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Wang J, Wang Y, Zhou B, Wang L, Lai Z. Age-Related Reduction of Foot Intrinsic Muscle Function and the Relationship with Postural Stability in Old Adults. Clin Interv Aging 2024; 19:1005-1015. [PMID: 38855030 PMCID: PMC11162186 DOI: 10.2147/cia.s454068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/11/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction The risk of falls among the elderly significantly increases, which has become a serious public health concern. Falls can not only lead to serious complications such as fractures and brain injuries but also limit their mobility function, reducing quality of life. Foot intrinsic muscles (FIMs) are an essential part of foot core stability even overall postural stability. This study aimed to investigate the effects of aging on the function of FIMs and to explore the influence of FIMs on postural control in the elderly. Materials and Methods 56 healthy old participants (60-75 years) and 57 healthy young participants (18-29 years) joined this study. An ergoFet dynamometer was used to determine foot muscle strength (Doming, T1, T23 and T2345), and ankle muscle strength (plantarflexion and dorsiflexion). The morphology of FIMs and extrinsic foot muscle was determined using a Doppler ultrasound system, whereas the postural stability was assessed through Limits of Stability test. Independent samples t-test was used to determine the differences in strength and morphological parameters and Spearman correlation analysis was used to determine whether an association existed between muscle strength and postural stability parameters in the elderly. Results Compared with young adults, foot muscle strength and ankle muscle strength (Doming, T1, T23, T2345, dorsiflexion, and plantarflexion, all p <0.05) and the morphology of foot muscles (all p <0.05) were significantly reduced in the elderly. The strength of FIMs and the limit of stability (r = 0.302-0.424, all p <0.05) were significantly correlated in the elderly. Conclusion Compared with young adults, the weakness of strength as well as the morphological decline of the intrinsic and extrinsic foot muscles were found in the elderly. In addition, a correlation was observed between FIM's strength and postural stability in the elderly, suggesting their potential role in posture stability.
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Affiliation(s)
- Jiayi Wang
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Yuanyuan Wang
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Bangguo Zhou
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Shanghai, People’s Republic of China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, People’s Republic of China
| | - Zhangqi Lai
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
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2
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Sharma T, Copeland PV, Debenham MIB, Bent LR, Dalton BH. Neuromechanical characterization of the abductor hallucis and its potential role in upright postural control. Appl Physiol Nutr Metab 2024; 49:293-305. [PMID: 37913527 DOI: 10.1139/apnm-2023-0226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
There is growing evidence to support a role for the abductor hallucis (AH) in standing balance control; however, functional properties of the muscle that may provide more insight into AH's specific contribution to upright posture have yet to be characterized. This study was conducted to quantify functional neuromechanical properties of the AH and correlate the measures with standing balance variables. We quantified strength and voluntary activation during maximal voluntary isometric contractions of the great toe abductor in nine (3 females and 6 males) healthy, young participants. During electrically evoked twitch and tetanic contractions, we measured great toe abduction peak force and constructed a force-frequency curve. We also evaluated peak abduction force, contraction time (CT), half-relaxation time (HRT), rate of force development (RFD), and relaxation rate (RR) from twitch contractions evoked using doublet stimuli. Strength, VA, CT, HRT, RFD, and RR were correlated to centre of pressure standard deviation (COP SD) and velocity (COP VEL) variables of the traditional COP trace and its rambling and trembling components during single-legged stance. AH twitch properties (e.g., CT: 169.8 ± 32.3 ms; HRT: 124.1 ± 29.2 ms) and force-frequency curve were similar to other slow contractile muscles. Contractile speed related negatively with COP VEL, suggesting AH may be appropriate for slow, prolonged tasks such as ongoing postural balance control. Correlation coefficient outcomes for all variables were similar between rambling and trembling components. Our results provide further evidence for the importance of AH neuromechanical function for standing balance control, at least during a challenging single-legged posture.
