Toe Flexor Muscle Strength Research Articles

Inter-rater reliability of a new instrument for measuring isometric strength of toe flexor muscle

The assessment of toe flexor muscle strength is an important factor in the analysis of the muscles that contribute to sustaining the longitudinal plantar arch. Intrinsic muscles have several functions such as providing support and stabilization to the arches of the foot, shock absorption, and rigidity for the transmission of forces and postural stability. Objective: To evaluate the reliability of a device to measure the isometric strength of the toe flexor muscles individually. Method: Methodological study with a quantitative approach to assess the reliability of the instrument for evaluating the maximum voluntary isometric strength of the flexor muscles of the toes individually. 20 feet of healthy volunteers were evaluated in two moments: initial evaluation performed by evaluator 1 and evaluation after one week performed by evaluator 2, to test the interclass reliability through the statistical test of Intraclass Correlation Coefficient (ICC). Results: The results showed excellent ICC in all toes with values ranging between 0.805 and 0.921. Toe 4 had the lowest standard error of measurement (SME) and minimal detectable change (MMD), demonstrating lower collection error and greater sensitivity. Conclusion: The proposed instrument is reliable for measuring the intrinsic flexor muscle strength of the foot, being an alternative for evaluating it in different populations, as it presents good reliability and reproducibility at an affordable cost, and can be used in future clinical studies and clinical practice.

The Relationship between Toe Flexor Muscle Strength and Physical Fitness in Middle-Aged and Elderly Women

The Relationship between Toe Flexor Muscle Strength and Physical Fitness in Middle-Aged and Elderly Women

Association Between Toe Flexor Strength and Activity Levels in Community-Dwelling Japanese Older Women.

This study aimed to explore the relationship between toe flexor strength and the daily activity levels in 56 Japanese older women aged between 70 and 88 years. The activity levels were measured as the average number of steps/day using a pedometer and the life space assessment (LSA) scores. The Mann-Whitney U test was used to compare toe flexor muscle strength and the LSA scores between those with fewer than and more than 6,000steps/day. Spearman's correlation coefficient was used to investigate the relationship between toe grip strength according to age and each variable. The LSA scores were significantly higher in the group with >6,000steps/day (β = 0.188, p < .05). A correlation was found between the number of steps/day and toe flexor strength (r = .424, β = 0.419, p < .05) and the LSA scores (r = .417, β = 0.435, p < .05) in the participants in their 80s. Increasing the number of steps/day may benefit women in their 80s.

Increased toe-flexor muscle strength does not alter metatarsophalangeal and ankle joint mechanics or running economy

ABSTRACTThe intrinsic foot musculature (IFM) supports the arches of the foot and controls metatarsophalangeal joint (MTPJ) motion. Stronger IFM can increase the effective foot length, potentially altering lower-extremity gearing similar to that of using carbon-fibre-plated footwear. The purpose of this study was to investigate if strengthening of the IFM can alter gait mechanics and improve running economy. Eleven participants were randomly assigned into an experimental group and nine into a control group. The experimental group performed IFM strengthening exercises for ten weeks. Toe-flexor strength, gait mechanics, and running economy were assessed at baseline, five weeks, and ten weeks; using a custom strength testing apparatus, motion capture and force-instrumented treadmill, and indirect calorimetry. Toe-flexor strength increased in the experimental group (p = .006); however, MTPJ and ankle mechanics and running economy did not change. The dearth of changes in mechanics may be due to a lack of mechanical advantage of the IFM, runners staying within their preferred movement path, a need for MTPJ dorsiflexion to facilitate the windlass mechanism, or the primary function of the IFM being to support the longitudinal arch of the foot as opposed to modulating MTPJ mechanics.

Toe Flexor Muscle Strength and Morphological Characteristics of the Foot in Judo Athletes.

