Postural analysis of children with muscle retraction after six-month exercise or heel cup interventions in a randomized trial

Balance and proprioception are crucial in children, especially in sports. The ankle joint plays a key role in postural control, and triceps surae retraction is common in active children. This study aimed to analyze the effects of stretching exercises versus heel cups on postural control in children aged 8 to 12 with triceps surae retraction. A six-month randomized controlled trial was conducted with 150 children assigned to either stretching exercises (n = 76) or heel cups (n = 74). The study was registered at ClinicalTrials.gov under the identification number NCT05902949 (first posted on 06/15/23). The area of oscillation was measured using the Gyko system under four conditions: eyes open/closed and firm ground/foam. A linear mixed regression model was applied to analyze the effects of the treatments, adjusting for sex, age, and physical activity. Stretching exercises were associated with significant reductions around oscillation across all conditions (p < 0.001 at six months). In contrast, heel cups were linked to significant increases around oscillation in all conditions (p < 0.001 at six months), indicating a negative effect on balance. Additionally, higher levels of physical activity and female sex were associated with better postural control (p < 0.001). In conclusion, stretching exercises significantly improved postural control in children with triceps surae retraction, whereas heel cups worsened this essential motor-performance ability. Further research is needed, but these findings support the incorporation of stretching exercises and regular physical activity in the management of these patients.