Abstract
It has been suggested that atrophied or weak toe flexor muscles are associated with the formation of toe deformities, but there is little evidence to support this theory. This study aimed to determine whether the size of the toe flexor muscles differed in older adults with and without toe deformities. Forty-four older adults (>60 years) were recruited for the study. Each participant had their feet assessed for the presence of hallux valgus or lesser toe deformities. Intrinsic and extrinsic toe flexor muscles were imaged with an ultrasound system using a standardized protocol. Assessor-blinded measurements of muscle thickness and cross-sectional area were taken using Image J software. Participants with lesser toe deformities (n = 20) were found to have significantly smaller quadratus plantae (P = 0.003), flexor digitorum brevis (P = 0.013), abductor hallucis (P = 0.004), and flexor hallucis brevis (P = 0.005) muscles than the participants without any toe deformities (n = 19). Female participants with hallux valgus (n = 10) were found to have significantly smaller abductor hallucis (P = 0.048) and flexor hallucis brevis (P = 0.013) muscles than the female participants without any toe deformities (n = 10; P < 0.05). This is the first study to use ultrasound to investigate the size of the toe flexor muscles in older adults with hallux valgus and lesser toe deformities compared to otherwise healthy older adults. The sizes of the abductor hallucis and flexor hallucis brevis muscles were decreased in participants with hallux valgus, whereas the quadratus plantae, flexor digitorum brevis, abductor hallucis, and flexor hallucis brevis muscles were smaller in the participants with lesser toe deformities.
Highlights
The intrinsic foot muscles of older people with hallux valgus and lesser toe deformities are significantly smaller than older people without toe deformitie
Female participants with hallux valgus (n=10) were found to have significantly smaller abductor hallucis (p=0.048) and flexor halluces brevis (p=0.013) muscles than the female participants without any toe deformities (n=10; p
The size of the abductor hallucis and flexor hallucis brevis muscles were decreased in participants with hallux valgus whereas the quadratus plantae, flexor digitorum brevis, abductor hallucis and flexor halluces brevis muscles were smaller in those participants with lesser toe deformities
Summary
Participants Potential participants were recruited from the community (Manchester, UnitedKingdom) via advertisements. Participants were excluded from the study if they had foot surgery or toe amputation or a history of neurological disorders. Ethics approval was obtained from the University’s Research Ethics Panel (REP10/062). Each particiant had their feet assessed using the Foot Posture Index and the presence of any lesser toe deformities (e.g. claw/hammer toes) were recorded. The test foot was based on the presence of deformity. If a unilateral toe deformity was present, that was the test foot. If bilateral deformity or no deformity was present, the dominant stance limb (preferred single-leg stance leg) was assigned the test foot. If a participant had unilateral hallux valgus and a lesser toe defomity present, but on contralateral limbs, the foot with hallux valgus was the test foot, as this deformity is less prevalent. Height (m) and weight (kg) were recorded and the body mass index (BMI, kg/m2) was calculated
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