomized into two groups. The experimental group performed foot intrinsic muscle and tibialis posterior muscle strengthening training, the control group performed only foot intrinsic muscle strengthening training. All groups received strengthening training for 30 minutes five times a week for six weeks. Results: The experimental group had significantly lower plantar pressure of medial heel area than the control group in stand (p<.05). The experimental group had significantly higher dynamic balance ability than control group (p<.05). Conclusion: The results of this study provide evidence to suggest that foot intrinsic muscle and tibialis posterior muscle of extrinsic muscle strengthening exercises may improve plantar pressure distribution and dynamic balance ability in adults with flexible pes planus.