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Affiliation(s)
- Tushar Sharma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Paige V Copeland
- School of Health and Exercise Sciences, University of British Columbia-Okanagan, Kelowna, BC, Canada
| | - Mathew I B Debenham
- School of Health and Exercise Sciences, University of British Columbia-Okanagan, Kelowna, BC, Canada
| | - Leah R Bent
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Brian H Dalton
- School of Health and Exercise Sciences, University of British Columbia-Okanagan, Kelowna, BC, Canada
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3
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Maeda N, Tsutsumi S, Arima S, Ikuta Y, Ushio K, Komiya M, Tashiro T, Nishikawa Y, Kobayashi T, Nakasa T, Adachi N, Urabe Y. Relationship between foot morphologic characteristic and postural control after jump-landing in youth competitive athletes. J Back Musculoskelet Rehabil 2024; 37:419-426. [PMID: 38073371 DOI: 10.3233/bmr-230122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND Foot arch dynamics play an important role in dynamic postural control. Association between foot arch dynamics and postural control among adolescent athletes remains poorly explored. OBJECTIVE To examine the relationship between foot arch dynamics, intrinsic foot muscle (IFM) morphology, and toe flexor strength and dynamic postural stability after jump landing and repetitive rebound jump performance in competitive adolescent athletes. METHODS Based on foot arch dynamics, evaluated from relative change in the foot arch height in sitting and standing positions, 50 adolescent athletes were classified as stiff, normal, or flexible. IFM morphology was evaluated by ultrasonography. Dynamic postural stability index (DPSI) was measured as participants jumped and landed with the right leg onto a force plate, whereas repetitive rebound jumping performance was assessed using the jump height and reactive jump index. RESULTS The stiff group had a significantly worse DPSI and vertical stability index than the normal group (p= 0.26, p= 0.44, respectively), and worse anteroposterior stability index (APSI) values than the flexible group (p= 0.005). Multivariate regression models of the relationship between the APSI and foot arch dynamics showed adequate power (probability of error = 0.912). CONCLUSIONS Increased foot arch stiffness negatively affects dynamic balance during jump-landing, which may deteriorate their performance.
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Affiliation(s)
- Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shogo Tsutsumi
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasunari Ikuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Kai Ushio
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsubasa Tashiro
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science and Engineering, Kanazawa University, Kanazawa, Japan
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Tomoyuki Nakasa
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Maeda N, Ikuta Y, Tsutsumi S, Arima S, Ishihara H, Ushio K, Mikami Y, Komiya M, Nishikawa Y, Nakasa T, Adachi N, Urabe Y. Relationship of Chronic Ankle Instability With Foot Alignment and Dynamic Postural Stability in Adolescent Competitive Athletes. Orthop J Sports Med 2023; 11:23259671231202220. [PMID: 37859752 PMCID: PMC10583524 DOI: 10.1177/23259671231202220] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 05/19/2023] [Indexed: 10/21/2023] Open
Abstract
Background Competitive adolescent athletes should be aware of the early signs of chronic ankle instability (CAI) and the connection between the condition and performance. Purpose To investigate whether CAI is related to foot alignment and morphology as well as dynamic postural stability after a jump landing among adolescent competitive athletes with and without a history of a lateral ankle sprain and CAI. Study Design Cross-sectional study; Level of evidence, 3. Methods Between July 2020 and August 2021, adolescent competitive athletes (N = 85; n = 49 boys; n = 36 girls) were classified into 3 groups using Cumberland Ankle Instability Tool (CAIT) scores: healthy athletes (n = 55), coper athletes (n = 19), and athletes with CAI (n = 11). Results of foot alignment assessments involving the leg-heel angle (LHA) and navicular height, intrinsic foot muscle morphology, dynamic postural stability index (DPSI), and other parameters were compared among the 3 groups. The relationship between the CAIT score and the LHA and dynamic postural stability and instability were examined using multiple linear regression. Results Compared with the healthy group, the CAI group had a significantly greater LHA (8.73°± 3.22° vs 6.09°± 3.26°; P < .05), higher DPSI (0.336 ± 0.046 vs 0.298 ± 0.035), and higher vertical stability index (0.303 ± 0.048 vs 0.264 ± 0.037; P < .05 for all). Multiple regression analysis showed that the LHA (β = -0.228; P = .033) and DPSI (β = -0.240; P = .025) were significantly associated with the CAIT score . Conclusion Valgus rearfoot alignment and poorer dynamic postural control were associated with CAI among adolescent athletes.
