scholarly journals Effect of Peroneus Longus Muscle Release on Abductor Hallucis Muscle Activity and Medial Longitudinal Arch before Toe-Tap Exercise in Participants with Flexible Pes Planus

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 44
Author(s):  
Youngkyu Choi ◽  
Jihyun Lee

Pes planus is a medical condition of the foot wherein there is a flattening or lowering of the medial longitudinal arch. The abductor hallucis muscle starts at the heel bone and attaches to the medial side of the first toe. Whenever it contracts, it plays a key role in elevating the medial longitudinal arch. Hence, the abductor hallucis muscle should be strong enough to control the depression on the medial longitudinal arch. The peroneus longus muscle plantarflexes the ankle and everts the ankle and subtalar joint. If this muscle contracts more than the abductor hallucis muscle does, the medial longitudinal arch of the foot is depressed. This study aimed to investigate the effect of myofascial release of the peroneus longus before performing the toe-tap exercise for strengthening the abductor hallucis muscle in participants with flexible pes planus. This cross-over study included 16 volunteers with flexible pes planus. The participants performed a toe-tap exercise before and after the myofascial release of the peroneus longus. During the toe-tap exercise, the muscle activity of the abductor hallucis and peroneus longus were measured using a Delsys Trigno Wireless Electromyography System. The angle of the medial longitudinal arch was measured using Image J software. Photos in the sagittal plane were used. The peroneus longus activity and medial longitudinal arch angles were significantly decreased. On the other hand, the activity of the abductor hallucis significantly increased after the myofascial release of the peroneus longus before performing the toe-tap exercise (p < 0.05). Individuals with flexible pes planus should be encouraged to perform myofascial release of the peroneus longus before the toe-tap exercise to improve the abductor hallucis activity and to elevate the medial longitudinal arch.

2020 ◽  
pp. 1-7
Author(s):  
Jung-Hoon Choi ◽  
Heon-Seock Cynn ◽  
Chung-Hwi Yi ◽  
Tae-Lim Yoon ◽  
Seung-Min Baik

Context: The improvement of hip joint stability can significantly impact knee and rearfoot mechanics. Individuals with pes planus have a weak abductor hallucis (AbdH), and the tibialis anterior (TA) may activate to compensate for this. As yet, no studies have applied isometric hip abduction (IHA) for hip stability during short-foot exercise (SFE). Objective: To compare the effects of IHA on the muscle activity of the AbdH, TA, peroneus longus (PL), and gluteus medius (Gmed), as well as the medial longitudinal arch (MLA) angle during sitting and standing SFE. Design: Two-way repeated analyses of variance were used to determine the statistical significance of AbdH, TA, PL, and Gmed electromyography activity, as well as the change in MLA angle. Setting: University research laboratory. Participants: Thirty-two participants with pes planus. Intervention(s): The participants performed SFE with and without isometric hip abduction in sitting and standing positions. Main Outcome Measures: Surface electromyography was used to measure the activity of the AbdH, TA, PL, and Gmed muscles, and Image J was used to measure the MLA angle. Results: Significant interactions between exercise type and position were observed in terms of the PL muscle activity and in the change in MLA angle only, while other muscles showed significant main effects. The IHA during SFE significantly increased the AbdH muscle activity, while the TA muscle activity was significantly lower. The muscle activity of Gmed and PL was significantly increased in the standing position compared with sitting, but there was no significant difference with or without IHA. The change in the MLA angle was significantly greater in SFE with IHA in a standing position than in the other SFE conditions. Conclusions: IHA may be an effective method for reducing compensatory TA activity and increasing AbdH muscle activity during SFE for individuals with pes planus.


2020 ◽  
Vol 28 (4) ◽  
pp. 415-422
Author(s):  
Min-Hyeok Kang ◽  
Sang-Min Cha ◽  
Jae-Seop Oh

BACKGROUND: Active interventions for pes planus, including short-foot exercises (SF) and toe-spread-out exercises (TSO), aim to continuously support the medial longitudinal arch (MLA) by activating the abductor hallucis (AbdH) muscle. However, compensatory movements, such as ankle supination and/or plantar flexion, often occur during these exercises. OBJECTIVE: To examine the effects of a novel exercise, i.e., the toe-tap (TT) exercise on AbdH activity and MLA angle. METHODS: A total of 16 participants with pes planus participated in this study. Participants performed SF, TSO, and TT exercises. Electromyographic activity of the AbdH and MLA angle during three AbdH contraction exercises were recorded using surface EMG system and digital image analysis program, respectively. The differences in outcome measures among the three exercises were analyzed using one-way repeated-measures analysis of variance. RESULTS: The EMG activity of the AbdH was significantly greater during the TT exercise compared to the SF and TSO exercises. The MLA angle was significantly smaller during the TT exercise compared with the SF and TSO exercises. CONCLUSIONS: These findings suggest that the TT exercise could be effective in activating the AbdH and increasing height of the MLA, as part of a sports rehabilitation program for individuals with pes planus.


