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Hile ES, Ghazi M, Chandrashekhar R, Rippetoe J, Fox A, Wang H. Development and Earliest Validation of a Portable Device for Quantification of Hallux Extension Strength (QuHalEx). SENSORS (BASEL, SWITZERLAND) 2023; 23:4654. [PMID: 37430569 PMCID: PMC10223981 DOI: 10.3390/s23104654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 07/12/2023]
Abstract
Hallux strength is associated with sports performance and balance across the lifespan, and independently predicts falls in older adults. In rehabilitation, Medical Research Council (MRC) Manual Muscle Testing (MMT) is the clinical standard for hallux strength assessment, but subtle weakness and longitudinal changes in strength may go undetected. To address the need for research-grade yet clinically feasible options, we designed a new load cell device and testing protocol to Quantify Hallux Extension strength (QuHalEx). We aim to describe the device, protocol and initial validation. In benchtop testing, we used eight precision weights to apply known loads from 9.81 to 78.5 N. In healthy adults, we performed three maximal isometric tests for hallux extension and flexion on the right and left sides. We calculated the Intraclass Correlation Coefficient (ICC) with 95% confidence interval and descriptively compared our isometric force-time output to published parameters. QuHalEx benchtop absolute error ranged from 0.02 to 0.41 (mean 0.14) N. Benchtop and human intrasession output was repeatable (ICC 0.90-1.00, p < 0.001). Hallux strength in our sample (n = 38, age 33.5 ± 9.6 years, 53% female, 55% white) ranged from 23.1 to 82.0 N peak extension force and 32.0 to 142.4 N peak flexion, and differences of ~10 N (15%) between toes of the same MRC grade (5) suggest that QuHalEx is able to detect subtle weakness and interlimb asymmetries that are missed by MMT. Our results support ongoing QuHalEx validation and device refinement with a longer-term goal of widespread clinical and research application.
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Affiliation(s)
- Elizabeth S. Hile
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center College of Allied Health, 1200 North Stonewall Ave., Oklahoma City, OK 73117, USA; (J.R.); (A.F.)
- OU Health Stephenson Cancer Center, 800 NE 10th Street, Oklahoma City, OK 73104, USA
| | - Mustafa Ghazi
- Infant Neuromotor Control Laboratory, Division of Developmental-Behavioral Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
| | - Raghuveer Chandrashekhar
- Department of Occupational Therapy, University of Florida, Gainesville, FL 32603, USA; (R.C.); (H.W.)
| | - Josiah Rippetoe
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center College of Allied Health, 1200 North Stonewall Ave., Oklahoma City, OK 73117, USA; (J.R.); (A.F.)
| | - Ashley Fox
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center College of Allied Health, 1200 North Stonewall Ave., Oklahoma City, OK 73117, USA; (J.R.); (A.F.)
| | - Hongwu Wang
- Department of Occupational Therapy, University of Florida, Gainesville, FL 32603, USA; (R.C.); (H.W.)
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Kamasaki T, Tabira T, Hachiya M, Tanaka S, Kitajima T, Ochishi K, Shimokihara S, Maruta M, Han G, Otao H. Comparison of toe pressure strength in the standing position and toe grip strength in association with the presence of assistance in standing up: a cross-sectional study in community-dwelling older adults. Eur Geriatr Med 2023:10.1007/s41999-023-00776-z. [PMID: 37024644 DOI: 10.1007/s41999-023-00776-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE We believe that toe pressure strength in the standing position, which is closer to the actual movement, is more associated with standing up in the older adults than the conventional toe grip strength. Therefore, the purpose of this study is to examine the association between toe pressure strength in the standing position and the presence of assistance in standing up in the older adults. METHODS Ninety-five community-dwelling older adults (82 ± 8 years old, 72% female) were included in this study. The patients were evaluated based on their need for assistance in standing up. Physical functions, including toe pressure strength in the standing position, toe grip strength, hand grip strength, knee extension strength, one-leg standing time with eyes open, and maximal walking speed, were measured. RESULTS When compared with and without assistance to stand up, the group requiring assistance had weaker toe pressure strength in the standing position than the group without assistance (p = 0.015, ES = 0.53). After adjusting for confounding factors, the final model revealed that toe pressure strength in the standing position was associated with the use of assistance in standing up (odds ratio 0.94 [0.88-0.99, p = 0.025]). CONCLUSION Toe pressure strength in the standing position was associated with the use of assistance in standing up in older adults. Improving toe pressure strength in the standing position may facilitate the ability of older adults to stand up.
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Affiliation(s)
- Taishiro Kamasaki
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, 4490-9, Ozaki, Kanzaki, Saga, 842-8585, Japan.
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Takayuki Tabira
- Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Mizuki Hachiya
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, 4490-9, Ozaki, Kanzaki, Saga, 842-8585, Japan
| | - Shinichi Tanaka
- Department of Physical Therapy, Faculty of Rehabilitation Science, Reiwa Health Sciences University, 2-1-12, Washirokaoka, Higashi-ku, Fukuoka, 811-0213, Japan
| | - Takahiro Kitajima
- Medical Corporation Hiramatsu Hospital, 1000-1, Ogi, Saga, 845-0001, Japan
| | - Kohei Ochishi
- Medical Corporation Ito Clinic Day Care Celery, 90-1, Maedu, Tikugo, Fukuoka, 833-0002, Japan
| | - Suguru Shimokihara
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Michio Maruta
- Department of Occupational Therapy, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8520, Japan
- Visiting Researcher, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Gwanghee Han
- Department of Occupational Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, 137-1, Enokizu, Okawa, Fukuoka, 831-8501, Japan
- Visiting Researcher, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Hiroshi Otao
- Faculty of Rehabilitation Sciences Department of Rehabilitation Sciences, Nishikyushu University, 4490-9, Ozaki, Kanzaki, Saga, 842-8585, Japan
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