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Affiliation(s)
- Noriaki Maeda
- Department of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasunari Ikuta
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shogo Tsutsumi
- Department of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoshi Arima
- Department of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Honoka Ishihara
- Department of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Makoto Komiya
- Department of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa, Japan
| | - Tomoyuki Nakasa
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Haelewijn N, Peters Dickie JL, Staes F, Vereecke E, Deschamps K. Current evidence regarding 2D ultrasonography monitoring of intrinsic foot muscle properties: A systematic review. Heliyon 2023; 9:e18252. [PMID: 37520980 PMCID: PMC10374929 DOI: 10.1016/j.heliyon.2023.e18252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background Ultrasonography can discriminate between intrinsic and extrinsic foot muscle properties and has therefore gained considerable popularity as an indirect strength evaluation. However, an overview on the use of ultrasound for assessing intrinsic foot musculature (IFM) is currently lacking. Research question What is the current evidence regarding (1) 2D ultrasonography protocols and its reliability? (2) Reference values for cross-sectional area and dorso-plantar thickness evaluation in asymptomatic and symptomatic persons? Methods The PRISMA guidelines were used to conduct this systematic review. Eight databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, SPORTDiscus and EuropePMC) were searched up to November 1, 2021. Studies reporting quantitative 2D ultrasound findings of the intrinsic foot muscles with no limitation to sex, BMI, ethnicity or physical activity were included. Studies were assessed for methodological quality using the Downs and Black checklist. Results Fifty-three studies were retained. Protocols showed an overall good to great reliability, suggesting limits of agreement between 8 and 30% of relative muscle size with minimal detectable changes varying from 0.10 to 0.29 cm2 for cross-sectional area and 0.03-0.23 cm for thickness. Reference values are proposed for both cross-sectional area and thickness measurements of the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis and quadratus plantae in asymptomatic persons. This could not be performed in the symptomatic studies due to a limited number of relevant studies addressing the symptomatic population, therefore a clinical overview is outlined. Clinically, IFM properties have been studied in ten distinct pathological conditions, predominantly pointing towards decreased muscle properties of the abductor hallucis. Significance We provide a clear and comprehensive overview of the literature regarding 2D ultrasonography of the IFM, making the available evidence more accessible to decision makers and researchers.
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Affiliation(s)
- Nicolas Haelewijn
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
| | - Jean-Louis Peters Dickie
- Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Filip Staes
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Tervuursevest 101, 3000 Leuven, Belgium
| | - Evie Vereecke
- Department of Development & Regeneration, Muscles & Movement Group, KU Leuven, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
- Haute Ecole Leonard De Vinci, Division of Podiatry, Avenue E. Mounier 84, 1200 Sint-Lambrechts-Woluwe, Belgium
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6
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Kaneda K, Maeda N, Ikuta Y, Tashiro T, Tsutsumi S, Arima S, Sasadai J, Suzuki Y, Morikawa M, Komiya M, Adachi N, Urabe Y. The Features of Foot Morphology and Intrinsic Foot Muscle Property in Adolescent Swimmers: An Ultrasound-Based Study. J Hum Kinet 2023; 87:95-103. [PMID: 37559776 PMCID: PMC10407327 DOI: 10.5114/jhk/163148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/30/2022] [Indexed: 08/11/2023] Open
Abstract
This cross-sectional study aimed to investigate the relationship between foot shape and intrinsic foot muscles (IFMs) in adolescent swimmers compared with other athletes. Foot morphology of swimmers was compared with other athletes of comparable age and a competition level (n = 32 [64 feet]; a total of 64 feet; 128 feet in two groups). Foot morphology and variables of IFMs were measured using a three-dimensional foot scanner and an ultrasound imaging system, respectively. Multiple linear regression analysis with forced entry was performed to clarify the association of the thickness and the cross-sectional area (CSA) of IMFs with the navicular height in both sitting and standing positions. Navicular height in a standing position, the thickness of the abductor hallucis (AbH) and the flexor digitorum brevis (FDB), as well as the CSA were significantly lower in swimmers compared with other athletes (p < 0.05). A larger CSA for the flexor hallucis brevis (FHB) was observed in swimmers than in other athletes (p < 0.01). The navicular height of swimmers in sitting and standing positions was positively correlated with the thickness and the CSA of the FHB and the FDB (p < 0.05). Multiple regression analysis showed that navicular height was associated with the CSA of the FDB in both sitting and standing positions (β = 0.395; p < 0.002, β = 0.201; p < 0.018). This study showed that the navicular height of elite adolescent swimmers was lower than that of other athletes. Furthermore, the swimmers' high navicular height was associated with the CSA of the FDB, suggesting that the FDB might be more involved in the formation of the medial longitudinal arch than the AbH.
