PHYSIOTHERAPY AFTER HALLUX VALGUS SURGERY

Abstract

Hallux valgus is a condition that causes pain and deformity of the big toe. The most common causes of the appearance of this pathology are genetic factors, falling arches (transverse, longitudinal or both), the use of inappropriate shoes, certain activities, sports causing hyperpressure in the metatarsal area, etc. Treatment often requires surgical intervention for maximum correction. After surgery, postoperative physical therapy is key to the patient's full recovery. This article discusses a study comparing two physical therapy protocols for postoperative rehabilitation after hallux valgus (bunion) surgery. The study was conducted at Femi clinic medical center, Sofia, where for a period of 18 months we applied postoperative physiotherapy to 26 patients who underwent surgical correction of hallux valgus. The study compared a standard physiotherapy protocol (control group – n13) with an advanced, more eclectic method (experimental group – n13) that included techniques such as proprioceptive neuromuscular facilitation (PNF), balance training, soft tissue mobilization, kinesiotape, analytical exercises and orthotic treatment.

The effectiveness of the two rehabilitation protocols was evaluated using the following outcome measures:

• Pain Level: Measured using the Visual Analog Scale (VAS) for pain.
• Range of Motion (ROM): Assessment of joint mobility in the first metatarsophalangeal joint.
• Strength: Quantitative measurement of foot and ankle strength using a hand-held dynamometer.
• Foot Function: Assessed using the Foot Function Index (FFI), which evaluates limitations in daily activities, walking, and standing.
• Patient Satisfaction: Survey conducted to assess the patients' subjective experience of recovery.

The results showed that the experimental group experienced faster pain relief, better range of motion, stronger foot muscles, and higher patient satisfaction compared to the control group. The study concluded that the advanced rehabilitation program significantly improved recovery outcomes, including functional ability and overall foot health, suggesting that advanced physiotherapy techniques should be incorporated into postoperative care for optimal recovery. Further research is encouraged to evaluate the long-term benefits of these protocols and their applicability to other foot surgeries.