Associations Between the Size of Individual Plantar Intrinsic and Extrinsic Foot Muscles and Toe Flexor Strength

Background The size of the plantar intrinsic and extrinsic foot muscles has been shown to be associated with toe flexor strength (TFS). Previous studies adopted the size of a limited plantar intrinsic foot muscle or a compartment containing several muscles as an independent variable for TFS. Among the plantar intrinsic and extrinsic foot muscles, therefore, it is unclear which muscle(s) primarily contributes to TFS development. The present study aimed to clarify this subject. Methods In 17 young adult men, a series of anatomical cross-sectional area of individual plantar intrinsic and extrinsic foot muscles was obtained along the foot length and the lower leg length, respectively, using the magnetic resonance imaging. Maximal anatomical cross-sectional area (ACSAmax) and muscle volume (MV) for each constituent muscle of the plantar intrinsic foot muscles (flexor hallucis brevis; flexor digitorum brevis, FDB; abductor hallucis; adductor hallucis oblique head, ADDH-OH; adductor hallucis transverse head, ADDH-TH; abductor digiti minimi; quadratus plantae) and extrinsic foot muscles (flexor hallucis longus; flexor digitorum longus) were measured. TFS was measured with a toe grip dynamometry. Results TFS was significantly associated with the ACSAmax for each of the ADDH-OH (r = 0.674, p = 0.003), ADDH-TH (r = 0.523, p = 0.031), and FDB (r = 0.492, p = 0.045), and the MV of the ADDH-OH (r = 0.582, p = 0.014). As for the ADDH-OH, the correlation coefficient with TFS was not statistically different between ACSAmax and MV (p = 0.189). Stepwise regression analysis indicated that ACSAmax and MV of the ADDH-OH alone explained 42% and 29%, respectively, of the variance in TFS. Conclusion The ADDH-OH is the key muscle that primarily contributes to TFS development among the plantar intrinsic and extrinsic foot muscles.

Differences in toe flexor strength and foot morphology between wheelchair dependent and ambulant older people in long-term care: a cross-sectional study

Background Hallux valgus, lesser toe deformity, and muscle weakness of the toe flexors contribute to falls in older people. This study aimed to examine the differences in toe flexor strength and foot morphology in older people requiring long-term care due to changes in the way they mobilize in everyday life. Methods This study included 84 people aged ≥70 years without motor paralysis who underwent rehabilitation. They were divided into those who could mobilize without a wheelchair (walking group, n = 54) and those who used a wheelchair to mobilize (wheelchair group, n = 30). The presence or absence of diseases was confirmed, and hand grip strength, toe flexor strength, and foot morphology using the foot printer were measured. The presence of diseases, hand grip strength, toe flexor strength, and foot morphology were compared between the two groups. Multiple logistic analysis was performed with wheelchair dependence as the dichotomous outcome variable, and the percentages of each strength measure observed in the wheelchair group to the average hand grip and toe flexor strength measures in the walking group were compared. Results No significant between-group difference in foot morphology was found. The factors related to the differences in ways of ambulating in daily life were history of fracture, heart disease, and toe flexor strength. After comparing the muscle strength of the wheelchair group with the mean values of the walking group, we found that the toe flexor strength was significantly lower than the hand grip strength. Conclusions Older people who used a wheelchair to mobilize have significantly less toe flexor strength than those who do not despite no significant difference in foot morphology. Use of a wheelchair is associated with a reduction in toe flexor strength.

Toe flexor strength and foot morphology in older people requiring long-term care due to changes in their means of mobilizing in daily life: a cross-sectional study

Background: Hallux valgus and lesser toe deformity reduce the strength of the toe flexors and are a cause of falls in older people. This study aimed to examine the differences in toe flexor strength and foot morphology in older people requiring long-term care due to changes in the way they mobilize in everyday life.Methods: Eighty-four people aged ≥70 without motor paralysis who are undergoing or had undergone ambulatory rehabilitation. They were divided into those who could mobilize without a wheelchair (walking group, n=54) and those who used a wheelchair to mobilize (wheelchair group, n=30). Presence of diseases, hand grip strength, toe flexor strength, and foot morphology were compared between the two groups.Results: No significant between-group difference in foot morphology was found. Factors related to differences in the means used to mobilize in daily life were a history of fracture, heart disease, and toe flexor strength. In muscle strength of the wheelchair group compared with the mean values of the walking group, the toe flexor strength was significantly more decreased in relation to hand grip strength.Conclusions: Older people who use a wheelchair to mobilize have significantly less toe flexor strength than those who do not despite having no significant difference in foot morphology. Use of a wheelchair is associated with a reduction in toe flexor strength.