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Affiliation(s)
- Kazuki Kaneda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasunari Ikuta
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Tsubasa Tashiro
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shogo Tsutsumi
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Junpei Sasadai
- Sports Medical Center, Japan Institute of Sports Sciences, Japan Sport Council, Tokyo, Japan
| | - Yuta Suzuki
- Department of Physical Therapy, Faculty of Rehabilitation, Kyusyu Nutrition Welfare University, Fukuoka, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Fujishita H, Ikuta Y, Maeda N, Komiya M, Morikawa M, Arima S, Sakamitsu T, Obayashi H, Fukuhara K, Ushio K, Adachi N. Effects of Rearfoot Eversion on Foot Plantar Pressure and Spatiotemporal Gait Parameters in Adolescent Athletes. Healthcare (Basel) 2023; 11:1842. [PMID: 37444676 DOI: 10.3390/healthcare11131842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/25/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. METHODS This retrospective study included 39 adolescent athletes who were divided into the rearfoot eversion and control groups according to a leg heel angle of 7°. A total of 78 legs were analyzed (45 and 33 legs in the rearfoot eversion [women, 53.3%] and control groups [women, 48.5%], respectively). Gait was assessed using an in-shoe plantar pressure measuring system and a wearable inertial sensor. RESULTS The foot plantar pressure distribution in the hallux was higher in the rearfoot eversion group than that in the control group (p = 0.034). Spatiotemporal parameters showed that the foot pitch angle at heel strike was significantly larger in the rearfoot eversion group than that in the control group (24.5° vs. 21.7°; p = 0.015). Total sagittal range of motion of the ankle during the stance phase of gait was significantly larger in the rearfoot eversion group than that in the control group (102.5 ± 7.1° vs. 95.6 ± 15.8°; p = 0.020). Logistic regression analysis revealed that plantar pressure at the hallux and medial heel and foot pitch angle at heel strike were significantly associated with rearfoot eversion. CONCLUSIONS Our findings suggest that rearfoot eversion affects the gait patterns of adolescent athletes. Notably, leg heel angle assessment, which is a simple and quick procedure, should be considered as an alternative screening tool for estimating plantar pressure and spatiotemporal gait parameters to prevent sports-related and overuse injuries in adolescent athletes.
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Affiliation(s)
- Hironori Fujishita
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Yasunari Ikuta
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Masanori Morikawa
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Tetsuhiko Sakamitsu
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Hiromune Obayashi
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Kouki Fukuhara
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
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Arima S, Maeda N, Tsutsumi S, Ishihara H, Ikuta Y, Ushio K, Fujishita H, Kobayashi T, Komiya M, Morikawa M, Adachi N, Urabe Y. Association of the intrinsic foot muscles and plantar fascia with repetitive rebound jumping and jump landing in adolescent athletes: An ultrasound-based study. Gait Posture 2023; 99:146-151. [PMID: 36436441 DOI: 10.1016/j.gaitpost.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/17/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The characteristics of foot structure in adolescents and adults are different, affecting sports performance and leading to the progression of foot and lower extremity disorders. RESEARCH QUESTION This study aimed to investigate the relationship between the intrinsic foot muscles (IFM) and plantar fascia morphology and the repetitive rebound jumping and jump landing ability in adolescent athletes. METHODS A total of 60 adolescent athletes (35 boys and 25 girls) participated in this study. B-mode ultrasonography was used to obtain images of the IFM and plantar fascia morphology [thickness and cross-sectional area (CSA) of the abductor hallucis (AbH), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and thickness of the plantar fascia]. The repetitive rebound jump performance was evaluated using the Optojump™ system. Participants were instructed to jump five times continuously with one leg, jumping as high as possible with minimal ground contact time. The jump landing was assessed by measuring the dynamic posture stability index (DPSI) using forward one-legged jump landings. RESULTS The thickness and CSA of the AbH and FDB were positively correlated with the jump height and reactive jump index. The DPSI score was significantly correlated with the thickness of the AbH, but not with other IFMs or plantar fascia. In the multiple regression analysis, only the thickness of the FDB was associated with the jump height and reactive jump index, indicating that FDB thickness might facilitate adolescent athletes to jump higher with minimal contact time in repetitive rebounding movements. SIGNIFICANCE The IFM (especially FDB) should be focused on when examining sports performance in adolescent athletes.