Whether practicing in judo influences the muscle strength and morphological characteristics of the foot is unknown. The purpose of this study was to determine the toe flexor muscle strength and morphological characteristics of the foot in judo athletes. Judo athletes (JUDO, men=24) and age-, gender- and body mass-matched physically active healthy subjects (CON, men=24) were recruited, and their toe flexor strength and morphological characteristics of the foot were compared. The maximum isometric toe flexor strength and foot intrinsic muscle thicknesses were measured using a toe grip dynamometer and a B-mode ultrasound, respectively. Foot arch height was assessed as the distance between the navicular tuberosity of the foot and the floor in the sitting and standing positions. JUDO showed a significantly lower foot arch height and smaller foot arch index than CON, whereas foot length and muscle thickness did not significantly differ between groups. The toe flexor strength relative to total muscle thickness was significantly larger in JUDO than CON. The foot arch dynamics was significantly larger in JUDO than CON. This study suggests that exercise training specific to judo may affect the force-generating capacity, morphological structure and arch function of the foot.

Non-linear growth trends of toe flexor muscle strength among children, adolescents, and young adults: a cross-sectional study.

There are only a few studies on the muscular strength of the foot in children and adolescents; thus, the developmental pattern and normative data of these populations during growth are unclear. We sought to elucidate the developmental pattern of the foot muscle strength among children, adolescents, and young adults compared with that of the hand. A total of 747 children, adolescents, and young adults participated in this study, and their maximum isometric toe flexor strength (TFS), hand grip strength (HGS), and foot length were measured. TFS was correlated with HGS (r = 0.785), age (r = 0.659), height (r = 0.757), body mass (r = 0.737), and foot length (r = 0.594). Multiple regression analyses revealed that TFS was correlated with age (β = 0.243 in boys; β = 0.461 in girls), squared value of age (age2; β = - 0.296 in boys; β = - 0.260 in girls), and body mass (β = 0.256 in boys; β = 0.311 in girls) in both sexes, indicating a non-linear relationship between age and TFS development. In a regression model for HGS, age was a significant variable, but not age2. HGS increased linearly from childhood until young adulthood, whereas TFS increased from childhood until adolescence and then levelled off. Our results demonstrate that TFS has a different developmental pattern compared with HGS.

Avaliação da musculatura flexora dos artelhos de idosos institucionalizados e comunitários: aspectos biomecânicos, mobilidade e quedas

RESUMO As mudanças morfológicas, biomecânicas e funcionais nos pés podem aumentar o risco de queda nos idosos. Os idosos institucionalizados apresentam menor mobilidade e maior risco de queda. O objetivo deste trabalho é verificar as relações das características dos pés com a mobilidade e quedas de idosos institucionalizados e ativos da comunidade. Participaram deste estudo 15 idosos institucionalizados e 15 idosos ativos da comunidade, que foram avaliados quanto à incidência de quedas e por meio do Timed Up and Go Test; presença de hálux valgo e pico de força muscular de flexores do hálux e dos artelhos pela plataforma de pressão. utilizou-se a análise de variância para comparar os grupos. Como resultado, os idosos comunitários apresentaram maior força muscular de flexores dos artelhos que os idosos institucionalizados (p&lt;0,05) e melhor mobilidade funcional. Observou-se risco de queda nos idosos institucionalizados. O hálux valgo grau leve foi a deformidade mais comum. O teste de Pearson não mostrou correlação entre as variáveis analisadas e a incidência de quedas. Conclui-se que a força muscular de flexores dos artelhos é maior nos idosos comunitários, assim como a mobilidade funcional, quando comparados com idosos institucionalizados.

Associations between ankle dorsiflexion range of motion and foot and ankle strength in young adults.

[Purpose] This study assessed the relationships between the ankle dorsiflexion range of motion and foot and ankle strength. [Subjects and Methods] Twenty-nine healthy (young adults) volunteers participated in this study. Each participant completed tests for ankle dorsiflexion range of motion, hallux flexor strength, and ankle plantar and dorsiflexor strength. [Results] The results showed (1) a moderate correlation between ankle dorsiflexor strength and dorsiflexion range of motion and (2) a moderate correlation between ankle dorsiflexor strength and first toe flexor muscle strength. Ankle dorsiflexor strength is the main contributor ankle dorsiflexion range of motion to and first toe flexor muscle strength. [Conclusion] Ankle dorsiflexion range of motion can play an important role in determining ankle dorsiflexor strength in young adults.

