Effectiveness of Plyometric Exercises Versus Flatfoot Corrective Exercises on Balance and Foot Posture in Obese Children with a Flexible Flatfoot: A Comparative Study

ABSTRACT Background and Purpose: Childhood obesity often leads to flexible flatfoot, which negatively affects foot posture, balance, and physical function. While exercise is commonly used in clinical practice, there is limited comparative evidence on plyometric training versus traditional corrective exercises in this population. This study aimed to compare the effects of an 8 week plyometric exercise program versus flatfoot corrective exercises on balance and foot posture in obese children aged 7 to 11 years with flexible flatfoot. Methods: A parallel, non-randomized comparative study was conducted with 120 children recruited from schools in Bengaluru. Participants were allocated to either Group A (plyometric exercises, n = 60) or Group B (flatfoot corrective exercises, n = 60). Both groups trained for 8 weeks (two 40-minute sessions weekly). Foot posture was assessed using the Foot Posture Index-6 (FPI-6), and static balance was measured as center-of-pressure path length using the BTrackS Balance Tracking System before and after the intervention. Results: Both groups demonstrated statistically significant within-group improvements in foot posture and balance after 8 weeks (p < 0.001). However, the plyometric group achieved slightly better improvements in foot posture (statistically significant for the left foot, p = 0.028) and markedly greater gains in balance (median path length: 30.39 cm vs. 37.45 cm, p < 0.001) compared to the corrective exercise group. Conclusions: Both exercise approaches are beneficial for obese children with flexible flatfoot. Plyometric training provides additional advantages in improving dynamic balance and neuromuscular control, supporting its inclusion in pediatric physiotherapy programs. Keywords: Center of pressure; Medial longitudinal arch; Neuromuscular control; Pes planus; Postural sway; Stretch-shortening cycle