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Affiliation(s)
- Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Shogo Tsutsumi
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Honoka Ishihara
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Yasunari Ikuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kai Ushio
- Sports Medical Center, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Hironori Fujishita
- Sports Medical Center, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Masanori Morikawa
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan.
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9
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Nguyen AP, Detrembleur C, Fisette P, Selves C, Mahaudens P. MyotonPro Is a Valid Device for Assessing Wrist Biomechanical Stiffness in Healthy Young Adults. Front Sports Act Living 2022; 4:797975. [PMID: 35265831 PMCID: PMC8899712 DOI: 10.3389/fspor.2022.797975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background The MyotonPro is a portable device for measuring biomechanical and viscoelastic properties in superficial soft tissues. The aims of this study are firstly to validate the MyotonPro compared to a reliable gold-standard frame and secondly to observe the influence of MyotonPro measurement on the total wrist viscoelasticity. Methods Three silicone polymers with different elastic properties were assessed with the MyotonPro and with a reference rheometer (Universal Tribometer Mod). Then, a free oscillations method was used to measure the passive elastic and viscous stiffness of the wrist and compared to MyotonPro forearm measurements. Results A one-way ANOVA demonstrated the validity of the MyotonPro's stiffness (p = 0.001), decrement (p < 0.001), and relaxation (p = 0.008) parameters for measuring the elastic stiffness (k) of the three polymers. The MyotonPro parameters demonstrated excellent reliability on the forearm. Proximal and distal anterior myofascial measurements of the MyotonPro were moderately correlated to the elastic stiffness (p = 0.0027-0.0275, absolute r = from 0.270 to 0.375) of the wrist while the postero-distal myofascial tissues of the forearm demonstrated a moderate correlation with the viscous stiffness of the wrist (p = 0.0096-0.0433, absolute r = from 0.257 to 0.326). Discussion The MyotonPro is a valid device for measuring elastic stiffness as well as a portable, affordable, and easy-to-use tool for quantifying the biomechanical properties and viscoelasticity of myofascial tissue in healthy subjects.
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Affiliation(s)
- Anh Phong Nguyen
- Neuromusculoskeletal Laboratory, Institut de Recherche Expérimentale et Clinique, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Christine Detrembleur
- Neuromusculoskeletal Laboratory, Institut de Recherche Expérimentale et Clinique, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Paul Fisette
- Institute of Mechanics, Materials and Civil Engineering, Mechatronic, Electrical Energy and Dynamic Systems, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Clara Selves
- Neuromusculoskeletal Laboratory, Institut de Recherche Expérimentale et Clinique, Catholic University of Louvain, Louvain-la-Neuve, Belgium
- Service de Médecine Physique et Réadaptation, Cliniques Universitaires Saint-Luc, Woluwe-Saint-Lambert, Belgium
| | - Philippe Mahaudens
- Neuromusculoskeletal Laboratory, Institut de Recherche Expérimentale et Clinique, Catholic University of Louvain, Louvain-la-Neuve, Belgium
- Service de Médecine Physique et Réadaptation, Cliniques Universitaires Saint-Luc, Woluwe-Saint-Lambert, Belgium
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Effect of Combined Balance Exercises and Kinesio Taping on Balance, Postural Stability, and Severity of Ankle Instability in Female Athletes with Functional Ankle Instability. Life (Basel) 2022; 12:life12020178. [PMID: 35207466 PMCID: PMC8879431 DOI: 10.3390/life12020178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/18/2022] Open
Abstract
Ankle sprain is a common musculoskeletal injury, and recurrent ankle sprains often lead to ankle instability. This study aimed to examine whether a 6-week balance training on a wobble board (WB) combined with kinesio taping (KT) is effective in improving balance, postural stability, and ankle stability among female athletes with functional ankle instability (FAI). Twenty-four female athletes with FAI were randomly assigned to study (SG) or control groups (CG). SG attended a 6-week training protocol of combined balance training on the wobble board with KT applied to ankles during exercise. CG only went through a 6-week balance training procedure that was the same as the SG. Before and after the training program, balance and postural stability and the severity of ankle instability were assessed by single-leg Biodex Balance system and Cumberland Ankle Instability Tool (CAIT), respectively. The analysis revealed that the scores of balance and postural stability decreased after the 6-week training for CG (p = 0.002) and SG (p = 0.001), which indicates an improvement for these variables, and the score of CAIT increased, which means the severity of instability reduced (p = 0.001 for both groups). Significant between-group differences were found for balance and postural stability (t = 2.79, p = 0.011, g = −1.99) and the severity of instability (t = 2.082, p = 0.049, g = 1.36), favoring SG compared with CG. This study showed that the addition of KT to balance training is more effective than balance training alone in improving balance, postural stability, and severity of ankle instability in female athletes with FAI. Our findings could provide a preliminary reference for designing combined balance and KT programs for delivering health benefits to females with FAI.