Effects of Age on Strength and Morphology of Toe Flexor Muscles

Study Design Descriptive, cross-sectional. Background Age-related muscle atrophy is common in lower-limb muscles. We therefore speculated that foot muscles may also diminish with age. However, there is a paucity of literature characterizing foot muscle strength and morphology, and any relationship between these 2, in older people. Objective To compare the strength and size of the toe flexor muscles of older adults relative to their younger counterparts. Methods Seventeen young adults with a normal foot type were matched by sex and body mass index to 17 older adults with a normal foot type, from an available sample of 41 younger (18 to 50 years of age) and 44 older (60 or more years of age) adults. Among the matched groups (n = 34), muscle thickness and cross-sectional area for 5 intrinsic and 2 extrinsic toe flexor muscles were obtained using ultrasound. Toe strength was assessed using a pressure platform. Differences in toe flexor strength and muscle size between the young and older matched groups were determined using analysis of covariance (controlling for height). Correlations between strength and size of the toe flexor muscles of the pooled group (n = 34) were also calculated. Results Toe strength and the thickness and cross-sectional area of most foot muscles were significantly reduced in the older adults (P<.05). Hallux and toe flexor strength values were strongly correlated with the size of the intrinsic toe flexor muscles. Conclusion The smaller foot muscles appear to be affected by sarcopenia in older adults. This could contribute to reduced toe flexion force production and may affect the ability of older people to walk safely. Interventions aimed at reversing foot muscle atrophy in older people require further investigation. J Orthop Sports Phys Ther 2016;46(12):1065-1070. Epub 29 Oct 2016. doi:10.2519/jospt.2016.6597.

Correlation between toe flexor strength and ankle dorsiflexion ROM during the countermovement jump.

[Purpose] This study assessed the relationships between peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Subjects and Methods] Eighteen healthy volunteers participated in the study. Each participant completed tests for peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Results] The results showed (1) a moderate correlation between ankle dorsiflexion range of motion and countermovement jump height and (2) a high correlation between peak first toe flexor muscle strength and countermovement jump height. Peak first toe flexor muscle strength and ankle dorsiflexion range of motion are the main contributors to countermovement jump performance. [Conclusion] These findings indicate that the measurement of peak first toe flexor muscle strength and ankle dorsiflexion range of motion may be useful in clinical practice for improving jump performance in athletes training for sports such as volleyball and basketball.

Relationships of ultrasound measures of intrinsic foot muscle cross-sectional area and muscle volume with maximum toe flexor muscle strength and physical performance in young adults.

[Purpose] To investigate the relationships between toe flexor muscle strength with (TFS-5-toes) and without (TFS-4-toes) the contribution of the great toe, anatomical and physiological muscle cross-sectional areas (CSA) of intrinsic toe flexor muscle and physical performance were measured. [Subjects] Seventeen men (82% sports-active) and 17 women (47% sports-active), aged 20 to 35 years, volunteered. [Methods] Anatomical CSA was measured in two intrinsic toe flexor muscles (flexor digitorum brevis [FDB] and abductor hallucis) by ultrasound. Muscle volume and muscle length of the FDB were also estimated, and physiological CSA was calculated. [Results] Both TFS-5-toes and TFS-4-toes correlated positively with walking speed in men (r=0.584 and r=0.553, respectively) and women (r=0.748 and r=0.533, respectively). Physiological CSA of the FDB was significantly correlated with TFS-5-toes (r=0.748) and TFS-4-toes (r=0.573) in women. In men, physiological CSA of the FDB correlated positively with TFS-4-toes (r=0.536), but not with TFS-5-toes (r=0.333). [Conclusion] Our results indicate that physiological CSA of the FDB is moderately associated with TFS-4-toes while toe flexor strength correlates with walking performance.

Influence of Ankle Braces on the Maximum Strength of Plantar and Toe Flexor Muscles.

