Background: Hallux valgus (HV) is a deformity of the first metatarsophalangeal joint with a prevalence of 23% among adults 18-65 years old, increasing to 36% among the elderly. It is more common in females. HV can cause pain, which is made worse when walking.

Aim: The aim of the study was to perform a pilot randomized controlled trial to evaluate the study design and the possibility of conducting a randomized controlled trial on a larger scale to assess the difference in participants' toe flexor strength, balance, and perceived health-related quality of life of a digitally supervised low load versus high load training for those with painful mild to moderate hallux valgus. 

Method: The study was a pilot randomized controlled trial. Twenty-one individuals were randomized to a high load or low load exercise group (HLEG and LLEG), training for eight weeks. Toe flexor strength, One-leg stance test (OLS), Lower quarter Y-balance test (YBT-LQ), and RAND-36 were measured before and after the intervention. The recruitment and randomization process as well as the dropout rate were evaluated.

Result: Nineteen of the participants were female and two were male. The recruitment rate was 7.5 participants per month with a conversion rate of 100%. The retention rate was 81%. 

There was a significant change in toe flexor strength over time with a marginally non-significant tendency for an interaction. For YBT-LQ there was a significant change over time with no significant interaction. For RAND-36 none of the eight concepts showed significant change. With HLEG and LLEG combined, there was a statistical significance for Physical functioning and Bodily pain over time. 

Conclusion: Training according to an exercise protocol for eight weeks regardless of load improves strength and dynamic balance in patients with mild to moderate HV. This study could serve as a help to design a larger randomized controlled trial to determine conservative treatment options in this patient group.