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11
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Ichikawa S, Kumai T, Okunuki T, Maemichi T, Matsumoto M, Yabiku H, Liu Z, Yamaguchi R, Iwayama A, Ayukawa G, Akiyama Y, Mitsui H, Niki H. Comparison of foot posture and foot muscle morphology between lifesaver athletes and healthy adults. Res Sports Med 2021:1-11. [PMID: 34802357 DOI: 10.1080/15438627.2021.2002330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to compare the foot muscle morphology and foot posture between healthy adults and lifesavers in sandy beach sports. The participants included 15 lifesaver athletes and 15 healthy adults. Using a non-contact three-dimensional foot measurement device, the foot length, width, and arch height of the right foot were measured while standing and sitting without back support, and the transverse arch length ratio and arch height index were subsequently calculated. Muscle cross-sectional area was measured using an ultrasound imaging device. Muscle cross-sectional areas, arch height, foot width, arch height index, and transverse arch length ratio were larger in the lifesaver than in the healthy adult group. Lifesavers had higher arches and more developed intrinsic and extrinsic muscles than healthy adults. Performing physical activity while barefoot on sandy beaches may effectively develop the foot intrinsic and extrinsic muscles and raise the arch.
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Affiliation(s)
- Shota Ichikawa
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan.,Department of Orthopaedic Surgery, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | | | - Masatomo Matsumoto
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan.,Department of Rehabilitation, Kuwana City Medicine Center, Mie, Japan
| | - Hiroki Yabiku
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Ryusei Yamaguchi
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Arina Iwayama
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Goro Ayukawa
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Yui Akiyama
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroyuki Mitsui
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hisateru Niki
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
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12
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Maeda N, Hirota A, Komiya M, Morikawa M, Mizuta R, Fujishita H, Nishikawa Y, Kobayashi T, Urabe Y. Intrinsic foot muscle hardness is related to dynamic postural stability after landing in healthy young men. Gait Posture 2021; 86:192-198. [PMID: 33756408 DOI: 10.1016/j.gaitpost.2021.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/28/2021] [Accepted: 03/03/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The human foot has competent mechanisms for supporting weight and adapting movement to various surfaces; in particular, the toe flexor muscles aid in supporting the foot arches and may be important contributors to postural stability. However, the role of intrinsic foot muscle morphology and structure in the postural control system remains unclear, and the relationship between them is not well known. RESEARCH QUESTION Are intrinsic foot muscle morphology and toe flexor strength related to static and dynamic postural stability in healthy young men?. METHODS A total of 27 healthy men aged 19-27 years participated in this study. intrinsic foot muscle morphology included muscle hardness and thickness. Cross-sectional area was measured by ultrasonography at an ankle dorsiflexion angle of 0°. The hardness of the abductor hallucis (AbH), flexor hallucis brevis, and flexor digitorum brevis (FDB) muscles was measured using ultrasound real-time tissue elastography. Static postural stability during single-leg standing on a single force platform with closed eyes was assessed for the right leg. In the assessment of dynamic postural stability, the subjects jumped and landed on single-leg onto a force platform and the dynamic postural stability index (DPSI) was measured. RESULTS FDB muscle thickness showed a positive correlation with anteroposterior stability index (APSI) (r = 0.398, p = 0.040). AbH muscle hardness was negatively correlated with APSI (r = -0.407, p = 0.035); whereas FDB muscle hardness was positively correlated with DPSI (r = 0.534, p = 0.004), vertical stability index (r = 0.545, p = 0.003), and maximum vertical ground reaction force (r = 0.447, p = 0.020). Multiple regression with forced entry revealed that only DPSI was significantly correlated with FDB muscle hardness (p = 0.003). SIGNIFICANCE The results indicated that intrinsic foot muscle hardness plays an important role in dynamic postural control among healthy young men, which may enable a more rapid muscular response to changes in condition during jump landing and better performance in balance tasks.