This study sought to investigate the influence of ankle braces on maximum strength of plantar and toe flexor muscles. 21 healthy participants volunteered, and their maximum isometric toe flexor muscle strength (TFS), plantar flexor muscle strength (PFS) and passive range of motion of the ankle joint (ROM) were measured. TFS, PFS and ROM were compared among barefoot as a control (BAR), ankle support (SUP) and ankle splint (SPL) conditions. TFS was significantly lower in SPL (90.7±32.5 N, p<0.0001) compared to BAR (117.3±39.5 N) and it was significantly lower in SPL than in SUP (110.5±36.7 N, p=0.0001), whereas it was not significantly different between SUP and BAR (p=0.2587). On the contrary, PFS and ROM were significantly lower in SUP (p=0.0087 for PFS; p=0.0095 for ROM) and SPL (p<0.0001 for PFS; p<0.0001 for ROM) compared to BAR, and they were significantly lower in SPL than in SUP (p=0.0073 for PFS; p<0.0001 for ROM). The ankle support could provide ankle joint stabilization without a large decrease in the muscle strength of the foot. The proper use of an ankle brace is required to prevent major impairment of the muscle functions of the ankle-foot complex.

Maximum toe flexor muscle strength and quantitative analysis of human plantar intrinsic and extrinsic muscles by a magnetic resonance imaging technique

BackgroundThe aims of this study were to investigate the relationships between the maximum isometric toe flexor muscle strength (TFS) and cross-sectional area (CSA) of the plantar intrinsic and extrinsic muscles and to identify the major determinant of maximum TFS among CSA of the plantar intrinsic and extrinsic muscles.MethodsTwenty six young healthy participants (14 men, 12 women; age, 20.4 ± 1.6 years) volunteered for the study. TFS was measured by a specific designed dynamometer, and CSA of plantar intrinsic and extrinsic muscles were measured using magnetic resonance imaging (MRI). To measure TFS, seated participants optimally gripped the bar with their toes and exerted maximum force on the dynamometer. For each participant, the highest force produced among three trials was used for further analysis. To measure CSA, serial T1-weighted images were acquired.ResultsTFS was significantly correlated with CSA of the plantar intrinsic and extrinsic muscles. Stepwise multiple linear regression analyses identified that the major determinant of TFS was CSA of medial parts of plantar intrinsic muscles (flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, lumbricals and abductor hallucis). There was no significant difference between men and women in TFS/CSA.ConclusionsCSA of the plantar intrinsic and extrinsic muscles is one of important factors for determining the maximum TFS in humans.

Importance and challenges of measuring intrinsic foot muscle strength.

BackgroundIntrinsic foot muscle weakness has been implicated in a range of foot deformities and disorders. However, to establish a relationship between intrinsic muscle weakness and foot pathology, an objective measure of intrinsic muscle strength is needed. The aim of this review was to provide an overview of the anatomy and role of intrinsic foot muscles, implications of intrinsic weakness and evaluate the different methods used to measure intrinsic foot muscle strength.MethodLiterature was sourced from database searches of MEDLINE, PubMed, SCOPUS, Cochrane Library, PEDro and CINAHL up to June 2012.ResultsThere is no widely accepted method of measuring intrinsic foot muscle strength. Methods to estimate toe flexor muscle strength include the paper grip test, plantar pressure, toe dynamometry, and the intrinsic positive test. Hand-held dynamometry has excellent interrater and intrarater reliability and limits toe curling, which is an action hypothesised to activate extrinsic toe flexor muscles. However, it is unclear whether any method can actually isolate intrinsic muscle strength. Also most methods measure only toe flexor strength and other actions such as toe extension and abduction have not been adequately assessed. Indirect methods to investigate intrinsic muscle structure and performance include CT, ultrasonography, MRI, EMG, and muscle biopsy. Indirect methods often discriminate between intrinsic and extrinsic muscles, but lack the ability to measure muscle force.ConclusionsThere are many challenges to accurately measure intrinsic muscle strength in isolation. Most studies have measured toe flexor strength as a surrogate measure of intrinsic muscle strength. Hand-held dynamometry appears to be a promising method of estimating intrinsic muscle strength. However, the contribution of extrinsic muscles cannot be excluded from toe flexor strength measurement. Future research should clarify the relative contribution of intrinsic and extrinsic muscles during intrinsic foot muscle strength testing.

Effects of increased toe flexor muscle strength to foot and ankle function in walking, running and jumping

Driven by experience and intuition, barefoot training is commonly used by athletes to increase foot muscle strength, to prevent injury and to enhance performance. With the aim to simulate barefoot ...

Toe Flexor Muscle Strength as a Measure of Motor Function in Community-Dwelling Elderly People

Toe Flexor Muscle Strength as a Measure of Motor Function in Community-Dwelling Elderly People