Immediate Effect of the Toe Spreader on Tibialis Anterior and Peroneus Longus Muscle Activities: a Pilot Study

Immediate effect of the use of toe separators on dynamic balance and ankle range of motion: a pilot study

BACKGROUND AND OBJECTIVES

Injuries involving ankle stability and range of motion are among the most frequent in athletes and in the general population. In response, this study aimed to assess the immediate effects of toe separators on dynamic stability and ankle range of motion in healthy young individuals.

METHODS

Among the 68 eligible participants, 50 healthy and active subjects completed all trials. The impact of the intervention was evaluated using the Weight Bearing Lunge Test and Y-Test. The control condition performed the tests without toe separators, while the experimental condition performed the tests with toe separators. All participants performed both conditions with a wash-out period of at least 7 days between trials.

RESULTS

Statistical analysis revealed no significant differences in dynamic balance (p > 0.05) and range of motion (p > 0.05) between the two conditions. Additionally, no asymmetries were detected between the lower limbs in both tests (p > 0.05).

CONCLUSIONS

The results of this pilot study indicate that using toe separators does not have an immediate effect on ankle range of motion and dynamic balance in young, healthy individuals. Future research should consider evaluating intervention programs of longer duration and exploring different populations.

Dynamic biomechanical effect of lower body positive pressure treadmill training for hemiplegic gait rehabilitation after stroke: A case report

BACKGROUND

Lower body positive pressure (LBPP) treadmill has potential applications for improving the gait of patients after stroke, but the related mechanism remains unclear.

CASE SUMMARY

A 62-year-old male patient suffered from ischemic stroke with hemiplegic gait. He was referred to our hospital because of a complaint of left limb weakness for 2 years. The LBPP training was performed one session per day and six times per week for 2 wk. The dynamic plantar pressure analysis was taken every 2 d. Meanwhile, three-digital gait analysis and synchronous electromyography as well as clinical assessments were taken before and after LBPP intervention and at the 4-wk follow-up. During LBPP training, our patient not only improved his lower limb muscle strength and walking speed, but more importantly, the symmetry index of various biomechanical indicators improved. Moreover, the patient’s planter pressure transferring from the heel area to toe area among the LBPP training process and the symmetry of lower body biomechanical parameters improved.

CONCLUSION

In this study, we documented a dynamic improvement of gait performance in a stroke patient under LBPP training, which included lower limb muscle strength, walking speed, and symmetry of lower limb biomechanics. Our study provides some crucial clues about the potential dynamic mechanism for LBPP training on gait and balance improvement, which is related to rebuilding foot pressure distribution and remodeling symmetry of biomechanics of the lower limb.

Changes in Muscle Activation and Ground Reaction Force of the Lower Limbs According to Foot Placement During Sit-to-Stand Training in Stroke Patients

OBJECTIVE

The aims of the study were to investigate the kinetic effects of sit-to-stand training in various foot positions on the coronal plane in patients with strokes and to suggest appropriate exercises.

DESIGN

Thirty-six poststroke subjects participated in this study. The subjects performed three sit-to-stand trials in the following foot positions: (a) symmetric foot positioning (symmetric), (b) affected foot placed to the side (asymmetric 1), and (c) and less affected foot placed to the side (asymmetric 2). They were asked to perform sit-to-stand training at a spontaneous velocity and remain standing for 5 secs, whereas the vertical ground reaction force was measured using force platforms. The activation of lower limb muscles was evaluated using surface electromyography, and the peak and mean vertical ground reaction force and weight-bearing symmetry ratio were evaluated using force platforms.

RESULTS

Our results showed significant increases in the muscle activation, peak and mean vertical ground reaction force, and weight-bearing symmetry ratio of the lower limbs using the asymmetric 2 strategy (P < 0.05).

CONCLUSIONS

Our results suggest that sit-to-stand training with the less affected foot placed to the side by the width of the subject's foot may be the most beneficial in the rehabilitation of patients with hemiparetic stroke.

Effects of toe spreader on plantar pressure and gait in chronic stroke patients

BACKGROUND

The feet make the initial contact with the ground when walking and critically control both posture and gait. Claw toe, a structural change in the foot that may develop after stroke, triggers functional changes affecting both the lower limbs and balance.

OBJECTIVE

We analyzed the effects of a toe spreader on foot pressure and gait in chronic stroke patients.

METHODS

We enrolled 25 stroke patients. We used Gaitview AFA-50 and GAITRite instruments to measure plantar pressure distribution and gait with and without a toe spreader.

RESULTS

The average and rear foot pressures increased somewhat when a toe spreader was used. However, the differences were not significant in post hoc tests. In terms of gait, all variables significantly improved when the toe spreader was used.

CONCLUSIONS

A toe spreader may improve overall gait and spatiotemporal gait parameters in chronic stroke patients.

Metatarsophalangeal joint flexion affects dorsiflexor activity in subjects with a dominant extensor hallucis longus

BACKGROUND AND OBJECTIVES

Normal dorsiflexion (DF) required for normal gait is achieved through balance of the tibialis anterior (TA) and extensor hallucis longus (EHL). Imbalance may induce ankle and foot deformities and exacerbate pathology. EHL dominance is associated with progressive TA weakness, attributable to muscle non-use. When the EHL dominantly dorsiflexes the ankle, the big toe extends at the metatarsophalangeal joint (MTPJ) and pure ankle DF is absent. The effects of active MTPJ flexion on TA and EHL muscles, TA/EHL ratio, and the force applied during active DF in EHL-dominant (EHL-D) and EHL-non-dominant (EHL-ND) subjects were compared.

METHODS

The 38 subjects were divided into EHL-D and EHL-ND groups. All subjects performed active ankle DF with and without active MTPJ flexion. Surface electromyographic data, ankle active range of motion, and DF force were measured. Two-way mixed analysis of variance was used to evaluate differences in dependent variables.

RESULTS

Compared to the EHL-ND group, the EHL-D group exhibited less TA activity, more EHL activity, and a reduced TA/EHL activity ratio. Active application of MTPJ flexion during DF significantly reduced muscle imbalance, whereas EHL activity decreased and the TA/EHL activity ratio increased. The DF force decreased significantly with MTPJ flexion in both groups.

CONCLUSIONS

Active MTPJ flexion can reduce EHL and/or increase TA activity and increase the TA/EHL activity ratio during active ankle DF in both EHL-D and EHL-ND subjects.