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Affiliation(s)
- Noriaki Maeda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Arisu Hirota
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Makoto Komiya
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Masanori Morikawa
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Rami Mizuta
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Hironori Fujishita
- Sports Medical Center, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa, Japan
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China
| | - Yukio Urabe
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
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13
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Morikawa M, Maeda N, Komiya M, Hirota A, Mizuta R, Kobayashi T, Kaneda K, Nishikawa Y, Urabe Y. Contribution of Plantar Fascia and Intrinsic Foot Muscles in a Single-Leg Drop Landing and Repetitive Rebound Jumps: An Ultrasound-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094511. [PMID: 33922807 PMCID: PMC8123000 DOI: 10.3390/ijerph18094511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/10/2021] [Accepted: 04/19/2021] [Indexed: 11/16/2022]
Abstract
The plantar fascia and intrinsic foot muscles (IFM) modulate foot stiffness. However, it is unclear whether the corresponding ultrasonography findings reflect it. This study aimed to examine the effect of the plantar fascia and IFM morphologies on force attenuation during landing and reactivity when jumping in healthy adults (n = 21; age, 21-27 years). Thickness, cross-sectional area (CSA), and hardness of the plantar fascia, abductor hallucis (AbH), and flexor hallucis brevis (FHB) muscles were measured using ultrasonography. Single-leg drop landing and repetitive rebound jumping tests assessed the ground reaction force (GRF) and reactive jump index (RJI), respectively. The CSA of FHB was negatively correlated with maximum vertical GRF (r = -0.472, p = 0.031) in the single-leg drop landing test. The CSA of AbH was negatively correlated with contact time (r = -0.478, p = 0.028), and the plantar fascia thickness was positively correlated with jump height (r = 0.615, p = 0.003) and RJI (r = 0.645, p = 0.002) in the repetitive bound jump test. In multivariate regression analysis, only the plantar fascia thickness was associated with RJI (β = 0.152, 95% confidence interval: 7.219-38.743, p = 0.007). The CSA of FHB may contribute to force attenuation during landing. The thickness of the plantar fascia and CSA of AbH may facilitate jumping high with minimal contact time.
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Affiliation(s)
- Masanori Morikawa
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Noriaki Maeda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Makoto Komiya
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Arisu Hirota
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Rami Mizuta
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China;
| | - Kazuki Kaneda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa 076-264-5111, Japan;
| | - Yukio Urabe
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
- Correspondence:
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14
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Park DJ, Hwang YI. Comparison of the Intrinsic Foot Muscle Activities between Therapeutic and Three-Dimensional Foot-Ankle Exercises in Healthy Adults: An Explanatory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197189. [PMID: 33019530 PMCID: PMC7578945 DOI: 10.3390/ijerph17197189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/22/2020] [Accepted: 09/29/2020] [Indexed: 01/26/2023]
Abstract
Background: In recent years, a three-dimensional ankle exercise has been proposed as a practice for strengthening the intrinsic foot muscles, however this topic still requires further research. This study aimed to compare the activities of the intrinsic muscles in healthy participants during 3D foot–ankle exercises, namely, short foot (SF), and toe spread out (TSO). Methods: Prior to the experiment, 16 healthy adults were trained on how to perform SF, TSO, and 3D foot–ankle exercises for an hour. Once all participants passed the foot–ankle exercise performance test, we randomly measured the activity of the intrinsic foot muscles using electromyography while the patients were performing foot–ankle exercises. Results: The abductor hallucis (AbH), extensor hallucis longus (EHL), and flexor hallucis brevis (FHB) activities showed significant differences among the exercises for intrinsic foot muscle strengthening (p < 0.01). Additionally, the AbH/AdH (adductor hallucis) ratio showed significant differences among the exercises for strengthening the intrinsic foot muscles (p < 0.01). Conclusions: Our results showed that the 3D extension exercise is as effective as the therapeutic exercise in terms of the AbH and FHB activities, and the AbH/AdH ratio. On the contrary, the 3D flexion exercise showed superiority in terms of the EHL activity.
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Affiliation(s)
- Du-Jin Park
- Department of Industrial Health, College of Health Sciences, Catholic University of Pusan, Busan 46252, Korea;
| | - Young-In Hwang
- Department of Physical Therapy, College of Life and Health Science, Hoseo University, Asan 31499, Korea
- Correspondence: ; Tel.: +82-41-540-9973
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