{
  "abstract": "Purpose: To evaluate the effects of exercise programmes incorporating proximal kinetic-chain components versus local or basic foot–ankle exercise in individuals with study-defined flexible flatfoot or low-arch/pronated-foot phenotypes.\n\nMethods: PubMed, Web of Science, Scopus, and SPORTDiscus were searched from inception through 19 July 2026. Randomised controlled trials comparing exercise programmes incorporating proximal kinetic-chain components with local or basic foot–ankle exercise programmes were included. Random-effects meta-analyses used restricted maximum likelihood estimation. Risk of bias was assessed with RoB 2 and certainty of evidence with GRADE.\n\nResults: Fourteen randomised trials reported in 15 publications were included; 13 trials (14 reports) contributed to at least one meta-analysis. Programmes containing proximal or kinetic-chain components were associated with lower navicular-drop values (11 trials, 410 participants; mean difference −2.34 mm, 95% CI −3.30 to −1.37; I²=84.6%; low-certainty evidence). The Foot Posture Index estimate was uncertain (4 trials, 157 participants; mean difference −1.67 points, 95% CI −3.36 to 0.01; I²=89.1%; very-low-certainty evidence). The exploratory Plantar Arch Index and all three exploratory Y-Balance estimates had confidence intervals including the null and very-low-certainty evidence. Evidence for muscle, plantar-pressure, gait, kinematic, patient-reported, adherence, and adverse-event outcomes was limited and mainly derived from individual trials.\n\nConclusion: Programmes incorporating proximal kinetic-chain components may reduce short-term navicular drop compared with local or basic foot–ankle exercise programmes, but substantial heterogeneity limits confidence in the magnitude of this response; effects on FPI-6 remain uncertain. Evidence for dynamic, functional, and patient-reported outcomes remains insufficient.\n\nSystematic review registration: identifier CRD420261455079.",
  "abstract_shown": true,
  "affiliations": [
    "School of Sports and Health Engineering, Hebei University of Engineering, Handan, Hebei, China",
    "School of Physical Education and Health Science, Guangxi Minzu University, Nanning, Guangxi, China"
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zheyu Xiong"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiguo Liang"
    },
    {
      "affs": [
        1
      ],
      "name": "Guanghua Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5tyv3h4h5c0q6.bib",
  "cited_by": 0,
  "doi": "10.3389/fphys.2026.1959545",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696242/",
  "id": "5tyv3h4h5c0q6",
  "issns": [
    "1664-042X"
  ],
  "landing_url": "https://doi.org/10.3389/fphys.2026.1959545",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Systematic Review"
    ],
    [
      "openalex",
      "2204|Lower Extremity Biomechanics and Pathologies"
    ]
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  "openalex": "W7221472190",
  "pdf_url": "https://europepmc.org/articles/PMC13696242?pdf=render",
  "pmcid": "PMC13696242",
  "pmid": "42935502",
  "published": "2026-10-12",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/5tyv3h4h5c0q6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:38Z",
      "native_id": "PMC13696242",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fphys.2026.1959545"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42935502",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42935502"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Exercise programmes incorporating proximal kinetic-chain components in flexible flatfoot: a systematic review and meta-analysis of foot posture, neuromuscular, and dynamic outcomes",
  "title_text": "Exercise programmes incorporating proximal kinetic-chain components in flexible flatfoot: a systematic review and meta-analysis of foot posture, neuromuscular, and dynamic outcomes",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:37Z",
  "url": "https://research.draconitic.com/paper/5tyv3h4h5c0q6",
  "venue": "Frontiers in Physiology",
  "versions": []
}