2011 ◽  
Vol 12 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Do-Young Jung ◽  
Moon-Hwan Kim ◽  
Eun-Kyung Koh ◽  
Oh-Yun Kwon ◽  
Heon-Seock Cynn ◽  
...  

2020 ◽  
Vol 8 (4.1) ◽  
pp. 7782-7787
Author(s):  
Adjei-Antwi Collins ◽  
◽  
Chrissie Stansie Abaidoo ◽  
Nketsiah James ◽  
Joshua Tetteh ◽  
...  

Flatfoot (pes planus), commonest foot deformity caused by the absence or collapse of the medial longitudinal arch. Flatfoot results in serious health problems and postural defects. It is highly variable in different populations with many factors associated. This study was conducted to find the plantar arch index and the prevalence of flatfoot and its relationship with tribes in Ghana. A total of 278 participants (172 males and 106 females) with ages ranging from 16 to 34 years were recruited for the study. Ethical approval and participants’ informed consent were sought prior to the study. Participants were drawn from the Akan, Ewe, Ga-Dangbe and other tribes (Dagomba, Dagabaa, Frafra, Gonja, Wale Wale etc). Foot imprints were taken from each participant using the ink method. The plantar arch index was calculated using the ratio of the width of the central and the heel region of the footprint. The mean right plantar arch index was higher than the left. The prevalence of flatfoot was 15.1% (6.1% unilateral left, 5.8% unilateral right and 3.2% bilateral). The prevalence rate was 15.7% in males and 14.1% in females. The prevalence rates reported for the Ga-Dangbes and Ewes were 30.8% and 23.6% respectively. On the other hand, both Akans and individuals belonging to the other tribes recorded the same prevalence rate of 13.7%. Flatfoot was found to be high among the Ga-Dangbes. Ethnicity as an external factor has a great role in influencing foot arch structure. Also, sex has an influence on the morphology of an individual’s foot. KEY WORDS: Flatfoot, Pes planus, Foot deformity, Medial Longitudinal Arch.


2018 ◽  
Vol 40 (3) ◽  
pp. 352-355 ◽  
Author(s):  
Eric Swanton ◽  
Lauren Fisher ◽  
Andrew Fisher ◽  
Andrew Molloy ◽  
Lyndon Mason

Background: Weight-bearing radiographic analysis of pes planus deformities show, with varying degree of severity, a break in the Meary line. The break in the Meary line occurs not only at the talonavicular joint but also distal to the spring ligament and reported tibialis posterior insertion. Our aim in this study was to investigate the distal plantar ligaments of the medial longitudinal arch, to try to identify other areas where deformity correction could be affected. Methods: We examined 11 cadaveric lower limbs that had been preserved for dissection in a solution of formaldehyde. The lower limbs were carefully dissected to identify the plantar aspect of the medial longitudinal arch. Results: In all specimens, the tibialis posterior tendon inserted into the plantar medial aspect of the navicular with separate slips to the intermediate and lateral cuneiform. The navicular cuneiform ligament extended from the navicular to medial cuneiform. This structure was statically inserted between the navicular and medial cuneiform, which would allow the pull of the tibialis posterior to act on the navicular and medial cuneiform in tandem. The average width of the naviculocuneiform ligament was 15.2 mm (range 12.4-18.0) compared to 9.5 mm (range 7.6-11.4) for the tibialis posterior tendon. Conclusion: The tibialis posterior tendon inserted into the navicular and continued onto the medial cuneiform to provide a static restraint between 2 bony insertions, thus supporting the distal aspect of the medial longitudinal arch. Clinical Relevance: We are confident that it is a structure of importance in maintaining the distal aspect of the medial longitudinal arch and may therefore have significant clinical and surgical implications when treating the pes planus deformity.


2007 ◽  
Vol 28 (9) ◽  
pp. 991-995 ◽  
Author(s):  
Sandor Roth ◽  
Branko Sestan ◽  
Anton Tudor ◽  
Zdenko Ostojic ◽  
Anton Sasso ◽  
...  

Background: The aim of this study was to correct heel valgus in children and to lift the longitudinal arch of the foot using a temporary cancellous screw placed percutaneously across the talocalcaneal articulation. Methods: From April, 1997, to June, 2003, 94 procedures were done on 48 children between the ages of 8 and 14 years. The Meary angle to determine the degree of collapse of the medial longitudinal arch was 170 degrees or less, and the weightbearing hindfoot was in valgus. Presumably, the screw achieves correction by stimulating the proprioceptive foot receptors allowing active inversion of the foot. Results: At 5 years followup, no serious complications occurred. The correction of the Meary angle on average was 17.10 ± 5.51 degrees. In every foot, heel valgus and the longitudinal arch of the foot were improved radiographically and clinically without the loss of function. We removed the screws in all patients. In 91 feet, the arch of the foot and heel valgus remained in the corrected position. Conclusions: The ‘calcaneo-stop’ method is a simple, effective, minimally invasive technique for the treatment of idiopathic, flexible pes planus in carefully selected pediatric patients.