Toe flexor strength is associated with mobility in older adults with pronated and supinated feet but not with neutral feet

Background Older adults are known to have more pronated foot posture and decreased toe flexor strength (TFS), as well as decreased mobility in daily life compared to young adults. Although foot posture is reported to be an influential factor for walking biomechanics in young adults, there is less information on this subject in older adults. Age-related reduction in TFS is shown to be associated with impairments of functional performance, but it is poorly understood whether foot posture influences the relationships between TFS and functional performances. Therefore, the present study aimed to elucidate this concern by examining older women. Methods Seventy community-dwelling older women (76.8 ± 4.4 years) voluntarily participated in this study. Foot posture was evaluated by the 6-item foot posture index (FPI). Based on the FPI score, participants were allocated to pronated, neutral, or supinated group (n = 33, 26, and 11, respectively). TFS was assessed using a toe grip dynamometer in a seated position. Scores of 30-s chair stand, timed up-and-go, 5-m comfortable-speed walking, and static balance tests were determined to evaluate functional performances. Pearson’s correlation coefficients were computed to examine the relationships between TFS and functional performances in each group. Results TFS positively correlated with comfortable walking speed in the pronated (r = 0.37, p = 0.03) and supinated (r = 0.76, p < 0.001) groups, but not in the neutral group (r = 0.17, p = 0.42). For the two significant relationships, an analysis of covariance showed that there was no significant difference between the pronated and supinated groups in the slopes of the regression lines, suggesting a similar relative contribution of TFS to comfortable walking speed between the two groups. In addition, TFS tended to negatively correlate with timed up-and-go time in the pronated (r = − 0.32, p = 0.07) and supinated (r = − 0.56, p = 0.08) groups, and positively correlate with 30-s chair stand score in the pronated group (r = 0.31, p = 0.08). Conclusions The present study indicates that TFS would be associated with mobility, walking performance in particular, in older women with pronated and supinated feet but not with neutral feet.

Toe flexor strength is associated with mobility in older adults with pronated and supinated feet but not with neutral feet

Background: Older adults are known to have more pronated foot posture and decreased toe flexor strength (TFS), as well as decreased mobility in daily life compared to young adults. Although foot posture is reported to be an influential factor for walking biomechanics in young adults, there is less information on this subject in older adults. Age-related reduction in TFS is shown to be associated with impairments of functional performance, but it is poorly understood whether foot posture influences the relationships between TFS and functional performances. Therefore, the present study aimed to elucidate this concern by examining older women. Methods: Seventy community-dwelling older women (76.8 ± 4.4 years) voluntarily participated in this study. Foot posture was evaluated by the 6-item foot posture index (FPI). Based on the FPI score, participants were allocated to pronated, neutral, or supinated group (n = 33, 26, and 11, respectively). TFS was assessed using a toe grip dynamometer in a seated position. Scores of 30-second chair stand, timed up-and-go, 5-m comfortable-speed walking, and static balance tests were determined to evaluate functional performances. Pearson’s correlation coefficients were computed to examine the relationships between TFS and functional performances in each group. Results: TFS positively correlated with comfortable walking speed in the pronated (r = 0.37, p = 0.03) and supinated (r = 0.76, p < 0.001) groups, but not in the neutral group (r = 0.17, p = 0.42). For the two significant relationships, an analysis of covariance showed that there was no significant difference between the pronated and supinated groups in the slopes of the regression lines, suggesting a similar relative contribution of TFS to comfortable walking speed between the two groups. In addition, TFS tended to negatively correlate with timed up-and-go time in the pronated (r = -0.32, p = 0.07) and supinated (r = -0.56, p = 0.08) groups, and positively correlate with 30-second chair stand score in the pronated group (r = 0.31, p = 0.08). Conclusions: The present study indicates that TFS would be associated with mobility, walking performance in particular, in older women with pronated and supinated feet but not with neutral feet.