Background: Intrinsic foot muscle strengthening and orthotic devices such as toe spacers are commonly used to improve foot alignment and function. However, evidence regarding the combined effects of strengthening exercises and interdigital spacers remains limited. Objective: To examine whether adding a silicone toe spacer to a foot strengthening exercise program provides additional benefits compared with exercise alone. Design: Randomized controlled trial. Setting: University biomechanics laboratory. Participants: Twenty-five healthy adults (mean age 23.8 ± 1.3 years) without lower limb injury or neurological disorders were randomly allocated to one of two intervention groups. Interventions: Participants performed a six-week foot strengthening program (22 sessions). One group performed exercises alone, while the second group performed the same exercises while wearing a silicone interdigital toe spacer. Main outcome measures: The primary outcome was hallux valgus angle. Secondary outcomes included active and passive hallux range of motion (ROM), ankle dorsiflexion ROM (weight-bearing lunge test), navicular drop, and postural stability during single-leg stance assessed using center-of-pressure (CoP) measures. Results: Both groups demonstrated improvements over time in hallux valgus angle (p = 0.001, η2 = 0.361), active hallux range of motion (p < 0.001, η2 = 0.545), and ankle dorsiflexion (p < 0.001). However, no significant between-group differences were observed for the primary outcome or most secondary outcomes. A significant time × group interaction was observed only for passive hallux range of motion (p = 0.040, η2 = 0.170), indicating greater improvement in the exercise-only group. Navicular drop and postural stability variables did not change significantly. Conclusions: A six-week foot strengthening program improved hallux alignment, hallux mobility, and ankle dorsiflexion in healthy adults. The addition of a silicone toe spacer did not provide additional short-term benefits compared with exercise alone.
Meh et al. (Wed,) studied this question.