2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0021
Author(s):  
Gavin Heyes ◽  
Amir Vosoughi ◽  
Lyndon W Mason ◽  
Andrew P. Molloy

Category: Hindfoot, Midfoot/Forefoot Introduction/Purpose: Maintenance of the medial longitudinal arch is crucial to efficient kinematics in gait. It is supported by as complex interplay of osseous structures, ligaments, extrinsic tendons and plantar fascia. Two ligaments critical to stabilising the medial longitudinal arch are the Spring (Calcaneofibular) and Naviculocuneiform ligaments. The Spring Ligament serves as a sling within the “Acetabulum Pedis” to orientate the Talus relative to the Calcaneus and Navicular. The Naviculocuneiform ligament is an important plantar tension band and a separate entity to the Posterior Tibial Tendon (PTT) insertion. Attenuation of these ligaments leads to Pes Planus deformity and subsequent defunctioning of the PTT. This study evaluates the functional and radiological outcomes of Spring and Naviculocuneiform ligament reconstruction using Hamstring (Semitendinosis) Allograft and Synthetic ligament (Internal BraceTM, Arthrex). Methods: 33 consecutive Pes Planus reconstructions were performed between 11/11/2013 and 06/03/2018. All patients were followed up prospectively with serial radiographs and functional scores including; MOXFQ, EQF5D and VAS. Minimum follow up was six months. At the midpoint during the study there was transition to using Synthetic Ligament instead of allograft. This was due to availability and ease of use. Surgical technique for both reconstructions included a proximal medial gastrocnemius recession and medialising calcaneal osteotomy. For allograft reconstructions, a pre-tensioned Semitendinosis allograft was fixed proximally to Talar neck using a tenodesis screw and passed plantar to PTT and through a bone tunnel in the medial cuneiform. Synthetic ligaments were inserted from the Sustentaculum Tali to the medial cuneiform in a hammock fashion. In both reconstructions tendinopathic PTTs were excised and a Flexor Digitorum Longus transfer used. Results: There were 17 synthetic ligament reconstructions (6 male, 11 female) and 16 allograft reconstructions (6 male, 10 female). Groups were matched pre-operatively for age, functional scores and radiological markers (T test P values >0.05). At six months significantly better improvements were observed in the synthetic ligament group compared to allograft group with regards to VAS, MOXFQ pain score, Meary’s line, 1st metatarsal Talus angle, Talonavicular uncoverage angle and Hindfoot alignment (T test P < 0.05). Statistical significance was maintained at 12 months with the synthetic ligament providing a significantly better reduction of Meary’s line 1st Metatarsal Talar angle, Talonavicular uncoverage and hindfoot alignment. 2 patients were revised to double fusions in the allograft group and 1 patient revised in the synthetic ligament group. Conclusion: Statistically significant improved functional scores and radiological appearance can be found up to 1 year following Synthetic ligament reconstruction of the Spring and Naviculocuneiform ligaments when compared to Hamstring allograft.


2016 ◽  
Vol 106 (5) ◽  
pp. 344-351 ◽  
Author(s):  
Nicholas A. Campitelli ◽  
Scott A. Spencer ◽  
Kaitlyn Bernhard ◽  
Kristen Heard ◽  
Alan Kidon

Background: This study investigated the effect of Vibram FiveFingers Bikila minimalist shoes on intrinsic foot musculature. We hypothesized that a gradual transition into minimalist shoes will increase the thickness of the abductor hallucis muscle. Methods: Forty-one individuals were divided into four groups: control (traditional shod) (n = 9), restricted walking in Vibram FiveFingers (n = 11), running in Vibram FiveFingers (n = 10), and unlimited walking in Vibram FiveFingers (n = 11). At baseline, 12 weeks, and 24 weeks, the thickness of the abductor hallucis muscle was determined using ultrasound. Statistical analysis was performed to determine the significance of differences in muscle thickness at the three different time points. Results: The mean thickness of the abductor hallucis muscle at 24 weeks was significantly greater than that at baseline for the restricted walking (P = .005) and running (P &lt; .001) groups. In the unlimited walking group, the mean thickness of the muscle at 12 weeks was significantly greater than that at baseline (P &lt; .05) but not at 24 weeks. There were no significant differences in muscle thickness among the three time points for the control group (P = .432). Conclusions: This study demonstrated that wearing Vibram FiveFinger Bikila footwear over a controlled period of time, an unlimited amount of time, as well as transitioning runners over a 6-month period of time using the 10% philosophy for increasing mileage, significantly increases intrinsic muscle thickness of the abductor hallucis. The abductor hallucis muscle aids in support of the medial longitudinal arch, and an increase in this muscle thickness may help reduce running-related injuries thought to arise from arch weakness.


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